THIS TIME ON CODE WACK!
We’re digging into big questions: Are reduced health insurance subsidies leaving Americans with a bad case of sticker shock? If you’re shopping on the ACA marketplace, what should you watch out for before picking a plan? And what happens if you’re pre-authorized for treatment in 2025, but can’t afford to renew with the same plan in 2026? (It’s not pretty).
For these answers and more, we talked to Sherry Davis Johnson — a former nurse turned long–time insurance agent in Southern California. Sherry has seen our challenging healthcare system from every angle, as a nurse and home health provider, insurance agent and patient, having personally gone through five major surgeries in just two years. Today, she’s licensed in health, property, casualty, accident, and life insurance — and she’s here to help us make sense of it all.
Check out the Transcript and Show Notes for more!
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SHOW NOTES
WE DISCUSS
How did you first get into the healthcare field?
Johnson: “I was a home health nurse at 19 years old. And of course most of my life I didn’t have health insurance. My mother had it at her most recent job right before I was out of her household. And that was about the only time that I think in my lifetime I had insurance. When I started working in home health, I was what they call the ‘stick’ nurse. I went around and did blood draws for patients and collected lab specimens and gave shots, that kind of thing.
“[Later] it was my job to get our company paid for the nurses and therapists to go out to see people. … And I learned insurance from the provider’s perspective, how we had to document what kind of things we could ask them for. And even if we did all the things right, sometimes they just say no.
“I understood what power there was in that position for me to be an advocate for my patients. I did the job for a few years and when I left, it was because my husband said to me, because he went on to sell insurance, you would kill it at this job because you understand what’s going on, you’d be able to explain it to people.
“So I set out my [insurance] business with my mission … to make sure that people understood what they were doing when they made those decisions because there’s a right way and a wrong way to use your health insurance. And I’m here to give my clients personal guidance into how to access their healthcare. That’s what I care about.”
In recent years, enhanced federal subsidies kept health insurance premiums lower. Now the subsidies are shrinking. How is this impacting people?
Johnson: “… some people are concerned if they’re even going to be able to keep coverage. I probably have about 3,000 people that I’ve enrolled at Covered California directly and a great percentage of them are self-employed. I’d say more than 25%, 30% are self-employed. They are barely scraping by with inflation. The cost of food, housing and those things going up and insurance going up, they’re hurting. They’re very uncomfortable.
“And some of them are trying to strategize how they’re going to finish some treatments that they’re in for next year and keep their health plans if they can. Do they have to change their health plan and pick a new [medical] group …? I’ve heard a myriad of reasons why people are panicking and for good reason.
“Especially if you have an HMO, it’s difficult to get the authorizations. You gotta go to your primary care doctor, they have to refer you, you have to get an authorization, you can’t get into the doctor very quickly. And so the time is running out in the year. … it’s causing widespread panic on many levels for many reasons.”
So what would you tell someone who is thinking about forgoing health insurance next year?
Johnson: “You should have health insurance at all points in time. But if you can’t afford the health insurance, if you’re gonna pay for January and February and you know you can’t pay for March, you are putting yourself in just greater financial risk …
“So some people have opted not to have the coverage. If they can’t afford it, they’re not gonna make the initial premium by December 31st, which is what they have to do to effectuate their plan.
“And if they don’t make that premium payment, then they won’t be covered for January at least. And January 31st is their last opportunity to get enrolled for February 1st.
“After that, the open enrollment is closed unless you have reason for a special enrollment period, which is marriage, birth, death, divorce, or adoption, or if you move. Other than that, you can’t get enrolled in a plan in the middle of the year.”
Helpful Links
Profiting at the Expense of Seniors: The Financialization of Home Health Care, Center for Economic and Policy Research
How churn threatens Americans’ health, STAT
Your Health Insurance Bill May Surge Again in 2026. Here’s Why Costs Keep Rising, Investopedia
How Covered California Subsidies Work in 2026, Cover Health California
Reference Chart: Yearly Guidelines & Thresholds, Coverage Year 2026
How Much and Why Premiums are Going up for Small Businesses in 2026, KFF
Episode Transcript
Read the full episode transcript.
Guest Biographies: Sherry Davis Johnson
Sherry became a nurse in 1985. She has worked in hospitals, clinics, doctors’ offices, long-term care, and as a travel nurse. Home health was her favorite.
Modern Health provided careful infusions, critical observation, and accurate documentation for special studies programs at UCLA during the early days of the AIDS crisis for Michael Gottlieb, MD, and Ardis Moe, MD. Sherry held many clinical positions within that uniquely talented company of nurses, from a visit nurse, intake and staffing coordinator, insurance case coordinator, sales, and assistant director of nurses. Sherry learned to navigate through the care, treatment and authorization process. She learned insurance from the provider’s perspective.
In 2003, Sherry began her career as an insurance broker, providing exceptionally well-orchestrated employee benefits packages for companies ranging from 2 to 1,700 employees. She learned insurance from the employer and employee perspectives.
Between April of 2009 and June of 2010, Sherry had five major surgeries, including a 13-hour pancreatic surgery and neurosurgery to remove a golf ball-sized pituitary tumor. She learned insurance from the patient’s perspective.
Sherry Davis Johnson is a property, casualty, accident, health, and life insurance agent, Medicare-certified in the states of California, Colorado, Florida, Georgia, Michigan, Montana, Nevada, Texas, and Washington. Certified through healthcare.gov and state exchanges.
Each of these experiences on her journey has culminated in her ability to give expert advice from the employer, provider, patient, and insurance agent’s perspectives to anyone in need of guidance. Sherry is a nurse masquerading as an insurance agent, and that makes Sherry feel like a superhero.
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