Pre-existing Condition

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 In a cruel and cynical ploy, Republican legislators repealed the mandate–the least popular aspect of the ACA–in last year’s hastily passed tax bill.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.

Sleepless in Trumpcare’s America

My husband was diagnosed with melanoma in January 2010, the same week Republican Scott Brown won Ted Kennedy’s Senate seat, thus eliminating the Democrats’ brief filibuster-proof majority. (Remember that long-ago nanosecond?) As our lives turned upside down, so did the outlook for health care reform.

Our sleepless nights and worst fears were compounded by the added stress over health care. I’m self-employed, and we depended on my husband’s job for insurance. We were a decade away from Medicare. What if he died, or grew too sick to work?

“Until now, I haven’t had any pre-existing conditions,” my husband fretted as sleep eluded us. “Now I’ll never be able to get insurance on my own.”

My husband and I were lucky — we had money in the bank, a home, jobs, and insurance, at least for the moment. Luckier still, my husband’s melanoma was caught early and successfully treated through surgery. Back then he still would never have been able to get insurance on his own if he lost his job, but we had dodged a bullet.

As my husband and I discovered, though, fortune can change in an instant.

Luckily for us and for tens of millions of Americans, the Affordable Care Act became law not long after my husband’s surgery. We rested easier about the future—ours and our daughters, who could now stay on my husband’s insurance until age 26.

Our lives were upended again in 2012, when I was diagnosed with cancer. Once again we were plunged into the realm of sleepless nights and fear, but thanks to the Affordable Care Act, we at least did not worry about losing access to health care, exceeding annual and life-time caps, or going bankrupt.

My treatment, like my husband’s, was successful, and our lives returned to normal, although with a newfound appreciation that health care should never be a game of Russian roulette or depend on luck, employment status, or wealth.

Thanks to the Affordable Care Act, our eldest daughter–an artist, part-time worker, and student who makes very little money–was able to find quality health care under the ACA’s Medicaid expansion once she turned 26. (We’re in California; she would have been out of luck if she lived in one of the 19 states that have refused to expand Medicaid.)

Also thanks to the Affordable Care Act, in 2015 my husband was able to leave his corporate job to pursue his longstanding interests in research and freelance writing. Employer-provided health insurance had kept him tied to his job, but with the ACA, he could slip those golden handcuffs and we could both be assured of coverage despite our pre-existing conditions. Additionally, the good job with good benefits my husband vacated became available for somebody else. Many of our friends also became self-employed and freed up jobs for others because of the security the ACA brought. We make too much money for any subsidies from the ACA, but that’s as it should be. Although our premiums are expensive, at least we have excellent care. It is not only lower-income people who benefit from the law: Economic vibrancy, flexibility, and innovation are under-appreciated but significant aspects. We are so grateful that President Obama signed the Affordable Care Act. Imperfect as the law is, it is has benefited us and tens of millions of Americans.

But now with Republicans celebrating a legislative milestone in their relentless march against Americans’ health, we are back to sleepless nights.

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What has the ACA–and the Republicans’ attempts to unravel it–meant to you?

 

Signs of the Times

Last night the Write on Mamas, a wonderful group I belong to, held an Open Mic Mamas event in a local cafe. The theme was “Plan B: Now What Do We Do?” Here’s my essay:

After the primary season was over, I kept two “California for Hillary” signs on my desk in our kitchen, where they were safely hidden and kept nicely flat under a box of books.

“I’m going to frame these and give them to the girls for Christmas!” I told my husband.

“Maybe for Emma,” Jonathan remarked about our eldest, who has a penchant for memorabilia.  “But Ally will hate it.”

“That’s not the point,” I snapped.

I had grander considerations than what the girls might actually like. Maybe I’d even crack the picture frames’ glass for special symbolic significance marking the historic event to come on November 8!  Continue reading

O is for Obamacare

iheartobamacare_400pxFirst 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!

All Aboard!

High speed train

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:

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.nytimes.com/2013/09/28/your-money/health-insurance/a-guide-to-the-new-health-insurance-exchanges.html?_r=0&hp=&adxnnl=1&adxnnlx=1380564316-6/3NmZyBAPPxs2/tTVLb/w

http://www.scholarsstrategynetwork.org/node/3747

http://www.newrepublic.com/article/114870/obamacare-exchanges-start-tuesday-oct-1-heres-why-theyre-worth-it