Talk about adding insult to injury.
A Virginia woman experiencing a life-threatening allergic reaction was told to pay hundreds of dollars before a nurse would administer her an EpiPen.
“I asked, ‘If I didn’t have that money, would you have let me die?’ ” recalled Stephanie Rowell in an interview with KFF Health News. “And they said, sorry, that’s their policy.”
Like millions of Americans, Rowell, director of an agritourism company, does not have health insurance.
The 53-year-old has been without coverage since 2025, when she said she could no longer afford to take out an insurance policy on her own.
The harsh reality of being left without protection hit him in July, when a wasp sting at his parents’ house triggered a terrifying cascade of symptoms.
Suddenly, Rowell’s arm felt like it was “on fire.” His body began to itch profusely while his face swelled and turned red.
She took a Benadryl and jumped in the car with her father, heading to the nearest emergency room, about 25 minutes away.
But just 10 minutes into the ride, his throat began to tighten. Realizing she couldn’t wait, the couple went to a nearby TruHealthNow urgent care center in hopes of getting her treated faster.
Once inside, she told staff she didn’t have health insurance. A nurse practitioner examined her and diagnosed her with anaphylaxis.
The serious, life-threatening reaction can occur within seconds or minutes after exposure to an allergen, according to the Mayo Clinic.
When this happens, the immune system releases a flood of chemicals that can cause blood pressure to drop and the airways to swell, making breathing difficult or impossible.
This condition is considered a medical emergency requiring an immediate injection of epinephrine, the medication used in EpiPens, to counteract the reaction and help restore normal breathing.
An estimated 1 to 5 in 100 Americans have suffered from anaphylaxis, costing approximately 225 lives each year, according to the Allergy & Asthma Network.
But even after Rowell’s diagnosis, she said a medical assistant asked her to pay $400 before the clinic would give her the injection that could save her life.
Stunned, she went to the waiting room to retrieve her debit card. After receiving the vaccine, she said, her throat began to loosen and her symptoms quickly eased.
“I thought I was going to die,” Rowell said.
Officials with TruHealthNow, which owns and operates eight urgent care centers in Northern Virginia and Maryland, confirmed to KFF Health News that Rowell was asked to pay before staff administered the EpiPen.
But the company’s CEO, Preet Takhar, told the outlet that its policy is to “give it a go and worry about the money later.”
The company argued that staff initially determined that Rowell’s condition was stable and that the request for payment came during preparation for the injection.
“The patient was stable, and that’s why we accepted the payment then,” Manbir Takhar, married to Preet Takhar, told KFF Health News, denying that the payment request delayed Rowell’s treatment.
Federal law generally requires hospital emergency departments to stabilize patients regardless of their ability to pay, but this protection does not necessarily extend to urgent care clinics.
Most are not covered by the law unless they are owned by a hospital, according to Barry Furrow, director of the health law program at Drexel University in Philadelphia.
And while urgent care centers offer a range of medical services, they are not designed to handle life-threatening emergencies, although patients sometimes turn to them in crises.
After receiving the injection, Rowell was monitored by a medical assistant for about 30 minutes before being sent home. Her brother stayed with her to monitor for possible complications.
“I felt devastated,” she said, noting that it took several days before she felt completely better.
The frightening ordeal ultimately cost Rowell $605: $400 for the medication, $40 in administration fees and $165 for the urgent care visit.
She said she wasn’t upset about the price itself, but thought she should never have been asked to pay before receiving the epinephrine. She now carries her own EpiPen.
The news about Rowell’s experience comes as millions of Americans face growing uncertainty about their ability to afford health care.
The number of uninsured working-age adults in the United States has climbed to 11.2% this year, up from 8.9% in 2024, according to an October analysis from the Commonwealth Fund, a nonprofit health policy and philanthropy organization.
The increase comes after Congress allowed enhanced federal subsidies that made Obamacare plans more affordable during the pandemic to expire at the end of 2025.
The group’s biennial survey of 7,362 working-age adults found that 46% were uninsured, underinsured or experienced a gap in their coverage in 2026.
Half reported delaying or ignoring medical care due to cost, up from 46% in 2022.
And the problem will only get worse.
The Commonwealth Fund estimates that 37 million Americans will be uninsured by 2036, about the same number as in 2014, when the Affordable Care Act changes took effect.
Gn Health
