The View From Your Obamacare

Apr 18 2014 @ 3:40pm

A reader writes:

Thank you so much for giving me a platform to share my Obamacare success story! Well, actually, it’s my brother’s story and it starts about a year ago. He was 25 and working for a small radio group in President Obama Visits Boston To Talk About Health CareIthaca, NY. He got into a PhD program at IUP, and since he was barely making any money, he decided to quit his job and spend the summer relaxing and traveling and visiting friends before starting school.

Those plans got thwarted when he was diagnosed with thyroid cancer in June. Three surgeries later, I am happy to say that he is in recovery and doing great, but damn, my family would’ve been fucked without Obamacare. It let my brother stay on my parents’ insurance, so he was covered when he got his diagnosis. I’m not sure what the costs of his treatment have been exactly, but the bill for just administering the radioactive iodine pill he had to take was almost $200,000. When you add to that all the tests and the three surgeries, the costs have got to be close to a million, if not more. My family would likely be considered well-off, but those costs would’ve bankrupted us.

It’s possible that he would’ve been on Cobra without Obamacare, but I think it’s at least equally likely that he would’ve decided to just wait until he could join the school plan because Cobra is so expensive. At the very least, Obamacare has saved my family from significants costs. And, because he now has a pre-existing condition, it’s the only reason he can buy health insurance and will be able to for the rest of his life.

A reader in Georgia:

My ex and I are splitting soon. I’m leaving my job in a few weeks and moving to another state across the country and will be unemployed for a few months as I switch careers. He’s staying here and working his way through his last couple of semesters of college. He has a pre-existing condition that requires medical oversight and expensive prescriptions. Until I leave my employer in a few weeks, I pay for his insurance through my employer-provided domestic partner coverage. Now that I’m leaving my job and moving to another state, he will have to purchase insurance on his own, something that was impossible before Obamacare due to pre-existing exclusions from the individual health insurance market.

Because we live in a GOP state, thanks to Obamacare, he can buy insurance (yay!) but doesn’t make enough to qualify for subsidies (boo!).

Instead of something affordable, he has the option to pay full-cost for ACA medical coverage ($200 to $250/month) in addition to the deductibles for medical visits and prescriptions needed for his medical condition. He doesn’t make enough annually to qualify for subsidies because he is a full-time student and part-time employee. If Georgia had opted into the ACA Medicaid expansion, he would have qualified for that, saving the monthly premium altogether.

There couldn’t be a starker contrast between the two parties on healthcare. The Democrats want to make it available to millions of Americans like him and the Republicans are doing everything in their power to prevent that from happening. As a bonus, they are also fighting against raising the minimum wage, which would be a huge boost for all the students out there who have to support themselves and go to school. More and more, the GOP seems to be working against hard-working Americans and not for them. I don’t understand why more people don’t see this.

Another reader in a red state:

I am a physician working in Indianapolis. Much of my work is at a county hospital system that supports the poor of the city by providing healthcare to any citizen in the county regardless of their income. Obamacare has allowed many of these patients to come off the county system’s rolls.

Indiana sadly has not fully expanded Medicaid because our governor, uber Republican Mike Pence, refuses to do so. Even without expanded Medicaid, many of my patients have been able to sign up and all are incredibly appreciative. One interesting effect is that many of them now have the ability to get a second opinion and different care options because they are no longer tied to the county system. I started to get worried about our system (and myself) when after the first of the year, I had about five patients leave for second opinions but was rewarded by all of them returning to our practice. Obamacare has allowed these patients to both not be tied down to a system strapped for funding and also gain confidence in the care they receive when they note that we are caring for them just as well as they can get elsewhere.

Our system has its limits and we can’t provide some very expensive care, like radiation, but Obamacare allows these patients to find providers that can give this care. This effect will reduce suffering and prolong lives. I have always been a big supporter of this legislation but the benefits I am seeing are remarkable and under reported.

Another in the medical field:

I have a lifelong chronic disease, Crohn’s, for which I take a biologic that costs about $130,000 per year. These meds keep me and many other people healthy, and out of the surgical OR and off emergency room beds. It also saves me from debilitating pain and allows me to be a productive member of society. Before the ACA, I was stuck paying incredibly high premiums (>$1300/mo) through COBRA and then a HIPPA conversion plan.

Unfortunately for me, I live in a state that did not (yet) expand Medicaid, and since I am a no-income student, I do not qualify for subsidies on the exchanges. So instead, I use my school’s health insurance plan, which is better than nothing, but not excellent. With no out-of-pocket-maximum, I end up with about $10,000 of out of pocket costs every year.

While the ACA hasn’t given me cheaper insurance, it has given me immense security knowing that if my circumstances change, my medical care won’t suffer. As you wrote of your own experience, “It gave me a baseline of security that simply didn’t exist before.”

Finally, and perhaps most interestingly, as a medical student, the ACA has changed the landscape for medical providers. I anticipate that it will pump money into the medical establishment’s pockets much like Medicare made physicians rich several generations ago (and continues to do so today). Whether that is a good, bad, or neutral thing, I can’t say. But for those people who now newly have access to a lifesaving service, it is of incalculable value.

(Photo by Yoon S. Byun/The Boston Globe via Getty Images)