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.

[jaycam, RN]

You can NOT spread prosperity equally,

But you can spread misery equally...

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

That assumed everyone is in misery. Obviously, some are not.

[Mama Jules]

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.

Don't be. I am in the same boat. If you live in a state that did not accept Medicaid expansion, Obamacare punished said state by not subsidizing any insurance premiums. Also, my husband is disabled right now due to taking aggressive treatments for stage iv cancer; he is receiving Medicare; however, when it comes time to enter my financial information in the HCA system, I have to count his SSI income EVEN THOUGH I CANNOT COVER HIM WITH AN HCA POLICY. That's right, he gets no secondary insurance coverage, but I have to count his income, which means we make too much to qualify for any federal subsidy. As I stated above, I am in a state which offers no state subsidy because the federal government felt the need to penalize my state for attempting to curb Medicaid costs, which more tax dollars are spent on, than Medicare costs. So, yeah, I pay 500 monthly for crappy insurance that DOES NOT PAY FOR ANY VISITS, MEDICATIONS, OR HOSPITALIZATIONS until I've met a 10,000.00 deductible. I agree affordable health care should be offered to everyone, but affordable for who? Certainly not me. And I'm not certain I believe health care should be a "right". It most certainly should be affordable based on income, if it is going to be mandated. I don't feel it is. I make less than 50,000 a year, am supposed to pay 6000 of that for insurance, and be able to afford payment out of pocket for all medical expenses until I owe 10,000.00? Prior to the ACA, I had a policy with 25.00 copays for specialists, 15.00 copays for generalists, and 5.00 copays for generic meds. My insurance, offered through my employer, was 300.00 monthly.

[Bailey_lou]

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 have no interest in politics. However, I think part of the reason people may not like the affordable care act is disinformation like this that is prevalent. Deductibles, co pays and medication costs have been rising exponentially for the last 15 years due to health insurance company policies, not a relatively new affordable care act. We pay more because companies want to make billions in profit--plain and simple. And I agree with others that there are still a lot of changes to make but it IS a start.

[jaycam, RN]

I have no interest in politics. However, I think part of the reason people may not like the affordable care act is disinformation like this that is prevalent. Deductibles, co pays and medication costs have been rising exponentially for the last 15 years due to health insurance company policies, not a relatively new affordable care act. We pay more because companies want to make billions in profit--plain and simple. And I agree with others that there are still a lot of changes to make but it IS a start.

I think there are a number of people that also do not understand why employer based plans are so common either, and why they tend to cost less. I didn't realize that myself until my 100 dollar a month employer based plan was offered to me under Cobra at 600 and researched it.

[Turtles2]

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.

I see. Your opinion matters but the opinions of hundreds of people on Yelp does not. Got it.

[kbrn2002, ADN, RN]

I have no interest in politics. However, I think part of the reason people may not like the affordable care act is disinformation like this that is prevalent. Deductibles, co pays and medication costs have been rising exponentially for the last 15 years due to health insurance company policies, not a relatively new affordable care act. We pay more because companies want to make billions in profit--plain and simple. And I agree with others that there are still a lot of changes to make but it IS a start.

Not necessarily disinformation. I mentioned in an earlier post the only med my daughter regularly takes is birth control pills which she obtains through Planned Parenthood. When she was uninsured these pills cost her $38.00 for a 3 month supply. Now, one month later the exact same prescription is $148.00 for a 3 month supply. Granted there are differences in coverage to cost ratios by state as well by insurance company and even by individual policy but it makes me kind of crazy that having this legally mandated insurance with an over 12,000 annual deductible and an over $500.00/month premium actually makes her meds cost more than before she had this crappy coverage. In this case, her cost increase can be blamed squarely on the shoulders of the insurance provider not the pharmaceutical company.

[jaycam, RN]

I see. Your opinion matters but the opinions of hundreds of people on Yelp does not. Got it.

I never passed my story of as proof. It's just that, my story. You don't have to believe it's anything more than just a story. You're trying to pass stories off as proof, when we live in a world of evidence based practice. We can show each other stories all day long but until you show me a study they are all just stories. I can show you thousands of success stories, but I'm not here to prove anything.

[Turtles2]

I truly believe that jaycam likes Obamacare. I also truly believe that millions of Obamacare customers hate it.

[Tenebrae, BSN, RN]

I truly believe that jaycam likes Obamacare. I also truly believe that millions of Obamacare customers hate it.

Wheres the evidence? Would it be fairer to say you dont like it?

I had a read of an american senators web page recently. The senator had asked for negative stories of the ACA, instead got flooded with stories of people who had been able to get the needed health care that they wouldnt have been able to get prior to the passing of the ACA

[SubSippi]

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.

Currently in the real world, singing its praises.

[pmabraham, BSN, RN]

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.

[Turtles2]

52 percent of polled Americans disapprove of obamacare. Source.... RealClearPolitics - Election Other - Public Approval of Health Care Law