Why I cannot hate the Affordable Care Act (ACA)

There was a time when I would've considered the ACA unnecessary. That I would've been annoyed by it. This was also a time where I had little to no interest in politics. It's funny how life has a way of humbling a person and teaching them something new about themselves on a regular basis. This is a story about how I ended up needing the help in order to make myself better. Nurses Announcements Archive Article

Why I cannot hate the Affordable Care Act (ACA)

"Well why didn't you just get a new inhaler?" I felt a sinking pit in my stomach. I was at a follow up visit to my doctor after ending up in the ER a few weeks before because bronchitis had made my asthma worse and I couldn't breathe. The first thing my doctor asked me was where my inhaler was when this had happened. After all, that was in my plan. I tried to explain to her that I only had one inhaler and it had been stolen the week before when I was riding the bus. Somehow, despite my explanation she didn't understand that since I was uninsured at the time, I just couldn't afford a new one. It was only after the ER trip that a friend of mine had pity on me and bought the inhaler for me.

I lost my insurance in April 2012 because I had been working at a call center that had outsourced its customer service department overseas. This was my fourth lay off in about six years. The whole time I had been trying to go back to school but in playing musical jobs I had never managed to do so. I decided to make school my focus and work secondary and deal with it.

Because I have asthma, I've never been able to get insurance without going through my work before. COBRA would've cost me over six hundred a month, and while my state had opened a high risk pool, it was still too expensive. My NP was awesome and made sure I got refills of my medication before I lost my insurance and gave me a list of community services for when I did lose it, because she knew I wouldn't be able to come back afterwards.

I did everything I could to make sure I would be taken care of. I signed up for a prescription plan at a local pharmacy, I found local clinic that was free, run on community donations. Still there are things that free clinics couldn't handle. Waiting all week to see a doctor because you got sick on Sunday and the free clinic is only open on Saturday isn't helpful when you're so sick you can't breathe. The doctors are volunteers so there's no guarantee of continuous care. In fact, the push is to get you into a local public health or community clinic, but they often were not taking new adult patients or were an hour drive away.

It was about a month after I lost my insurance when I found a lump on my right side, along the edge of the breast tissue. The free clinic provided me a referral but when I called the places they suggested I was turned away. I was told I was too young, that the office no longer provided services, or that they were out of funds for the year. I continued to fight to find a way to access services, but without a referral from a PCP I was getting nowhere. I finally took the time to bus out to one of the few clinics taking patients. They contacted a local imaging center attached to a public hospital to get me in. This started in June, I was finally in for imaging in October. In November I would get a biopsy and find out it was benign. It took me six months from start to finish to find out what was there.

It would be another year before I would get insurance again. In that time I ended up in the ER enough times the doctors started to recognize me. There really wasn't anything either of us could do. I couldn't manage my health without being able to afford regular doctor's visits and medication and they couldn't make a solution appear out of thin air. My wisdom teeth got infected and had to be removed but had to wait two months for a dentist who would help. I was on antibiotics so long I ended up with a GI infection. Bronchitis, allergic reaction, a set of second degree burns from how bad at cooking I can be. They got to deal with it all, despite the fact that most of these things were preventable.

All if this changed in January of last year. I live in one of the states that approved the Medicaid expansion and set up their own healthcare exchange. I was there on day one to shake hands with the Governor, tell him my story, and sign up. I stood up with him to others to encourage them to use the exchange as well. It is the only day of class I've missed since I started back.

Because of the Affordable Care Act I was able to get needed blood work that I had not been able to afford. Reliable access to medication. The first thing my PCP did, remembering how just a few months earlier I had ended up in the ER because I didn't have an inhaler was make sure to get me a prescription for one so I had a backup. One thing I know is I appreciate the opportunity more than I could ever express.

I know there are naysayers out there who will tell me that those things are not really free and that someone has to pay for them. One day I'll graduate and that person will be me. I seriously hope that I am paying to make sure someone gets the care they need with the money I pay into the system. It's saner than paying for what happens when they can't. The system we have isn't perfect, but it can only get better if we put effort into it.

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jaycam

About jaycam, RN

RN, Psychiatric Nurse. I learn best through stories and examples. I also may have a love affair with data.

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I'm glad for my taxes to go to healthcare, and I'm ashamed that our country has been so backwards.

I've always had health insurance and honestly I was one of those that thought if you worked hard you would be able to obtain healthcare. Boy did I have some real situations put in my way to realize otherwise. It's not about work ethics, it's about healthcare as a right, in the same way as education, in a developed country.

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Amen. I am deeply in debt from the two years that my kids didn't have health insurance. Until you are in a position where you have to choose between buying food and filling the prescription for your kid who was just diagnosed with strep throat, it's hard to understand the concept of unaffordable care. Thanks to the ACA, my kids qualify for assistance and I have been able to get them the medical care they need without going even further into debt. Eventually I will have access to affordable insurance through my employer, but until then I am truly thankful that this assistance is available while I need it.

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Specializes in Labor and Delivery.

Wow. Just wow. Thank you for sharing your story. Affordable healthcare should be available to EVERYONE. I have always felt like this.

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Wal-Mart has had a 9 dollar environmentally friendly inhaler since 2008.

Also Medicaid reimbursement to primary care is getting slashed as Obamacare only increased the rate for 2 years.

" Just as millions of

people are gaining insurance through

Medicaid , the program is poised to

make deep cuts in payments to many

doctors, prompting some physicians and

consumer advocates to warn that the

reductions could make it more difficult

for Medicaid patients to obtain care.

The Affordable Care Act provided a big

increase in Medicaid payments for

primary care in 2013 and 2014. But the

increase expires on Thursday — just

weeks after the Obama administration

told the Supreme Court that doctors and

other providers had no legal right to

challenge the adequacy of payments

they received from Medicaid."

mobile.nytimes.com/2014/12/28/us/obamacare-medicaid-fee-increases-expiring.html?referrer=&_r=0

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Specializes in NICU.
Wal-Mart has had a 9 dollar environmentally friendly inhaler since 2008.

I'm not sure Wal-Mart carries $9 scalpels to cut out breast tissue (along with a microscope to diagnose yourself) or teeth extractors though.

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I'm glad things are working out better for you eggyweggy. I feel very much the same way, thankful to have it while I need it.

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Wal-Mart has had a 9 dollar environmentally friendly inhaler since 2008.

While it's wonderful that they offer that, it's a 30 dose inhaler. Great for an emergency inhaler for someone with mild asthma or for a week for someone with bronchitis. Not always the best solution for anything else. I also live in an area that is traditionally anti WalMart. At the time this happened, the closest one to where I lived was about a 45 minute drive, one way. Add in the fact that I live on a shoestring budget most months, I just didn't have the money, not even nine dollars, never mind the expense of getting to it.

As for making it harder to get care, at least in my state, it's not been an issue. My state has 5 medicaid plans to choose from, I choose one of the ones that my doctor accepts, and I've been with her since they opened this clinic. It's the same clinic from my story, but they opened a new site closer to me, and I transferred there. Personally I think it's the fact we actually have options for Medicaid here, it forces the companies that provide it to think about what they can offer to their patients to keep them happy and not switching to their competitors.

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Specializes in Postpartum, Mother/Baby, Comm. Health, Geriatric.

Our country still has alot of work to do with our healthcare insurance industry. I have worked in a hospital pharmacy for the past 7 years and its sad that people that have health insurance still can NOT afford their medications. 100 co-pays, 300 co-pays for 1 medication is absurb. The affordable healthcare act still has horrible clauses and add-ins that we are still finding out about. So while it has helped alot of people, it has hindered alot of working class people as well (mainly those that had to move from full-time to part-time from their place of employment just so their employer didn't have to offer them healthcare insurance, and paying privately they are right where they started.)

I just hope and pray our nation looks at other options, because our healthcare system still has a very long way to go.

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Specializes in Dialysis.

You're a 34 year old nurse who works in a call center as a customer service rep? Laid off 4 times in 6 years? I think I'm missing some part of this story. Why are you so unemployable?

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Qualifying for Medicaid under the ACA is a completely different world than being in the working class and trying to afford the doubled premiums and insanely high deductibles the ACA brought to most working adults.

My deductible is so high that I end up paying cash for all of our prescriptions and in most years will never satisfy a $12,600 deductible that I pay over $500 a month for. That was the cheapest policy I would find, even through the glorious "exchanges". That's over $18,000 a year I would be responsible for before my insurance kicks in!

Prior to the ACA, I had a perfectly good policy that cost $223 a month with a 10K deductible that worked well for my needs. I saved enough money each month that spending 200-300 on medications or doctor's visits was no big deal. Funny how Obama touted if you like your policy, you can keep it! Thanks to the ACA, health insurance companies were required to add-on additional coverage to their policies, passing on the higher deductibles to the policy holders.

I wouldn't get all warm and fuzzy about the ACA until you are out of school and working and see exactly how expensive your healthcare will be due to the ACA.

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Specializes in NICU.
Qualifying for Medicaid under the ACA is a completely different world than being in the working class and trying to afford the doubled premiums and insanely high deductibles the ACA brought to most working adults.

My deductible is so high that I end up paying cash for all of our prescriptions and in most years will never satisfy a $12,600 deductible that I pay over $500 a month for. That was the cheapest policy I would find, even through the glorious "exchanges". That's over $18,000 a year I would be responsible for before my insurance kicks in!

Prior to the ACA, I had a perfectly good policy that cost $223 a month with a 10K deductible that worked well for my needs. I saved enough money each month that spending 200-300 on medications or doctor's visits was no big deal. Funny how Obama touted if you like your policy, you can keep it! Thanks to the ACA, health insurance companies were required to add-on additional coverage to their policies, passing on the higher deductibles to the policy holders.

I wouldn't get all warm and fuzzy about the ACA until you are out of school and working and see exactly how expensive your healthcare will be due to the ACA.

The difference is that your health care plan that was a lot cheaper was allowable because of so many Americans that did not have health insurance that now do. I pay more for my health care plan than I did 5 years ago, it's true. But a healthier society is a better one and the whole, "all for me, me, me" at the expense of other people is unconscionable, imo.

eta: If we don't agree that health care is a right and not a privilege, I don't think we'll get anywhere in the discussion (and I believe that is at the stem of most disagreements regarding the ACA). If I believed health care was privilege, I'd be pissed off too. But I believe it's a fundamental human right.

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