Voices: My ACA experience

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Devin Williams, a chiropractor and nurse practitioner at the Clinical Educational Center at University Medical Center Brackenridge, screen Juventina Martinez for knee pain in March. (Tamir Kalifa/American-Statesman)

Few pieces of legislation in recent years have generated as much intense national debate in recent memory as the Patient Protection and Affordable Care Act, known to many Americans as Obamacare.

An overhaul of the U.S. health care system, it was signed into law by President Barack Obama in 2010. Republicans have long vowed to repeal and replace the law, and on March 6 GOP lawmakers unveiled a House bill called the American Health Care Act, which would change how health care is financed for people who do not have insurance coverage through their work and eliminate the mandate requiring most Americans to have health insurance.

We asked Viewpoints readers to share their ACA experience with us. The following are some of their letters and photos:

ACA Howard Porter

Howard Porter (Contributed)

In 2013, I was in good health but my doctor had me on four meds for cholesterol and high blood pressure. No big deal — in fact, three of these were on the $4 list at Wal-Mart Pharmacy. So, then I decided to buy an individual health insurance policy. Aetna, Blue Cross and other insurers declined to cover me for any price because of the number of meds I took to stay healthy. When the Affordable Care Act became effective in 2014, I had a choice of insurers through the health insurance exchange. So even though I didn’t qualify for subsidy, the ACA made it possible for me to finally buy health insurance because insurers are no longer permitted to cherry pick customers by excluding pre-existing conditions. — Howard Porter, Austin

EDITORIAL: GOP health care plan goes up in smoke; now fix Obamacare

ACA Tiffany Gillman

Tiffany Gilman (Contributed)

I was diagnosed with breast cancer at age 31 in 2015. With no family history, it was a terrible surprise nine months before my wedding. But I was lucky that the cancer had not spread, although my oncologist still recommended surgery, chemo and radiation. Again, I was lucky — I had health insurance, which picked up the $280,000 tab for my treatments. I didn’t need Obamacare for myself, but I cannot imagine what it would have been like to receive this diagnosis without insurance. It would have destroyed my dreams for the future. I know that before the ACA, this happened to Americans constantly. Repealing Obamacare will directly impact me — specifically, repealing the pre-existing conditions clause. Even though I no longer have cancer, I will forever be considered either uninsurable or gouged for health insurance without this provision. It isn’t my fault I got cancer, but if Obamacare is repealed, I will keep paying for it. — Tiffany Gilman, Austin

Never mind the lines: “If you like your doctor, you can keep your doctor,” or “If you like your policy, you can keep your policy.” At this time of the year, the biggest issue with the ACA really hits home. This is tax time; I am again preparing to include my 1095-C form with my return — you know, that nagging little mandatory document that must be included to prove to the IRS that you had ACA-approved coverage for the year or you get to pay a big, fat penalty. I really get tired of seeing all the numbers that are insured under the ACA. Of course there are big numbers of insured Americans; they have no choice. Instead of the previous lies, the statement should have been: “You will purchase a policy that is approved by the ACA with whatever doctors they provide, or face a stiff penalty.” — Jeff Popnoe, Round Rock

032216 ACA Robin Durr

Robin Durr and her late husband, Ken (Contributed)

For about a year, due to pre-existing conditions, my husband, Ken, received his health insurance through the Texas High Risk Pool. When the Affordable Care Act debuted, he was glad to be able to choose a policy. Subsequently, due to a fall at home that resulted in a broken hip, he had surgery and was working on his rehabilitation in the hospital when we received devastating news: Although he had no outward symptoms, Ken had stage 4 pancreatic cancer. As we began to plan for his care, one of his doctors said, “I don’t know what you think of Obamacare, but be thankful that because of it. You are not looking at a cap on care.” Shockingly, Ken passed away only 12 days after the diagnosis. In the midst of such grief, I was very thankful for the coverage he had. There was no “Mickey Mouse” with the insurance company — as often seemed to happen before the ACA. I knew exactly what my financial responsibility was and there were no surprises. In a time of such sadness, with my brain feeling as if I was in a fog, Obamacare is something I will always be grateful for. — Robin Durr, Austin

To help pay for ACA, the cost for Medicare B went up. In 2013, I paid $98 per month for Medicare B. In 2014, it went up to $140 per month. In 2015, it went up to $280 per month, so I dropped Medicare B. —  Clyde Claggett, Georgetown

ACA Faith Sams

Faith Sams, husband Andy and daughter Ru (Contributed)

My husband, Andy, and I own a small business together. I was able to make the decision to join him and leave behind the 9-to-5 world the year the ACA was rolled out. Being able to purchase reasonably priced health insurance that would allow us to have a baby was the boost we needed to make that move confidently. As the gig economy and self-employment gains a greater share of the overall economy, it’s vital to have a health insurance marketplace that is inclusive to a broad spectrum of people — especially those who have to be able to provide for themselves and their families. I suspect that the health insurance marketplace and the expansion of the gig and sharing economy and reduced unemployment are all interconnected. — Faith Sams, Austin

ACA Pam Hammond

Pam Hammonds and husband Jeff (Contributed)

In 2014, my husband, Jeff, and I had insurance with Blue Cross Blue Shield with a monthly premium of $941.43. We didn’t qualify for an ACA subsidy. That policy had a $6,000 deductible per person. In November of that year, I had to have carpal tunnel surgery on both hands. In December, my husband had to have knee surgery. In summary, in 2014, we paid $23,297.16 in out-of-pocket expenses — monthly premiums plus deductibles — before Blue Cross Blue Shield ever paid a penny on our behalf. Not to mention, since the knee surgery was performed at the end of December and his physical therapy didn’t start until January, our deductible started over and we immediately started having out-of- pocket expenses again. Lastly, our monthly premium of $941.43 has now gone up to $1,457.15 starting this January. — Pam Hammonds, Burnet

ACA jeff brown

Jeff Brown (Contributed)

My story is simple: I’m 61-years-old with two serious pre-existing conditions. I’m self-employed. If anyone would insure me, it would not be “affordable.” I’ve relied on the ACA from its beginning — and it has literally been a life-saver. I also happen to know several Republicans within my age bracket who have pre-existing conditions and also avail themselves to the program. Once they looked beyond the popular misconceptions, myths and blatant lies about the ACA, they figured out that it works pretty well for those of us who are not yet eligible for Medicare. Yes, costs have gone up while the program has worked out its early flaws, but I’ve yet to see or hear about any real alternatives that won’t cut services and raise costs even more. My biggest fear is that a bunch of grand-standing congressmen who have their own insurance are going to take mine away, leaving me — and millions of others — at risk until I reach 65. — Jeff Brown, Austin

COMMENTARY: Why affordable insurance alone won’t keep Americans healthy.

Though my brother Alan Arms worked as a contractor for many years, none of his employers offered health insurance. In November 2013, he was coughing up blood and went to an internist who ordered him immediately to a hospital. There, he was diagnosed with terminal liver cancer and faced a bill over $50,000. In January 2014, the ACA went into effect — and despite his pre-existing condition, Alan was able to buy health insurance for around $550 a month. When he died in May 2014, the sole reason he left a small estate — and not a smoking crater of medical bills — was the ACA covered his pre-existing condition and paid most of his bills. Though initially he had problems finding a plan with a network that covered his doctors, eventually he found one. Had he died indigent, the hospitals and doctors would have been forced to eat the payments for his treatment. Because of the ACA, they were paid. — David Arms, Austin

ACA Carolyn Cohagan 2

Carolyn Cohagan, top center, with members of Girls With Pens (Contributed)

The ACA was life-changing for me. I am a 44-year-old published novelist and teacher. Before Obamacare, the only option I had for health insurance was through the Author’s Guild. An HMO plan was $1,200 a month; a PPO was $1,600 a month. I have had a pre-existing condition since I was 21” a blood-clotting disorder that rarely effects my life. I was elated when I could get a decent plan for less than $500 a month. I was able to start an Austin organization called Girls With Pens because I didn’t have to worry about getting health insurance through my job. Now all that could all be taken away. Do you want me teaching your children how to love writing, or do you want me serving coffee at Starbucks for the insurance? The ACA isn’t perfect, but each and every one of us deserves affordable health care, no matter our fitness, class or working status. — Carolyn Cohagan, Austin

032216 ACA Rick Koepcke

Rick Koepecke (Contributed)

In 2010, my wife lost her job and we lost our health insurance. I worked for a small hardware store, where the health insurance they offered would have cost me $450 a month with a $5,000 deductible. I was making $10 an hour, so that was not an option. Then, we were able to get insurance through the ACA. For about $100 a month, we were both covered with excellent medical benefits, which included prescription benefits, preventative care and doctor visits with a $10 co-pay. Later I found out I had high cholesterol and went on medication for that. Both of these conditions are under control now. Without health care, I may not have even known I was at risk for either a stroke or heart attack. Even when the cost of our insurance went up to about $120 a month, it was still very affordable. If the ACA is repealed, my health will be in danger. — Rick Koepcke, Austin

Obamacare isn’t affordable. The plan’s premiums are going up 25 to 116 percent nationwide this year. Health insurance companies are dropping the exchanges, which forces customers in 70 percent of the U.S. counties to buy insurance from one or two companies. Republicans promised to repeal and replace Obamacare and voted over 60 times to repeal part of the law. Congress began the process in January by passing the fiscal year 2017 “shell” budget resolution — S.Con.Res.3 — which instructed the committees about how to write the repeal law. The language has existed in a bill passed in 2015. They’ve not met their self-imposed deadline — and repeal timeline is slipping. Millions will be negatively impacted by these exchanges. We’re so close to making this last chance a reality. Contact your congressional members. Tell them we want a full repeal of ACA and to replace it with a new, workable health plan. No more excuses. — Wanda Whitney, Georgetown

I am concerned about efforts to repeal the Affordable Care Act. For many millions of Americans, this act is very far from being a disaster, as some have glibly claimed. In fact, for some of us, it has been a life-saver. Without Obamacare, I could never have afforded to pay for a costly heart-valve replacement that may have saved my life. What will those with pre-existing conditions do without the guarantees of health care eligibility promised in the Affordable Care Act? Caring for the least among us is part of who we are as Americans. If we smash affordable health care, we shatter the fragile bonds that preserve our sense of unity. — Charles Rand, Austin

ACA Abby Brody

Abby Brody and her late daughter, Hallie (Contributed)

As a 62-year-old breast cancer survivor who’s losing employer-based health insurance this year, I’m terrified that without Obamacare I may be forced to choose between bankruptcy and life-saving treatment. We’ve needed the Affordable Care Act before. Our 23-year-old daughter died of a rare illness 16 months ago. The ACA allowed her to stay on my husband’s employer-based insurance and not worry about lifetime expenditure caps. Were it not for the ACA, we would have been bankrupt in addition to losing our daughter Hallie. I can’t sleep at night wondering if I’ll have ACA insurance to treat my breast cancer. Or will we again face the prospect of bankruptcy? — Abby Brody, Georgetown

ACA Chrstine Eady

Christine Mann (Contributed)

First, do no harm. We learn this in medical school, carrying it with us throughout our careers. In the U.S., access to affordable health insurance is a necessity for obtaining the best possible care. Shouldn’t our elected representatives share in this goal? Unfortunately, our new administration is pressing forward with repealing the law that puts insurance in reach for most. A survey in the New England Journal of Medicine found that 85 percent of family practice doctors are against repeal of the ACA. The president of the American Academy of Family Physicians, Dr. John Meigs Jr., says “too much is at stake to make significant changes to ACA.” Every day, primary care physicians see the struggles our patience face because of lack of insurance. Why isn’t our government listening to us? I hope they will join us in doing no harm — and keep the ACA. — Christine Mann, Leander

I had really good health insurance through my employers. When I went to work for myself, I had to buy insurance on my own. Though it was expensive and not very good, I knew that if I let it lapse it would be even harder to get back into the system later — and that I would have the issue of a pre-existing condition. I found the cheapest policy I could find and hoped that I wouldn’t get sick. The ACA changed everything. For the last two years, I’ve had good, affordable coverage thanks to the government subsidy. My prescriptions are just $5 — and ACA covered a large percentage of my carpal tunnel surgeries. Without that subsidy, I could not have afforded a good enough policy to cover my health care needs. Without the marketplace, I would not have had so many choices for a plan that works well for me. — Rona Distenfeld, Austin

ACA Rob Sanford

Rob Sanford (Contributed)

I had my pancreas removed 16 years ago due to a rare form of pancreatic cancer. I work at home under contract and have no option for work-related coverage. When my work coverage was discontinued, I tried to get insurance to cover my needs for medication, an insulin pump and other supplies — but was told “no way” by numerous insurance companies. Once the ACA was introduced, I was finally able to get coverage that was somewhat expensive but went a long way toward keeping me alive. Many of us need it. — Rob Sanford, Fredericksburg

The debate over the merits of the Affordable Care Act highlights the highly partisan environment of our times. “Repeal and replace” has been the mantra of many Republicans elected to national office — President Trump included. However, the evidence is clear that our country’s rate of uninsured is at a historic low of nearly 9 percent. As someone who purchased insurance through the health insurance marketplace, of course I would like a more affordable monthly premium. I am hopeful that a Republican-controlled Congress can help deliver this. I am also hopeful that other pieces of Obamacare that aim to improve our nation’s health care will continue to be embraced, such as efforts to expand primary care medicine and efforts to improve quality of care. As an entering medical student, these pieces have inspired me to advocate for improving and embracing — rather than repealing and replacing — Obamacare. — Mark Smith, Austin

COMMENTARY: This is what happens when health insurance is a privilege.

My wife, Linda, is a beneficiary of Obamacare. Prior to its enactment, she was covered by the Texas High Risk Pool. Due to her pre-existing type 2 diabetes, she could not get coverage from standard insurance carriers. My wife was 62 when the law was enacted — too young for Medicare. Her premiums went down with Obamacare — not up — with no subsidies. The good news is her premiums will go down again next year when she gets on Medicare. The bottom line is that Obamacare is flawed because it didn’t go far enough. Everyone should be on Medicare — and we should find a way to pay for it. Though Americans pay more for health care than any other developed country, our quality of care is not any greater. Americans should ask our congressmen and senators why. — Randy and Linda Johnson, Georgetown

ACA lisa federico 2

Lisa Federico with husband John and daughter Elodie (Melissa Glynn)

In December 2013, I was newly pregnant and working long hours as a self-employed consultant at a global law firm. Our COBRA policy was set to expire. My husband, John, was the third employee in a dot-com that offered no benefits. As pregnancy was considered a pre-existing condition, agencies were well within their rights to deny us coverage regardless of our willingness or ability to pay premiums. Through the ACA exchange, we enrolled in a policy and suffered no gap in coverage. That summer, our daughter Elodie was born with a previously undetected, life-threatening birth defect called duodenal atresia. Without this coverage, we would have lost everything to save her life. The bills from her surgery and monthlong neonatal intensive care unit stay totaled upwards of $500,000. We were so fortunate to pay a small fraction, thanks to the ACA. I urge your readers to consider the many hard-working families like ours that rely on the ACA’s protections. — Lisa Federico, Austin

0323 ACA Nabours 2

John Henry Hayes Nabours, son of Michelle Beebe Nabours (Contributed)

My son was prenatally diagnosed with a congenital heart defect that would leave him with one functioning ventricle and require a series of surgeries over his lifetime — two of them in the first six months of life. Today, my son is a sweet and mischievous 18-month-old toddler, thanks to an incredible medical team. But we have a long road ahead of us, and access to a good health care policy is a top priority in my world. The ACA means my son will have medical coverage for the rest of his life and will not be punished because he has a pre-existing condition. It means he won’t face a cap on his coverage. The idea that lawmakers could repeal Obamacare without a ready replacement is terrifying to families like mine. I guess when you have free health care for life — like our congressional representatives do — the rest of us don’t matter. — Michelle Beebe Nabours, Manchaca

ACA Laurie Filipelli

Laura Filipelli (Contributed)

Today is my daughter’s eighth birthday. She was born not long after Obama’s first inauguration. Before I got pregnant, I’d left a teaching job in favor of working with an educational nonprofit, though it offered no health coverage. Wishing to have a child, I stayed on COBRA and paid a $600 monthly premium. Two miscarriages later, a pregnancy stuck. My insurance coverage did not. COBRA terminates after 18 months. Because my pregnancy was deemed a pre-existing condition, I had no other viable option. My daughter’s birth was a 24-hour ordeal that was made harder because I was uninsured. Though my husband and I gained a beautiful child, we watched a down payment for a first home disappear. Our daughter’s middle name is Hope. Our hope for uninsured expectant parents was realized, albeit imperfectly, with the ACA. By repealing it, Republican lawmakers dash dreams and health for countless families, leaving them financially at risk. — Laurie Filipelli, Austin

032216 ACA Carolyn Blake

Carolyn Blake (Contributed)

My family had been waiting for March 15 for five years. It was the day I donated my kidney to my mother — so that she can live her life free of a machine. I remember sitting in the clinic and my donor advocate asking me what my plan is if the ACA is repealed, explaining that a kidney donation will count as a “pre-existing condition.” Without the ACA, health insurers can refuse to cover me. I went through a litany of health tests to even be chosen as a donor and am told I will live an ordinary life after surgery. Now I could be denied coverage at age 26. What about when I want to start a family? What if something else goes wrong? This gift to my mother is now a financial liability. I want to be part of a society that encourages giving life, not one that punishes donors. — Carolyn Blake, Austin

More than 133 million Americans like me have pre-existing conditions. For the first time in America, people with pre-existing conditions cannot be denied health coverage or charged exorbitant rates. The ACA prohibits these things. Now Republicans in Congress want to repeal the ACA, including the individual-responsibility part of the law. I know this is a tough pill to swallow, but maintaining protections for people with pre-existing conditions without requiring individual responsibility would cost millions of us coverage and increase premiums for even more of us. Health care reform is personal. Millions of lives are affected. The ACA allows those of us with pre-existing conditions to live healthier and more-productive lives. It also allows us to change jobs without losing health insurance. As Republicans work to repeal the ACA, I implore them to also follow the physician’s oath to first do no harm. — Janie F. Galko, Austin

ACA David Butler

David Butler (Contributed)

With the government push to repeal and replace Obamacare, why not consider a simple solution? Principal criticisms of the ACA are inflexibility and high costs. Tenets of a “replacement” plan are flexible coverage alternatives and interstate insurance options. These objectives could be met by simply amending the existing system. Allow insurance companies to offer alternative plans in addition to the existing four ACA plans. A similar approach has worked in Medicare Part B, where “Advantage Plans” are offered in addition to original “Supplement Plans.” Let the public choose which plan is best for them. Allow access to individual state insurance exchanges from any state. This change would introduce competition and reduce costs. Why subject the nation to the Sturm und Drang of “repeal and replace” when it would be so simple to amend the existing system? An amendment would be a bipartisan, win-win solution — and it would be best for the public. The plan’s name is irrelevant. — David Butler, Georgetown

ACA Jo Rae Di Menno

Jo Rae Di Menno (Contributed)

I am in full support of the Affordable Care Act. I have been able to obtain health insurance since its inception. Prior to ACA, I was paying $587 per month for health care through Blue Cross Blue Shield High Risk. It was a terrible plan and offered nothing beneficial. It was the only insurance I could obtain due to benign thyroid nodules. When ACA started up, I was able to have health care without having to worry about any pre-existing conditions and high monthly premiums. I am currently utilizing Sendero Ideal Care through the ACA. I am very happy with my doctors and the care I receive. — Jo Rae Di Menno, Austin

ACA Herman Morris

Herman Morris (Contributed)

Just as Martin Niemoller once said, I now say: “First they came after Obamacare, and I did not speak out, because I was not on Obamacare. Then they came after Medicaid, and I did not speak out, because I was not on Medicaid. Then they came after Medicare — and there was no one left to speak for me.” I am an 89-year- old with serious and expensive medical problems. Now, I am scared to death that I will have no medical coverage in my final years as I try to stay alive with some comfort and dignity. — Herman I. Morris, Plano

WHOM TO CONTACT

The following lawmakers represent Central Texas:

U.S. senators

  • John Cornyn: 202-224-2934; 517 Hart Senate Office Bldg., Washington, DC 20510
  • Ted Cruz: 202-224-5922; Russell Senate Office Bldg 404, Washington, DC 20510

U.S. representatives

  • 10th District: Michael McCaul (R); 202-225-2401; 2001 Rayburn House Office Building, Washington, DC 20515
  • 17th District: Bill Flores (R); 202-225-6105; 2440 Rayburn House Office Building, Washington, DC 20515
  • 21st District: Lamar S. Smith (R); 202-225-4236; 2409 Rayburn House Office Building, Washington, DC 20515
  • 25th District: Roger Williams (R); 202-225-9896; 1323 Longworth House Office Building, Washington, DC 20515
  • 27th District: Blake Farenthold (R); 202-225-7742; 1027 Longworth, Washington, DC 20515
  • 31st District: John Carter (R); 202-225-3864;2110 Rayburn House Office Building, Washington, DC 20515
  • 35th District: Lloyd Doggett (D); 202-225-4865; 2307 Rayburn House Office Building, Washington, DC 20515