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.
"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.
And why is it okay that there are probably millions of working poor in the same boat I'm in because of the state they live in? Doesn't seem to me like the ACA has been much of a solution at all
The ACA was designed to provide coverage for you and the millions you're talking about. It is a solution in the states that implemented the Medicaid expansion provided for in the law and paid for by the Federal government. It's a shame that so many of the states went to court in order to prevent their unemployed and working poor citizens getting coverage, just to prove a point.
And why is it okay that there are probably millions of working poor in the same boat I'm in because of the state they live in? Doesn't seem to me like the ACA has been much of a solution at all
Who said it's okay? But it's not the ACA that did that, it wasn't even part of what originally considered. It didn't become an issue until states decided to sue in order to prevent the expansion. We're not talking about a built in punishment, we're talking about a flaw that appeared because after the law was passes, there was a supreme court ruling. The good news is you won't have to pay a penalty. Those who would otherwise qualify for medicaid are exempt. It's part of the same exemption I mentioned earlier for members of healthcare sharing ministries.
I don't quite understand why they won't expand the subsidies to those of us in these states though rather than leave us no options. With the subsidy allowed if I were to make say 22,000 a year, I would be able to afford the premium at my current income.
I still don't buy it ... The ACA didn't put you in the position you find yourself. Your state government did. More specifically, it was the neocons who have been trying to blow up the ACA since the day it was proposed. If you voted for the idiots who chose to block that provision, or didn't vote at all, then you did it to yourself.
The ugly reality is that the disadvantaged have always been cannon fodder in our political wars. As long as you let anyone's propaganda hoodwink you into ignoring your own self-interest, nothing will change.
Meanwhile, that penalty will partially pay for the legally mandated care that must be provided regardless of insurance coverage.
The original law assumes that all the states would expand. People in your state still get the subsidies, just not ones who should have gotten medicaid instead.
I don't quite understand why they won't expand the subsidies to those of us in these states though rather than leave us no options. With the subsidy allowed if I were to make say 22,000 a year, I would be able to afford the premium at my current income.
I would love to see the money the state would of got go to a special subsidy just for people in your situation. I suspect more states would comply if that happened.
Why will I have to pay a tax penalty because my state "screwed me over"? Because the ACA says I will. I've been uninsured most of my adult life and while I'm certainly not happy about that theres not much I can do about it at the moment. Being penalized for that? Not cool. Its all i can do to keep a roof over our head right now, why kick people when they're down for something beyond their control?
Your problem is probably more accurately described as being that Obamacare didn't affect you, not that it did.
There have been various proposals as to how to help people afford insurance, the idea of putting all of these people on government-run insurance has been strongly opposed by certain political ideologies, so to make those folks happy it decided to only use government-run insurance for those that require 100% assistance, for those that only need partial assistance subsidies were introduced which would still keep privately run insurance with plenty of business.
Since the point at which people would require 100% assistance, the cutoff between medicaid and subsidized private insurance, was higher than the existing medicaid cutoff, part of the ACA was to give money to states to expand medicaid so that medicaid eligibility would extend all the way to where the subsidies kicked in, leaving no gap.
The assumption was that nobody would be so cravenly partisan as to leave their residents out to dry in order to make a political statement, which as it turns out was not correct.
I don't quite understand why they won't expand the subsidies to those of us in these states though rather than leave us no options. With the subsidy allowed if I were to make say 22,000 a year, I would be able to afford the premium at my current income.
Because the GOP is doing everything it can to sabotage the law. The ACA was written to require the expansion of Medicaid in all the states to accommodate people in your situation, and, because people like you are supposed to be covered by the expanded Medicaid programs, you are specifically excluded from purchasing insurance on the exchanges and receiving the subsidies available to those using the exchanges. Some of the conservative states went to the SCOTUS and got a ruling that the Feds can't force the states to expand Medicaid (and take the Federal money available to pay for that expansion), the Medicaid expansion has to be voluntary. So all the states with GOP legislatures and/or governors promptly refused the Federal money and refused to expand Medicaid.
But don't feel bad, it's not just you getting screwed over by the conservatives. Most of the conservative states also refused to set up and operate the state insurance exchanges written into the law, and left their citizens to use the Federal exchange (which is why the Federal website had such huge problems when it went live -- it was never designed or built to accommodate large numbers of people; it was only supposed to be used by the relatively small number of Americans who would somehow "fall through the cracks" and not have access to a state exchange). Now, the GOP is back in the SCOTUS, arguing that, since the wording of the law states that the subsidies are available to those shopping for insurance on the state exchanges, all the residents of the states that refused to set up their own state exchange, who are purchasing insurance through the Federal exchange, should also be ineligible for subsidies.
The GOP is doing everything it can to keep the law from working as designed, and then saying, every chance they get, "Look, the law isn't working! It's a complete failure and disaster!" (While hoping/assuming that most people won't notice that a large part of the reason the law isn't working, the extent it isn't, is because of the GOP machinations and obstructionism.)
The GOP is doing everything it can to keep the law from working as designed, and then saying, every chance they get, "Look, the law isn't working! It's a complete failure and disaster!" (While hoping/assuming that most people won't notice that a large part of the reason the law isn't working, the extent it isn't, is because of the GOP machinations and obstructionism.)
This is why I have no intention of voting republican anytime soon. I am not a party line democrat, I have voted for both democrat and republican candidates. The butchering of the ACA by the Republican states however really sets me off. How dare they make the decision to leave a good portion of their constituency without options for affordable coverage? All I can say is I really hope people vote with this in mind come the next election.
OK...off my soapbox as I broke my own rule of never discussing politics or religion.
Specializes in Rehab, Hospital, Travel Nurse, VNA,.
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?
Chisca, don't judge others, you don't know her circumstances, things are different in every State! Part of the country has a nursing shortage and other parts of the country have "flooded the field with nurses". And jobs are scarce, were I live new grad cannot find work for 1-2 years after graduation. They work as Nursing Assistants and waitresses, etc. until they find a job as a nurse. Every hospital in Boston has had lay-offs for years now, one hospital forced the oldest nurses out- the end of July which happens to be the end of the Fiscal Year!
You are missing the point, she is writing her story about how the ACA helped and how it changed an opinion against the ACA in favor of it, and she has found a new appreciation for Politics.
elkpark
14,633 Posts
The ACA was designed to provide coverage for you and the millions you're talking about. It is a solution in the states that implemented the Medicaid expansion provided for in the law and paid for by the Federal government. It's a shame that so many of the states went to court in order to prevent their unemployed and working poor citizens getting coverage, just to prove a point.