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.
Also from your CBO link:

"people who are currently working only in order to maintain insurance coverage will choose to work part-time or not at all (in their current jobs, at least).

If you are only working to supply yourself with medical insurance than how are you other financial needs being met? Pretty naive to think that people only have to work for insurance isn't it unless one is in their 30's and lives with their parents. Of course one can always go to a state with expanded medicaid and not work if they were only working for insurance in the first place...
Specializes in E/R, Med/Surg, PCU, Mom-Baby, ICU, more.
And how many employers actually did that? There was so much backlash against employers that even stated they might do it rather than look at other options. The more common response was to raise prices or stop providing insurance.

Google is your friend. You could cut hours to avoid the insurance mandate or you could be one of the many unions or business who donated to Obama's campaign that Obama gave a waiver.

ObamaCare Employer Mandate: A List Of Cuts To Work Hours, Jobs - Investors.com

Specializes in E/R, Med/Surg, PCU, Mom-Baby, ICU, more.
Obamacare is not universal healthcare.
Never said it was. In fact I was doing something else and wrote universal healthcare in error when I meant single payer. Changed that on the post you were referring to.
Specializes in NICU, PICU, Transport, L&D, Hospice.
If you are only working to supply yourself with medical insurance than how are you other financial needs being met? Pretty naive to think that people only have to work for insurance isn't it unless one is in their 30's and lives with their parents. Of course one can always go to a state with expanded medicaid and not work if they were only working for insurance in the first place...

Can you seriously not think of an example of someone who might be working for the employer health insurance?

Are you suggesting that the person who opts to quit the employer based job to start their own business ought to try to get medicaid rather than pay for insurance on the exchanges? Do you believe that only "irresponsible" people are helped by ACA subsidies?

Is there some sense that part time employment data is directly related to the passage of the ACA?

Google is your friend. You could cut hours to avoid the insurance mandate or you could be one of the many unions or business who donated to Obama's campaign that Obama gave a waiver.

ObamaCare Employer Mandate: A List Of Cuts To Work Hours, Jobs - Investors.com

I would really like to see the evidence that all those hours were cut due to the ACA and not for example school budget cuts. I know, for example, here, student employees are limited on how many hours we get, but it's not because of the ACA.

It's also worth noting, whenever anyone invokes the poll numbers of people opposed to the ACA, that a significant proportion of those telling pollsters that they don't like the ACA are people like myself (and others here) who dislike the ACA because it doesn't go far enough. I am a proud, open :) single-payer system supporter. I am disgusted that the ACA ended up, after all the sturm und drang getting it written and passed, being just minor tweaking around the edges of our current system, and leaving the for-profit insurance companies as the core of the system.

There has also been plenty of reporting on the fact that, thanks to the successful disinformation campaign by the anti-reform crowd, when people are asked about "Obamacare," they report in large numbers that they are opposed to it. Polling that asks about the "Affordable Care Act" gets significantly higher positive results, often from the same people who don't realize the two are the same thing.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
When the top causes of death and chronic disease are highly related to lifestyle, we should be looking into that first. And charging more for people that can modify their lifestyle….but wont'…related to their health care cost. That is the only sustainable way to affordable healthcare.

Otherwise people like me whom have a clean diet and exercise to stay healthy, will be paying for everyone that doesn't take care of their health.

I have no problem doing my part to help with people that do not have self-inflicted illness. But that population is not what is draining our society.

The top causes of death and chronic disease are also highly related to genetics. Should we require genetic counseling on everyone and deny coverage to those who test positive for genes for breast cancer? Alzheimer's? Diabetes? What about those who are exercising and have the "cleanest" diet they can afford? Those who can't exercise because they just broke their arms and a leg falling off their bicycle? You're on a very slippery slope. You're also being very judgemental, not a good quality in a nurse.

The only sustainable way to affordable health care is to stop spending the majority of our health care dollars extending the lives of the dying for another week or two with costly surgeries, tests and procedures. ECMO for a 78 year old who had difficulty separating from bypass? An LVAD for a 74 year old with multiple co-morbidities? I'd much rather spend my health care dollars vaccinating every kid in the state.

Specializes in Critical Care.
Google is your friend. You could cut hours to avoid the insurance mandate or you could be one of the many unions or business who donated to Obama's campaign that Obama gave a waiver.

ObamaCare Employer Mandate: A List Of Cuts To Work Hours, Jobs - Investors.com

Yes, good is your friend, for instance if you google "Obama gave unions an ACA waiver" it returns this: Politifact - Unions don't have to comply with Obamacare, says Crossroads GPS = Pants on Fire lie

Specializes in Critical Care.
Never said it was. In fact I was doing something else and wrote universal healthcare in error when I meant single payer. Changed that on the post you were referring to.

Between the two, Obamacare is closer to universal health care than it is to single payer, it's not single payer or even a move towards single payer since it mainly reinforces our multi-payer system.

Specializes in Forensic Nurse.
So we all understand that some are terribly unhappy with "Obamacare".

What are the proposed improvements or what is the preferred method to enable all American citizens to gain access to affordable preventative and acute health care in this country?

I'm okay with the notion of repealing the ACA.

Will it be replaced?

Will insurers again be allowed to disqualify those with pre-existing conditions?

Will parents be able to keep their young adult children on their policy regardless of college attendance?

Should we get rid of EMTALA in effort to reduce our health care costs as part of GDP?

Will the amount of insurance premiums spent on actual health care vs. "overhead" go back down if we repeal the ACA? Will the insurer get to keep 25, 30, 40% of premiums to pay for executive salary and bonus packages again?

Will we see a return to the previous pattern of rate and cost hikes (>119% between 1999 and 2008) when we repeal the ACA?

We understand that so many people are so unhappy with the ACA and want it repealed.

We simply don't understand what the plan is after the repeal. We don't understand what improvements or replacements are planned.

Will it just go back to the way it was before?

Perhaps rather than calling liberals names and trying to incite agravation and irritation some concrete ideas for improving our health insurance system could be explored by those who hold such deeply felt animus for the ACA.

In the absence of that we are left with the notion that some Americans are just too poor or too ill or too stupid and they should be allowed to die because that is what is most fiscally responsible for the American government and society.

Well one thing I would propose is that if as a nation we are FORCED to have health insurance, then their shouldn't be limitations on test. As I stated earlier, they are covering things when they know people wont use. Eg. Providing coverage for fertility treatment for women in their 60's but they wont cover Mammograms when they need it now. It's these stipulations why people think its a rip-off. I pay close to $6000/yr for premium yet my son can not get the ABA that he needs?! That is just crazy! That's $6000 I could use towards my sons treatment, if I wasn't forced to waste it, and yes, it is wasting because I am getting nothing from it.

I have no problem in paying for the less fortunate, but not when I have to sacrifice and pay and get nothing while they get everything.

just recently I got the stomach bug and puking my guts out, and even though I'm paying premium, I could not afford to go to the hospital so what is the point?!

Specializes in Critical Care.
If you are only working to supply yourself with medical insurance than how are you other financial needs being met? Pretty naive to think that people only have to work for insurance isn't it unless one is in their 30's and lives with their parents. Of course one can always go to a state with expanded medicaid and not work if they were only working for insurance in the first place...

I already gave you one example; someone who's spouse makes more than enough for financial support but for whom group insurance is not available, such as someone who is self-employed. I work with a number of nurses who had been wanting to start their own small businesses for a long time, but couldn't give up their employer-sponsored insurance. Now that they can get a similar product without having to go through their employer they've all finally gotten the chance to start their own businesses. Then there are those who would prefer to work less to care for children or elderly family members, but have had to work enough to remain eligible for employer-sponsored insurance.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Good day:

Reasons why I dislike the Patient Affordable Care Act commonly known as Omabacare:

1. Sold on lies.

2. 100% Partisan bill (brought to us only by one party).

3. Not read before it was signed; Nancy Pelosi's infamous statement, "We Have To Pass The Health Care Bill So You Can Find Out What's In It" -- now, as a nurse, can you imagine... "we have to give you the medicine in order to find out what's in it" would fly over well with any patient or instructor? Or we don't have to proof read our papers... etc.

4. ACA does cover abortion. For those of us who believe abortion is cold blooded murder of an innocent baby; this is a huge deal.

5. ACA does not guarantee access to Healthcare. I repeat, ACA does not guarantee access to healthcare. Since any provider (this goes for drugs, hospitals, doctors, etc) in a free country cannot be forced to accept insurance, the provider has the right to refuse service unless they are paid via vehicles of payment they accept.

6. ACA is not revenue neutral (part of the lies that sold ACA).

7. ACA involves forcing people to buy a product whether they want to buy the product or not. For those that can afford the product, they are forced to pay for coverage they will not need so as to jack up the price so that part of the money that doesn't go into the pockets of those evil insurance companies (the democrats called them evil and corrupt before ACA; do you think management changed after ACA?) goes towards paying for insurance (aka subsidies) of those who cannot pay.

The list goes on... and for all those that sing praises, as more and more doctors and hospitals rebel (as is their right in a free country) and refuse to accept insurance brought to you by ACA, then the access issue noted in #5 becomes a larger and larger picture showing that ACA was a train wreck to start, and still is a train wreck now.

Thank you.

You don't believe in abortion, don't have one. I don't have any kids to educate -- does that mean I shouldn't have to pay the portion of my taxes that goes to the education system? Abortion is legal in this country. If you're anti-choice, you get to choose NOT to have an abortion.

But I'm having difficulty believing that the ACA actually pays for abortions.