Why I cannot hate the Affordable Care Act (ACA)

[jaycam]

"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.

[eroc]

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.

[LonghornChic, BSN]

I am unfortunately in "the gap". My state decided not to expand on medicaid, I am not 138% (I think this is the number) of the poverty level and I do not qualify for subsidies. My husbands job is barely holding us afloat but apparently we have to be homeless (and have only one vehicle worth $1500 or less) in order to qualify for crumbs. Coverage for both my husband and I costs about $500 a month (catastrophic only). We are 30 years old and pretty much healthy. Unfortunately, my nursing school is requiring that I obtain health insurance before I begin clinicals so I will have to find a way to eat the cost one way or another. My 2 children are in another ridiculous gap between CHIP and medicaid. Our "income" is too much for medicaid but not enough for CHIP so we kept getting referred between the two. The office I work part time at is currently providing basic and preventive healthcare for my entire family free of cost which is really the only lifeline we currently have. Sad but true.

[Phoenix16, RN, MSN]

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.

I agree with you!! When I gave birth to my son in 2010 we did not pay a penny, not one penny for copay. Since this ACA we now have a huge deductible, so now if its not a broken bone or something severe, we don't even mention the words doctor, or hospital.

To the person who feels this is so great not having to choose between healthcare and finding food; newsflash! millions of Americans now have to do that with this ACA including me. Health insurance should be right just like education, you don't see people having to pay thousands out of pocket before the government contributes to their child education. So why are we stuck with these cost? If it actually worked, it may be tolerable, but we know it doesn't.

This act was sold to Americans that it would make insurance cheaper, because instead of us paying the cost for those without insurance, they would be held accountable for themselves. Unfortunately, that is not the case, insurance companies have drastically increased premiums. People are stuck having to pay insurance that they are afraid to use. Because our deductible is $4000, we have to spend that out of pocket first, meanwhile still paying premiums every month. So in event that we don't use our insurance (only because we cant afford to do so), we pay the insurance company close to $5000 every year, because if we don't, we will have to pay a fine.

We are still living off of years a go legacy, acknowledging us as the best. If you read the researches and the studies and findings, you will see the countries that really provides great, affordable, uncomplicated healthcare for their people, and one of them is not USA. Our insurance covers fertility treatment for women in their 70's, but it wont cover things they need now in their 40's?! Come on, how can this be the best!!

[cgjames]

If that poster is in WI, yep..that is sadly correct. The best policy my daughter and son in law could find is $580.00/month premium with a $12,600.00 deductible. That is coverage for both of them.

That's really the rub though. So much of the ACA is based on states supporting the act. If the states don't accept various parts of the act, the citizens of the state (not the politicians, mind you) pay out the nose for their insurance. Wouldn't it be a convenient ploy for anti-ACA politicians to refuse to support the program in order to ensure that their citizens also don't support it? But that would be slimy, and no politician would deliberately deny healthcare access to their constituents just to win a political battle. Oh wait.

[Phoenix16, RN, MSN]

Well you may like this ACA now because you are a student, but wait until you're in the real world of work, lets see how much praises you sing it then.

[Yosemite, RN, ASN, EMT-I]

For those of you who find this abomination helpful, good for you. On the positive, ending "pre-existing conditions" IS a plus. At 60 years old, a GLUT of nurses, poor job market, I lost my health coverage when I couldn't meet "full time" productivity for Home Health Care. "ObamaCare" cost: $538 per month, $6000 deductible. For catastrophic: covers only 80%. As my income varies, yet just enough that prevents subsidy; no WAY can I afford that and live indoors, eat from a refrigerator.

So, I utilize a NP @ a walk-in clinic for $90, urgent care if need be. Proventil HFA: $149 + tax. Pay full cost of chiropractic. Still, my taxes pay for those who can't work, won't work or are underemployed (as am I). I see them in their homes. Of course, no one thanks me for contributing to their subsidies while getting no health care for myself as I change their dressings, draw their blood, instruct them on disease state management (usually futilely).

Bitter? I'm past that; I just try to hang on, live from day to day praying for no further illness or injury and that my vehicle will continue to function.

[jaycam, RN]

I like the ACA because I live in a state that bothered to make it work. We have a decent amount of competition on our state run exchange and even the non exchange plans have to be aware of that. Graduating and going full time with my company won't change the fact I like it. Remember, pre ACA, I couldn't get privately held insurance at all, so I was at the whim of employers to have it. Now I'll have options that'll allow me more choices when I graduate. If I get cranky about it, I can always remember the last three years and how someone else is benefiting. We have to stop being a country where people die from being poor.

[jaycam, RN]

Yosemite, I understand. When I was without insurance I used a local flat rate clinic if it couldn't wait and I had money, and paid for my medication out of pocket. The inhaler was always the worse one. I realize that there are still cracks for people to fall into and hope we can work to make it better.

[jaycam, RN]

I looked into coverage under the ACA. It would have cost me $400. a month, with a $1,200. deductible, and I'm 50 years old.

I just dropped my private, individual BCBS insurance. No deductible, but premium was $650. per month, for just me.

You have a $12,600. deductible and pay over $500. per month?

Sorry, but I am skeptical.

I think the difference is that resqbug is talking about a family plan. Individual plans max out at 6600, where as family plans can go to 13600.

[Turtles2]

jaycam, of course you like the ACA because you are getting freebies from it. Unfortunately, most people do not like the ACA. Here is proof. Read the reviews of Calfornia ACA on Yelp....

Covered California - Insurance - Sacramento, CA - Yelp

[banterings]

You can NOT spread prosperity equally,

But you can spread misery equally...

...and that is just what the ACA did!

[jaycam, RN]

jaycam, of course you like the ACA because you are getting freebies from it. Unfortunately, most people do not like the ACA. Here is proof. Read the reviews of Calfornia ACA on Yelp....

Covered California - Insurance - Sacramento, CA - Yelp

Turtles, that is not proof. If that was proof, I could show you the Facebook of one of the local federal senator who tried to get people to tell her negative stories and instead ended up with her page flooded with stories of sick children, pre existing conditions, and don't you dare try and take it aways as proof it is great. Also assuming I like it just because I "get free stuff" is demeaning. I like it because I have a pre existing condition. I like it because I know how scary it can be to not be able to get healthcare outside of an emergency. I know what is like to be trapped in a spiral of debt to get access. Healthcare should be a fundamental right, not a privilege of the rich. By dismissing it as "free stuff" we dismiss the human right to be healthy and productive.