A lot of people dread turning 65, but not me. Ever since a cancer diagnosis in 2012, there’s nothing I’d rather do than tick off the years toward old age. I’ve eagerly awaited certain milestones:
- 60 for most senior discounts at the movies
- 62 for the lifetime pass to National Parks (I lucked in at the $10 rate just before it increased to $80—still a steal!)
- 65 for Medicare
- 66 and two-thirds for collecting 100% of my Social Security.
This month, I achieve Milestone #3, and I couldn’t be happier. Not just because it means I’m still alive and well, but because of the hundreds of dollars I’ll save every month for the same insurance and doctors I have now.
Don’t get me wrong—as a self-employed cancer survivor, I was thrilled when the Affordable Care Act passed, and pre-existing conditions could no longer be used as an excuse to deny people coverage. I was lucky enough to have good coverage pre-ACA through my husband’s employer. But my husband felt he couldn’t leave no matter how unhappy he became as the job grew more stressful. Employer-provided health insurance, which we were fortunate to have, equaled golden handcuffs. The ACA changed all that. My husband, also a cancer survivor, was thrilled to join me in the ranks of the happily self-employed.
We paid through the nose to keep our good coverage through Covered California, and it was a privilege to do so (in all senses of the word).
Still, as great an accomplishment as the ACA is, it highlights the problems in our for-profit healthcare industry. It’s why single-payer, universal coverage, the public option, and Medicare for All are so front and center in the 2020 campaign. Democrats have varied but serious proposals about how best to improve healthcare, while Republicans continue to sabotage an imperfect but substantial reform, even threatening to eliminate the ban on pre-existing conditions altogether and putting healthcare out of reach for tens of millions of Americans.
Medicare for All has always struck me as a way to borrow a catchy name and a popular program as an umbrella description of our aspirations for universal coverage. There are different ways to skin this cat. My personal preference is to initially lower the age at which Medicare eligibility starts (a proposal that Senator Joe Lieberman thwarted in 2009), funnel much younger people dropped from their parents’ coverage into it, and allow an opt-in for everybody by expanding the public option—essentially the glide path described by many Democrats to achieve Medicare for All. I understand the appeal and economic rationale of a rapid and far-reaching overhaul, but a more gradual transition avoids the risk for major implementation glitches and has far more buy-in from voters.
Which brings me back to Medicare for Me, my “OK, Boomer” achievement that moves me higher up the ladder on which I was already born—a ladder whose bottom rung swings far beyond the reach of so many. I am glad to have reached this milestone, which makes my life easier and more affordable. I will be gladder still when Medicare for Me becomes Medicare for All.
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I was in Kaiser’s waiting room, scrolling through my phone while listening for my name to be called. Out jumped the news that the Trump Administration was going after the Affordable Care Act again: The Justice Department declared that protecting people with pre-existing conditions from discrimination was unconstitutional.
I am one of the 52 million Americans at risk of losing my health coverage due to this latest assault; I’ve had cancer. I’m fine now, but my trip to Kaiser was for the CT scan I get every year to make sure I stay that way. I will need such follow-up care for the foreseeable future. It’s a similar story for anyone with heart disease, diabetes, depression, and a million other ailments, both major and minor. Before the ACA, my friend’s premature twins could never have gotten health insurance on their own as adults because of their early months in the neonatal intensive care unit. Another friend’s 20-something son was denied health insurance because he had been treated for mild acne as a teenager! Sooner or later, everybody ends up with a pre-existing condition. It’s called life.
Life is what I’ve continued to enjoy thanks to my excellent doctors and post-cancer scans. Normally I’m not anxious as I glide through the CT machine. I feel relieved and grateful to make sure I’m still cancer-free, or if not, to catch and treat it early. As I lie on my back, a soothing voice instructs me when to hold my breath, when to breathe. Normally my intake and release are as relaxed as they are at the end of a yoga class. But not today. After the news, I am hyperventilating. I don’t fear cancer nearly as much as I fear the determination of this President and his Republican enablers to take away my health care.
Since their several dozen failed attempts at repealing the Affordable Care Act, Republicans in Congress and the White House have waged a relentless sabotage campaign. In a cruel and cynical ploy, Republican legislators repealed the mandate–the least popular aspect of the ACA–in last year’s hastily passed tax bill. The mandate’s undoing is now the rationale for eliminating the highly popular provision that prohibits excluding or jacking up the rates of people with pre-existing conditions.
The DOJ’s move will take a while to reverberate through the courts, but the uncertainty it creates will drive up premiums even more, furthering Trump’s goal of imploding the law he hates largely because it’s his predecessor’s signature domestic achievement.
Will this risky gambit work for the Republicans? Maybe not. It turns out people like having access to treatment if it’s not called “Obamacare.” Protecting healthcare has been the #1 issue on voters’ minds across the country, and this has translated into Democratic victories.
So rather than hyperventilating, I’m going to work hard to elect people who want to make America well again. I’m voting as if my life depends on it. Because it does.
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First off, let me just say that I believe single payer is the way to go. No system is perfect, but single payer delivers quality healthcare more equitably, efficiently, and cost-effectively.
That said, I’m a huge fan of the Affordable Care Act, aka Obamacare. Yes, its origins lie in conservative think tanks like the Heritage Foundation and the American Enterprise Institute, which promote market-based policies that privilege the profit motive. Obamacare does not go nearly far enough for many, including me.
Yet it’s what could get through a political system that is sclerotic, controlled by monied interests, and held hostage by a Republican Party practically unhinged in its hatred of President Obama.
It’s a profound success that more than 16 million Americans now have health insurance they couldn’t before afford or couldn’t get due to preexisting conditions. Obamacare is also slowing skyrocketing healthcare costs.
My family has been among Obamacare’s many beneficiaries:
For one thing, our kids have been covered under my husband’s employer-provided insurance until they turn 26. Since Emma aged out last year, she’s been fortunate to get healthcare she could not have otherwise afforded. Pieced-together, low-wage employment is common for young people now: Emma survives as an artist on part-time Russian translation work while also working in a restaurant. Initially, Emma benefited from Medicaid expansion (again, she’s lucky to live in a state that opted into this provision of the law). Now that she’s a bit more stable economically, subsidies help her afford excellent health care through our state’s health exchange. When our younger daughter, Ally, moves back this summer from Spain (where she’s enjoyed the benefits of national health care) she, too, will be able to find affordable health insurance.
Of course, since Ally’s only 24, she could also still be covered under my husband’s plan. Except that he’s retiring in May! This, too, is something he never could have done before Obamacare. We’ve both had cancer, which involves ongoing monitoring. I am self-employed, and there is no way we could have gotten individual insurance because of our pre-existing conditions—a heinous denial of coverage that Obamacare outlaws. Now my husband can pursue other interests free from the burden of remaining tethered to a job simply because we need health insurance we otherwise couldn’t get. And somebody else who needs and wants a job can have the position my husband will soon vacate.
Sure, we’ll pay a lot for coverage on our own. We’re too well off to qualify for subsidies, which is as it should be–they are designed to help those less fortunate. Of course, we’ll still benefit from annual out-of-pocket caps, free preventive services, and the knowledge that we and tens of millions of other Americans will no longer have to worry about the Russian roulette that used to be national policy.
Don’t get me wrong—I know that Obamacare is far from a panacea, and that for those who are healthy and whose incomes are a little but not a lot above the subsidized level, health insurance is far from affordable. For some it’s become more expensive. And because our system has engendered such a complicated law, tax season has become even more migraine-inducing than usual.
Yet we should be careful not to blame Obamacare for what had been happening for years anyway—premiums skyrocketing, people getting dropped, families going bankrupt due to lifetime caps, employers reducing hours to avoid providing benefits, or simply no longer offering health insurance at all.
It is a reform in process, but its benefits far outweigh whatever drawbacks exist.
What saddens and outrages me the most, though, is how much energy has been put into destroying rather than improving Obamacare. And I’m not even talking about the lies (remember death panels?) designed to thwart it from the get-go. The Supreme Court allowed states to opt out of Medicaid expansion, leaving millions of poor Americans who live in 23 (mostly Republican-controlled) states uncovered yet unable to afford healthcare on the exchanges.
Now even the federally managed exchanges (set up because so many of these same states refused to take responsibility for their own residents, and passed the buck to the Feds they deplore) are at risk as the Supreme Court considers King v. Burwell. If the Supreme Court rules in favor of the plaintiffs in a case that is based on what most see as the political exploitation of a semantic glitch, it will likely prove Obamacare’s unraveling. Which is exactly what its scorched-earth opponents want.
What do I want? It’s simple, really. I want a law that has helped tens of millions of Americans already, and which promises to benefit many more in the future. I’m grateful to President Obama for achieving what no other president had been able to accomplish.
Please—hands off our Obamacare!
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A version of this piece recently aired on KQED’s Perspectives.
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With the holidays here, I know just what I’m going to ask my daughter for this year. Emma’s almost 26, and like a lot of young adults, she’s piecing together a couple of part-time jobs while figuring out what comes next. I don’t want her to spend her hard-earned cash on stuff I don’t need. Instead, I’m asking Emma to make sure she signs up for something she needs: health insurance under the Affordable Care Act.
It’s true that the rollout has been riddled with problems, but the Affordable Care Act’s tremendous benefits remain. Besides, Californians are lucky to have Covered California, the state’s fully functional and easy-to-navigate healthcare exchange. Those who enroll by December 23 will be covered when the law goes into effect January 1. What better way to start the New Year?
Our family has already benefited greatly from the Affordable Care Act–it’s allowed us to keep our daughters on our plan until they turn 26. Soon, though, Emma will need her own health insurance. Before, she never could have afforded it. It’s hard to find jobs these days that offer coverage. Emma, like millions of Americans, might have been forced to rely on costly ER visits or the “Cross my fingers and hope I don’t need it!” plan. Now, under the Affordable Care Act, she and the many Californians like her who’ve risked disaster due to unattainable insurance will be eligible for expanded Medicaid, federal subsidies, or tax credits.
As parents, we make sure our kids are safe: teaching them to buckle up, wear bike helmets, and drive defensively. Grown-up children may think of themselves as Young Invincibles who don’t need insurance, but accidents and serious illness happen, putting health and family finances at risk. Here’s our chance to further guide our kids into responsible and secure adulthood, continuing to protect them by making sure they’re covered.
That’s why I’m asking Emma for the best present of all: good and affordable healthcare for her, peace of mind for me.
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Covered California: www.coveredca.com or 800-300-1506
Other states: check your local resources or www.healthcare.gov or 800-318-2596
Open enrollment period ends March 31, 2014
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According to congressional Republicans and right-wing media, the Affordable Care Act, aka Obamacare, is a “train wreck.” Nonsense. What’s really going on is that hyper-partisans determined to thwart President Obama have been busy since the law’s inception laying dynamite on the tracks. Now they’re even threatening to blow up the government and the economy if they don’t get their way! These saboteurs hope to derail a reform that will make better and more affordable health care insurance available to almost all Americans, including 25-30 million who are currently uninsured.
So don’t trust the wannabe train wreckers for accurate information. Here are some highlights of what Obamacare actually provides:
- Young adults can stay on their parents’ plans until age 26
- Insurers can no longer deny coverage for pre-existing conditions, dump patients, or charge women higher premiums than men
- Free screening tests, immunizations, and preventive care
- Elimination of yearly caps and lifetime limits on insurance coverage
- Closing the “doughnut hole” that leaves seniors on the hook for prescription drug costs
- Making sure at least four out of five of your healthcare dollars go to ensuring your health, not insurance companies’ administrative costs or profits
- Tax credits for small businesses providing coverage for their employees
- Expansion of Medicaid for people making up to 133% more than the poverty level
- Subsidies to make healthcare insurance affordable for low- and middle-income earners
- Health exchanges in each state to make comparison shopping easier and to create large risk pools, thereby lowering the cost for those now at the mercy of buying individual or family plans on the open market
Obamacare will NOT force you to give up your current insurance policy, drive up medical costs, increase the deficit, put bureaucrats in charge of your healthcare decisions, or take away your freedom.
It WILL, however, make you free from anxiety should you get sick, have an accident, or lose or change jobs. Because Obamacare brings almost everyone under the protection of insurance, it also eliminates exorbitant costs of sole-resort, emergency-room care for the uninsured.
Let’s stop in their tracks those laying dynamite on the tracks. All aboard for affordable healthcare for all!
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Obamacare goes into effect January 1, 2014. (Some key provisions are already bringing relief to millions!) Health care exchanges open October 1, 2013, with the enrollment period lasting through March 31, 2014.
For more information about Obamacare, the exchanges, how to sign up, costs, and your eligibility for subsidies, go to:
- In California: http://www.coveredca.com/
- Nationally: https://www.healthcare.gov/ or 1-800-318-2596
Contact your elective representatives to urge them to support Obamacare: http://www.usa.gov/Contact/Elected.shtml
Suggested reading for more in-depth understanding:
http://www.scholarsstrategynetwork.org/node/3747
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