During the 2008 presidential campaign, Barack Obama often discussed his mother's struggle with cancer. Ann Dunham spent the months before her death in 1995, Obama said, fighting with insurance companies that sought to deny her the coverage she needed to pay for treatment.
"I remember in the last month of her life, she wasn't thinking about how to get well, she wasn't thinking about coming to terms with her own mortality. She was thinking about whether or not insurance was going to cover the medical bills and whether our family would be bankrupt as a consequence," Obama said in September 2007.
"She was in her hospital room looking at insurance forms because the insurance company said that maybe she had a pre-existing condition and maybe they wouldn't have to reimburse her for her medical bills," Obama added in January 2008.
"The insurance companies were saying, 'Maybe there's a pre-existing condition and we don't have to pay your medical bills,'" Obama said in a debate with Republican opponent Sen. John McCain in October 2008.
It was a simple and powerful story, one Obama would tell many more times as president during the national healthcare debate. But now we're learning the real story of Ann Dunham's health coverage is not quite what her son made it out to be.
The news is in "A Singular Woman: The Untold Story of Barack Obama's Mother," a generally admiring new biography written by former New York Times reporter Janny Scott. According to the book, Dunham, an anthropologist who spent most of her working life in Indonesia, moved from Jakarta to New York in 1992 to work for a nonprofit called Women's World Banking, which encouraged micro-lending in Third World countries. Unhappy in New York, in 1994 Dunham took a job with an American company called Development Alternatives, which had a contract with the Indonesian State Ministry for the role of women. Dunham returned to Jakarta to work, and Scott reports the job provided Dunham with health insurance, a housing allowance and a car.
At the time she took the job, Dunham was increasingly worried about her health; she was suffering from intense abdominal pains. In November 1994, Dunham went to an Indonesian doctor, who diagnosed appendicitis. As Dunham debated whether to leave the country for surgery, she called her boss at Development Alternatives. "You've got health insurance; that's taken care of," the boss told her. "We can cover the airfare."
Dunham decided to stay in Jakarta, where she underwent an appendectomy. But the pain did not go away, and Dunham feared, correctly, that she was terribly ill. In January 1995, she left Indonesia to go home to Honolulu, where she was diagnosed with advanced uterine and ovarian cancer. She began a regime of surgery and chemotherapy.
That is the time during which Obama says his mother battled insurance companies to cover her illness. But Scott, who had access to Dunham's correspondence from the time, reveals that Dunham unquestionably had health coverage. "Ann's compensation for her job in Jakarta had included health insurance, which covered most of the costs of her medical treatment," Scott writes. "Once she was back in Hawaii, the hospital billed her insurance company directly, leaving Ann to pay only the deductible and any uncovered expenses, which, she said, came to several hundred dollars a month."
Scott writes that Dunham, who wanted to be compensated for those costs as well as for her living expenses, "filed a separate claim under her employer's disability insurance policy." It was that claim, with the insurance company CIGNA, that was denied in August 1995 because, CIGNA investigators said, Dunham's condition was known before she was covered by the policy.
Dunham protested the decision and, Scott writes, "informed CIGNA that she was turning over the case to 'my son and attorney, Barack Obama.'" CIGNA did not budge.
In September 1995, Dunham traveled to New York for an evaluation at the renowned Memorial Sloan-Kettering Cancer Center. Returning to Hawaii, she began a new course of treatment. She died in November.
A dozen years later, her son turned her ordeal into a campaign pitch for national health care. But the story Obama told, Scott writes, was "abbreviated" -- the abbreviation was to leave out the fact that Ann Dunham had health insurance that paid for her treatment. "Though he often suggested that she was denied health coverage because of a pre-existing condition," Scott writes, "it appears from her correspondence that she was only denied disability coverage."
That's a different story altogether. One the president never told.