Mary Lou Retton still raises questions with lack of insurance claims

When Mary Lou Retton finally spoke out on the “Today” show last week about being hospitalized for a month with a rare and potentially deadly form of pneumonia, she wasn’t really pressed to answer certain pertinent questions, reports show.

Notably, co-host Hoda Kotb didn’t push Retton to adequately explain why she, a decorated Olympic gymnast who must have earned millions in endorsement deals over the years, didn’t have health insurance when she was hospitalized. Meanwhile, reports also say that Retton and her daughters have not responded to reporters’ questions about her income, which Texas hospital treated her and what happened to the $459,000 in online donations that she and her family received in donations, ostensibly to cover her potentially massive medical bills.

During Retton’s appearance Monday on the “Today” show, Kotb seemed eager to tell a dramatic but uplifting narrative about the Olympic star surviving a terrifying medical crisis. So, Kotb lent a sympathetic ear as the woman once dubbed “America’s sweetheart” described her hospital ordeal. Wearing an oxygen tube, Retton detailed the moment in the intensive care unit when “they were about to put me on life support.”

Following Retton’s “Today” interview, USA Today columnist Christine Brennan wrote that the 1984 Olympic gold medalist and her daughters still have not answered “basic” questions, which means that many answers “remain unaddressed.”

“Retton’s unwillingness to answer the most basic questions about her health care is receiving increased scrutiny for one simple reason: the decision by Kelley and her three sisters to seek public donations for their mother on the crowdsourcing site spotfund.com,” wrote Brennan. “Had they not done that, Retton’s illness likely would have remained a private matter, never bursting into public view and enticing so many strangers to send money.

Kelley also told USA Today that she and her sisters never expected that people would be so generous and that their spotfund.com campaign would raise so much money. More than 8,300 donors pledged various amounts, from $10 to $50,000, bringing the total to close to half a million dollars.

In the spotfund.com plea, Kelley revealed her mother was in the hospital with a “very rare form of pneumonia” and “fighting for her life.” Kelley also revealed her mother didn’t have insurance but wouldn’t say anything more, “out of respect for her and her privacy.”

“I don’t know if that’s ignorant of us or if that was just sweet,” Kelley told USA Today. ““This was not supposed to be a big media thing. … We didn’t even think about what this would turn into. It was simply four daughters who felt helpless who wanted to help their mom who knew that this would help take a burden off.”

During the “Today” interview, Kotb did ask Retton about her lack of health insurance. Retton said that insurance was simply too expensive for her, as a recently divorced woman with pre-existing health conditions.

“When COVID hit and after my divorce and all my pre-existing (conditions) — I mean, I’ve had over 30 operations of orthopedic stuff — I couldn’t afford it… That’s the bottom line: I couldn’t afford it,” Retton told Kotb.

“But who would even know that this was going to happen to me?” Retton exclaimed before confirming that she now has health insurance: “I’m all set now.”

In her USA Today interview, Kelley repeated her mother’s contention that she couldn’t afford insurance before her health care crisis, because of her surgeries, which Kelley said included four hip replacements that have left her mother in chronic pain, Brennan reported.

“Due to her medical history and the amount of surgeries she has endured from gymnastics and just life, it’s unaffordable for her,” Kelley said.

But Retton’s explanation about pre-existing conditions and insurance costs “sparks some mental gymnastics,” according to a report by KFF Health News, which was published by National Public Radio.

KFF Health News senior correspondent Julie Appleby agreed that Retton’s lack of health insurance was “shocking,” but she questioned Retton’s two main reasons for not buying coverage: preexisting conditions and cost.

Those are among the things that the Affordable Care Act directly addresses, Appleby said. In fact, under the ACA , which has offered coverage through state and federal marketplaces since 2014, insurers are barred from rejecting people with pre-existing conditions and cannot charge higher premiums for them, either, Appleby said. “This is one of the law’s most popular provisions, according to opinion surveys,” Appleby said.

The ACA also includes subsidies that offset all or part of the premium costs for the majority of low- to moderate-income people who seek to buy their own insurance, Appleby reported. Subsidies are set on a sliding scale based on household income. For consumers who make four times the federal poverty level or higher — which in 2023 was $14,580 for an individual — premium costs also are capped at 8.5% of household income, KFF News also reported.

People with higher incomes, who therefore are higher on the sliding subsidy scale, might still find the premium costs “a stretch,” especially if they must also pay deductibles, copayments and out-of-network fees, Appleby said. According to a KFF subsidy calculator, a 60-year-old with a $100,000 income could get a $300 monthly subsidy but still have to pay around $708 a month toward their premium, Appleby said.

Meanwhile, Brennan reported that USA TODAY Sports contacted an insurance agent who found two plans that the Texas-based Retton could qualify for, given her health history. One charged $545 per month and another charged $680 per month.

When Brennan said Kelley was informed of these policies, she explained that her mother had been covered by health insurance but “gave up her insurance” because she was not able to work and give speeches for two years due to the pandemic.

Appleby said another complication for Retton could have been timing. People typically need to sign up for ACA benefits during the annual open enrollment period, which typically runs from November through January in most states.

However, there are types of plans that fall outside the rules for open enrollment, Appleby reported. Retton also may have been able to qualify for an ACA plan if she met the requirements for “special enrollment,” with qualifying reasons including a marriage, divorce, a residential move or loss of other coverage.

Kelley insisted to USA Today that her mother was “about to get (health insurance) again but didn’t, and then she got sick.” Appleby said it’s hard to know how Retton fell between the cracks of health insurance coverage, given that neither she nor her daughters have offered any details about if or how she shopped for coverage. Appleby said that neither Retton nor her daughters could be reached for comment.

In USA Today’s communications with Retton and Kelley via phone calls and text messages, Brennan said the gymnast didn’t respond to questions about whether the spotfund.com donations had helped pay for her health insurance.

Brennan also said Kelly would not comment on how much of the nearly half-million dollars in donations had been spent on medical costs. Kelley only said that “all remaining funds” would go to a charity of her mother’s choice, but she offered no timetable or further information, Brennan said.

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