Putting a face on the Affordable Care Act
In recent months, discussion of the Affordable Care Act in the media has been mostly negative, with seemingly little acknowledgement of the everyday health care challenges faced by those who are without insurance.
Do you recognize a family member, friend or neighbor in any of the following situations?
Susan is a single female over 40 years of age and works less than 30 hours per week for a company that does not provide health insurance. She currently has several preexisting health conditions and probably would not qualify for an individual health insurance plan, even if she was able to include it in her budget.
Pedro is a married agricultural worker, who is unable to access health insurance through work. A legal resident with a wife and four children, he has been unable to provide consistent access to primary care for his family. His children are behind on their vaccinations, putting them at risk for many preventable childhood infections.
Bob is divorced with two children and works fulltime for a small company that does not provide benefits. He has a history of substance abuse problems and is devastated by a recent diagnosis of Hepatitis C.
Arthur is a small business owner with five full time employees. In the past, he was offered health insurance as a benefit, but had to drop insurance when his business struggled to maintain profitability during the recession.
What will happen to Susan, Bob, Pedro and Arthur if one of them, or a family member, has an accident or gets sick?
She or he may do nothing, hoping that the situation will resolve without treatment.
However, if the condition gets worse, she or he will probably end up in a hospital emergency room, getting treatment for the problem, with little prospect of being able to access appropriate follow-up care.
Bob, for example, will not be able to obtain ongoing treatment for his Hepatitis, putting him at risk for liver cancer or cirrhosis.
Constant uncertainty in regard to health care is very stressful to individuals and families, and this is why current attempts to undermine the ACA are so concerning.
Surely, individuals without access to insurance through work, those who have lost jobs, the working poor and those living under the poverty line deserve access to affordable health care.
Much of the ACA has already been implemented and it is mainly the "mandates," both individual and business, that are still being debated.
Accessing health insurance through the new "insurance marketplaces" is complicated, and the process of explaining the law to those who would benefit is being made more difficult by constant efforts to defund the law.
In addition, Florida's decision not to expand Medicaid has further undermined the implementation of the law. This means that many of the individuals the ACA was designed to help will not be able to benefit, even though our tax dollars are contributing to making Medicaid expansion possible in many other states.
In reality, the implementation of the ACA, which began in 2010, has brought, or will bring, benefits for most Americans.
Just a few of the changes already implemented include parents being able to cover children on their health insurance until the age of 26, insurance companies being prohibited from dropping coverage if premiums have been paid, elimination of lifetime caps on coverage and reduction of the doughnut hole for Medicare part D recipients.
Many more great improvements are promised in 2014, when, among other protections and quality improvements, the annual cap on coverage will be removed and insurance will not be able to be denied to those with pre-existing conditions.
If we can view the ACA with an image of how it can help Susan, Bob, Pedro and Arthur, how can we not see that they, and our own friends and family members, will benefit greatly from this law?
It's time for all of us to embrace the ACA, thus ensuring that, at last, all Americans can have the advantage of access to affordable health care.
Jo Shim, Cocoa