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

"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.

Specializes in E/R, Med/Surg, PCU, Mom-Baby, ICU, more.
So we swapping from a country where the people die poor, to the country whose people die from not being able to pay their deductibles, hence, don't go to the doctor and die anyway, while still having to pay high premiums? Good trade off.

The people who get freebies get medical care while the working stiffs don't because they can't pay the outrageous deductibles, co-pays, and out-of-pocket costs.

True, RNHopeful. I was hoping at worse to have people telling their own personal stories that didn't agree with my point of view, not an explosion of antagonism, which I didn't help. I understand that this is a topic that hits on three hot buttons with politics, money, and health, all of which are very closely held personal values for people. Personally, despite my good fortune with my state for the ACA, I do understand how bad some insurance can be, especially when effective treatments are not covered. I hope you get access to the ABA soon. To banterings, the question here is about bad versus no healthcare, it's about providing access at all before it's an emergency. Everyone should have good healthcare. Idealistic yes and yet still more likely than world peace. I like the previous example used describing diabetes care. Which is cheaper to do, provide a yearly screening and maintenance medications and education, or emergency surgeries related to uncontrolled diabetes. I mean if we, as tax papers are going to be on the hook for one of these, I'll go for the one that is cheaper and provides the best patient outcome.

Mama June, I happen to agree with you. Nothing about this has been easy. Our exchange was down for day one because it was overloaded. We had numerous technical issues. It's finally starting to calm down. We still have issues with best treatments being turned down because the state doesn't want to pay for it just like you would with any other insurance. I end up constantly jumping through hoops to maintain my status which takes time from my studies and work. I would hate to see how bad that is for a single parent who works or goes to school as well. One thing that bugs me personally was that veterans actually don't get as much covered as the poor, I'd like them have something at least equal to medicaid. After what many of gone through, it seems like the least we could do.

Specializes in E/R, Med/Surg, PCU, Mom-Baby, ICU, more.
...Come to find out this means they will also be terminating my insurance plan (why? No one has been able to answer me) and the deductible for the same plan has now quintupled from $700 to $3500 on the marketplace. Thats great that i got a super special enrollment period (eyeroll please) but its even MORE unaffordable now than it was before. I'm at a loss. I could care less about the tax credit; that will even itself out eventually. It would be cheaper to negotiate directly with my doctor and pay out of pocket than keep that plan or sign up for any of the others. That is what frustrates me about Obamacare, and that I would be penalized financially for finding a more affordable option than those plans by paying out of pocket.

Yet Jaycam happened to "like" your statement. Guessing she stopped reading after the first line...

Specializes in E/R, Med/Surg, PCU, Mom-Baby, ICU, more.
Andy and Turtles ....I stand with you :). I admire your tenacity to educate these libs, but like Michael Savage said : "Liberalism is a mental disorder".

Low info voters never check out the stats for themselves as they rather believe propaganda from an administration that makes Richard Nixon look honest. Yes Liberalism is indeed a mental disorder.

Yet Jaycam happened to "like" your statement. Guessing she stopped reading after the first line...

My like is because I happen to agree that it's not perfect, and believe in encouraging people to tell their stories. I agree that the hoops and bells and seal tricks involved can be confusing and complicated and make it worse. I want to see it get better, and in order for that to happen, we have to listen to people who haven't had the same experiences. You may think that I'm just a silly liberal who didn't read past the first line, but I actually don't stick to party lines, and like to learn. I can't learn if I don't listen to other people's perspectives.

Low info voters never check out the stats for themselves as they rather believe propaganda from an administration that makes Richard Nixon look honest. Yes Liberalism is indeed a mental disorder.

Extremism in any form is a mental disorder. Voting along party lines for the sake of voting along party lines is part of many problems.

Specializes in E/R, Med/Surg, PCU, Mom-Baby, ICU, more.
... Our exchange was down for day one because it was overloaded. We had numerous technical issues. It's finally starting to calm down... One thing that bugs me personally was that veterans actually don't get as much covered as the poor, I'd like them have something at least equal to medicaid. After what many of gone through, it seems like the least we could do.

By February 21, Washington Healthplanfinder had enrolled 160,732 people in private plans through the exchange. Amazon customers ordered more than 36.8 million items on Cyber Monday alone.

As for veteran care: The VA is filled with incompetent workers and you get about the equivalent type of care you receive from a county hospital.

Specializes in E/R, Med/Surg, PCU, Mom-Baby, ICU, more.
My like is because I happen to agree that it's not perfect, and believe in encouraging people to tell their stories. I agree that the hoops and bells and seal tricks involved can be confusing and complicated and make it worse. I want to see it get better, and in order for that to happen, we have to listen to people who haven't had the same experiences. You may think that I'm just a silly liberal who didn't read past the first line, but I actually don't stick to party lines, and like to learn. I can't learn if I don't listen to other people's perspectives.

Ok maybe you are starting to get enlightened. Obamacare is fine for people not working or working very little but it is hosing the people who work by flooding them with outrageous deductibles, premiums, max-out-of-packet charges, and co-pays. Income redistribution is not the way to go.

Take a gander and see what the insurance rates are for people in different states at the 30k-50k income range and you will be appalled. The site below allows you to do that.

Affordable Care Act (Obamacare) Health Insurance Exchanges

Specializes in Pediatrics, Emergency, Trauma.
We have to stop being a country where people die from being poor.

I just had to quote this...Too bad I can't like this MORE.

Specializes in E/R, Med/Surg, PCU, Mom-Baby, ICU, more.

Right from the CBO. Obamacare will cause a loss of 2 million jobs by 2017: http://www.cbo.gov/sites/default/files/cbofiles/attachments/45010-breakout-AppendixC.pdf

Specializes in Critical Care.
Right from the CBO. Obamacare will cause a loss of 2 million jobs by 2017: http://www.cbo.gov/sites/default/files/cbofiles/attachments/45010-breakout-AppendixC.pdf

The CBO never forecast "a loss of 2 million jobs". From the CBO itself:

Q: Will 2.5 Million People Lose Their Jobs in 2024 Because of the ACA?A: No, we would not describe our estimates in that way...Because the longer-term reduction in work is expected to come almost entirely from a decline in the amount of labor that workers choose to supply in response to the changes in their incentives, we do not think it is accurate to say that the reduction stems from people losing” their jobs...

Thus, there is a critical difference between, on the one hand, people who leave a job for reasons beyond their control and, on the other hand, people who choose not to work or to work less. The wording that people use to describe those differing circumstances reflects the different reactions of the people involved. In our report, we indicated that the estimated reduction [in employment] stems almost entirely from a net decline in the amount of labor that workers choose to supply,” so we think the language of losing a job” does not fit.

What the CBO said is that based on what we already knew; there are many people who have either worked or worked more hours not because they need the money but because they want the access to the much higher quality and better value employer-provided-group insurance.

Trader Joes gave the example of a cashier who's spouse was self-employed and made over 200k a year, but the cashier needed her job in order to have access to good insurance. Now that the equivalent of employer sponsored insurance is available through the exchanges, that cashier doesn't have to continue to take up labor hours she doesn't need, making them available to someone who does need the hours, not just the health plan.

So the CBO is predicted that the number of hours workers will chose to reduce is the equivalent of about 2 million FTE's, which would be a problem if we didn't have enough people looking to fill those hours, but that's not the case.

Specializes in E/R, Med/Surg, PCU, Mom-Baby, ICU, more.
The CBO never forecast "a loss of 2 million jobs". .

Explain to us why the link I gave to THE CBO WEBSITE has a CBO ISSUED statement that states (quote):

"The reduction in CBO's projections of hours worked represents a decline in the number of full-time-equivalent workers of about 2.0 million in 2017, rising to about 2.5 million in 2024."

http://www.cbo.gov/sites/default/files/cbofiles/attachments/45010-breakout-AppendixC.pdf