GratiTuesday: Healthcare and the Affordable Care Act

33 years ago today (for some reason I remember it was on Flag Day) what started out as a routine trip to my doctor for a simple, yearly check-up became day one of a medical journey. During the exam, my doctor discovered a lump in my neck – one that I hadn’t even noticed – and recommended very urgently that I have it checked out by a specialist.

Without going into a lot of detail, a battery of tests resulted in the diagnoses of cancer. My world, as I knew it, suddenly tilted and for the next year my and my family’s focus was on my treatments, tests, and getting healthy again.

I am very lucky that my disease was caught early and that my particular type is – and was at that time – no longer considered an automatic death sentence. After going through multiple chemotherapy and radiation treatments, I got through the ordeal and eventually regained my hair, weight, and my health.

aca-logoThe one thing I learned I would not regain is the ability to get health insurance from any other source other than a traditional employer. I now had what insurance companies considered a “pre-existing condition.”  I could never freelance or start my own business. I could never change jobs without having a new position waiting for me with minimal interruption. If there was a probationary period in a new job when I wouldn’t have coverage, I held my breath and didn’t let it out until the wait was over.

I am just one of millions of people in the U.S. who were, before the passage of the Affordable Care Act, considered uninsurable on our own. If we didn’t get coverage from our – or our spouse’s – employer, we had to go without health insurance. It could be a frightening and sometimes financially devastating place to be.

I will be forever grateful that I had traditional medical insurance coverage when I became sick and so very grateful to all of the doctors and healthcare professionals who took care of me. Today, I am especially grateful that the Affordable Care Act has allowed so many people get coverage that would have been out of luck before. The Affordable Care Act isn’t perfect by any means but it’s the best we have right now.

38 thoughts on “GratiTuesday: Healthcare and the Affordable Care Act”

  1. I cannot begin to imagine what the journey looked like for you and your family.
    Nor do I understand the opposition to the ACA.

    I’m glad you were one of the lucky ones who had the health insurance and early diagnosis that enabled you to get a return to health!

    1. I think it was harder for me to see my parents worry than it was to actually go through the process of getting better. I don’t understand the opposition either, but there is a lot I don’t understand about people supporting things that go against their own self interest… and that of others.

      1. I understand how difficult it would have been for your parents. A child is a child regardless of how old they are. My mother told me that once and now I feel it myself.

  2. Thank you for sharing this important post, Janis. I am very happy to hear that all turned out well for out for you.
    As a Canadian, having a publicly funded health care system that all contribute to (depending on income level), that is primarily free at the point of use, makes sense. Through this system, no Canadian is denied treatment and the quality of care is ensured through federal and provincial standards.
    Last month, when we were traveling out-of-province, my husband became ill and needed to go to emergency. Our British Columbia Health Card worked efficiently and smoothly even though we were in Manitoba.
    We are very thankful for this system. I look forward to reading other comments on this post.
    Donna
    http://www.retirementreflections.com

    1. It must be such a comfort not to have to worry about healthcare even when you are traveling. ACA makes things better, but we still have a screwy system here. I’m glad your husband found good treatment and it didn’t require jumping through hoops (like it probably would have here).

  3. Janis, relevant post. It is working pretty well, but could use some improvements. Two improvements off the top of my head is Congress eliminating the decrease in funding of the risk corridor payments to insurance companies to tied them over due to initial adverse selection. Our GOP friends did this to strangle ACA with intent, which is unfortunate as the consumers pay for this decision. Congress needs to fund these corridors, as needed. The other is to fully implement the ACA is the remaining 19 states who did not expand Medicaid. Many still go without coverage. It should be noted these states tend to have the worst healthcare outcomes per The Commonwealth Foundation and are run by GOP leaders. These are purposeful attempts to make the ACA be unsuccessful, which is unfortunate, as again people are harmed by this decision.

    I do not make these comments to be political, but the ACA is a lightning rod. Which is sad, because it is largely based off a Republican idea in the first place. It is working, but could work even better, if we make the effort. By the way, I have shared before I am a former Benefits Consultant, actuary and Manager of Compensation and Benefits, so I do follow what is happening with a different lens than politicians.

    Thanks, Keith

    1. I very much agree that ACA could be made much better and should have been more workable from the beginning. I feel so sorry for the residents of the states that decided not to fully implement ACA. I’m amazed that something as basic as healthcare became such a political hot potato (especially, as you pointed out) much of the architecture for it was developed by those opposed to it.

      1. Janis, I don’t know if you are following the plan to repeal and replace the ACA submitted by Speaker Paul Ryan. I have seen this plan taking shape for a couple of years. Here are few comments.

        It would deplete the number of insureds in a dramatic way, which would be harmful to the economy as people would not take advantage of the tax credits without the mandate. Ironically, when Tea Party leadership advocated Romneycare, on which the ACA built upon, they advocated the mandate as a measure of personal responsibility (this position is easily findable by Googling Jim DeMint and Romneycare).

        It also would block further expansion of Medicaid, saying the states that have doneso could keep it. Several foundation and a university study say the expansion helps people, hospitals and state economies, and the Federal Reserve Bank of NY said expansion reduces debt collections in states where implemented.

        Finally, the plan sneaks in the idea to delay Medicare eligibility to age 67 from age 65. Medical benefits are critical to a decision to retire and this move actually runs counter to the idea of lowering Medicare retirement extending it as a public option for older Americans. Plus, one idea to reduce our debt is to offer a public option (which would be Medicare) in places where competition is poor.

        I recognize I have offered to much detail, but what I have strongly recommended for about three years is to improve upon the ACA, not repeal it. Thanks for allowing me a soapbox, Keith

          1. Thanks Janis. The Medicare eligibility increase is getting noticeable pushback, as well as the lack of detail and elimination of the mandate, which means we will move closer to where we were when CFOs said we must change.

  4. I’m so glad that your treatment was successful. One more testimonial to the importance of routine checkups

    I worked for a health insurance company for 20 years. The hope, back in the 70’s, was that the Kaiser model of managed care would make health care affordable for all.

    It is unfortunate that the Republican’s focus is not on improving, but on eliminating, “Obamacare”. So much can be done with outcomes research, end of life counseling, preventive care, elimination of fraud (which is still rampant), use of physician extenders–the list is long.

    One more reason this year’s election is so very important.

    1. I’m in complete agreement, Shelley. We keep hearing about ” repeal and replace” but, funny thing, we don’t hear what they’d replace it with. I can’t imagine they would just throw all those people off a cliff by forcing them to go without coverage again, but what I can’t imagine has come true often enough. Yes, this election is crucial.

  5. Like Keith, my job as head of Human Resources included overseeing the healthcare benefits. I don’t understand the opposition to the ACA so I have to assume it’s all political. There were so many cases of people being “uninsurable” prior to this law. It’s so hard to believe that this great country cannot provide healthcare to the needy. Many other countries do. No system is perfect but we have one that can be tweaked. I can’t believe that politicians want to dump it. I also had a friend who was tied to employment by health insurance. That’s not a good reason to work for a company. I also had an employee marry a guy friend so he could get back surgery on her insurance.

    1. I’d love to have ACA adjusted and improved but what we hear is some just want to get rid of it completely (they, of course, will continue to have coverage). I wouldn’t be surprised if there weren’t more than a few of those insurance coverage marriages. I guess there are worse reasons to get married.

  6. I am so glad you are well. I hope the ACA stays in place and changes will be made to improve it. No one should be denied healthcare ever.

  7. There are so many wonderful angles to your story, Janis – good health, recovery, looking back with gratitude. But what I find most admirable is your emphasis on what others in the same situation might also go through. Thanks for this thoughtful post. Susan

  8. Glad you are well and got good health care when you needed it. As an outsider I cannot understand why anyone should be denied health care because of a political system. Our NHS is not perfect by any means, but I’m thankful for it.

  9. The ACA has been a double-edged sword in my experience. Glad it swung your way to keep you insured. Sorry to hear about your earlier cancer scare but happy to hear it was eradicated! My daughter (now 28) has relied on ACA for the last 4 years for health services (although she could use university care as a student). ACA severely restricted hiring part-time employees for my former workplace, especially government workplaces due to having to provide insurance for employees who worked more than 29 hours a week. ACA was terribly mishandled by many govt workplaces resulting in a horrible loss of services. I’m just glad I’m out of it. We all deserve healthcare but it needs to be managed better.

    1. It is definitely not the system many of us hoped it would be, nor was it implemented well. But, given the severe opposition, I guess it was the best they could cobble together. Wouldn’t it have been wonderful if the best and the brightest – without any political agendas – had worked together to create a plan that combined the best practices from other systems? I personally wish they could completely decouple it from employment and just make it universal coverage.

  10. I really don’t understand why anyone would be opposed to ACA. It is far from perfect, but it’s a damn good start. I have been fortunate to have excellent health insurance through various employers, and even now I’m on COBRA, another great piece of legislation. My insurance paid every dime of my cancer surgeries and treatment, and I had the luxury of choosing exactly what I wanted without thought to cost. Everyone is entitled to at least that much.

  11. So sorry you had to deal with cancer, Janis, but I’m grateful you’re healthy now. As a cancer survivor myself, I know how it changes your life ~ forever. ACA isn’t perfect, but it’s a start in the right direction.

    1. It is a start and I keep hoping that saner heads prevail (what are the odds?) and all sides get together and fix what isn’t working well, and keep what is. There are so many people who think what we had was great – it’s obvious they were insured… and probably didn’t need healthcare beyond basic services.

  12. I could not agree more! And, I am glad you got through your ordeal all right. The big C-word has touched many lives already and I fear it is one of our biggest enemies. Now, why so many people are against the ACA… They are either selfish, cannot think outside of the box (like realizing the obstructions when taking a sabbatical or start a freelance career) or have had no loved ones suffer financially due to the lack of healthcare…

    1. I think you are right about the reasons some people are against the ACA. Another reason, unfortunately, is strictly politics. Whatever one side supports, the other side is against (even though the against side used to be for it). I hope that it has been in place for long enough now that it would be impossible to gut.

      1. A sad thing about politics, indeed (and only having two parties). And, the hypocrisy about it. Aargh. It’s too bad that people can’t make up their own mind about something and then vote for their beliefs, not their party.

    1. We are just finishing up a trip to Canada. Because of their citizen-focused healthcare system (and lovely country in general), if the US election outcome is as horrible as is very well could be, we may be looking seriously at immigration.

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