Every day, it looks more and more likely that the Affordable Care Act will be repealed sometime in the near future. Already, a 51-48 vote on January 12 in the Senate made it possible for huge pieces of the Affordable Care Act (ACA, and also known as "Obamacare") to be repealed through something called "budget reconciliation," which means it cannot be filibustered. Many have talked about how many Americans will lose health insurance if it is indeed repealed, but the number of people who will be without health insurance if Obamacare is repealed can sometimes feel abstract. In my life, and for my family, this is not an abstract issue. At the risk of sounding melodramatic, let me say that the repeal of the Affordable Care Act would be dangerous for my family. In fact, undoing universal healthcare coverage represents not just a threat to our health and wellness, but a threat to our very lives.
My wife and I are covered by insurance which we are eligible for due to a Medicaid expansion which was part of the Affordable Care Act. Prior to that, I was completely uninsured for the majority of my adult life, and that made getting sick both difficult and scary. While my child will still (most likely) keep his insurance, having his primary caregivers have no access to basic healthcare puts him, as well as us, in a precarious position. To lose our insurance makes every illness, no matter how small, a potential threat to the stability of our family, and that is a fear that is literally keeping me up at night.
Back during the glory days of the election, when many of us still had hope for a brighter future, there was a lot of speculation about what was next for the Affordable Care Act. Donald Trump talked about repealing the ACA and replacing it. Yet Trump's statements about keeping key parts of Obamacare caused many people to believe that he wouldn't really kill it. Forced to choose which version of Trump’s reality to believe, many people said that he wouldn’t — and couldn’t — possibly repeal Obamacare. Since the election, many friends and family members have told me that my fears were unwarranted and overblown. Even many of his own supporters believed that his promise to get rid of the health care legislature was an empty bluff.
But as the inauguration creeps closer and closer, we are forced to face reality. It isn't only Trump; the GOP has made the repeal a major priority. To assume that they wouldn’t try to repeal Obamacare was wishful thinking at best, and willful ignorance at worst. And for a family like mine, the loss of the Affordable Care Act spells disaster.
I’m a low-income parent. I don’t have a ton of money, and I really never have. I don’t have a college degree, and I don’t have a “career” in the sense that most middle- and upper-class people mean by that word. I do the best that I can with what I’ve got, I work hard, and I get by. There was a time in my life when I imagined some kind of upward mobility for myself, that one day if I worked harder enough, I (just like my parents!) would be able to achieve my financial dreams. After the financial crisis of 2008, however, that looked a whole lot less likely. Like so many other millennials, I faced decreased job prospects, and a growing sense that the American dream might just be impossible for many of us.
I have (mostly) come to terms with that reality. I’m not a terribly materialistic person, so I’m not heartbroken about not having a ton of things, as long as my basic needs are met. And yet, throughout most of my adult life, one basic need was left horrifically neglected: healthcare.
The Affordable Care Act changed all of that. It got a lot of people who weren’t insured access to medical insurance, both through the market and through a medicaid expansion that went into effect in 31 states. My state was one of those states, and my wife and I are two of many adults in Michigan now on Medicaid insurance. To say it changed my life would be a massive understatement. Was it a perfect piece of legislation? No way! Was it exactly what I would have wanted? Absolutely not! But unlike my musings about single payer and socialized medicine for everyone, the ACA had the advantage of actually existing in the real world.
Before Obamacare, each time I got sick was fraught with peril. What if I needed to see a doctor? Would I be able to find someone who would see me without insurance? How much would it cost? And what if I needed prescription drugs for my illness? Would there be a generic version available? How much would that be? And would the pharmacy take pity on me? A case of sinusitis (something I’ve gotten at least once a year since childhood) could easily run me around $200. When you add that to the lost income from being unable to work, it was always a major financial blow. And always, looming on the edge of my mind, was this one horrible fear: what if something really, really bad happens?
Plenty of people believe that, as a poor person, if I get sick, I should have to suffer the consequences of… being a poor person who dared to get an illness. But this isn’t just about me. I have a child.
But these days I have insurance. Having insurance means that if I get sick, I can go see a doctor. It meant that, when my gallbladder went haywire after my son was born, I went to the hospital. It still sucked, but I was able to get the care I needed and focus on getting better. My kid also has insurance under Medicaid, but since he's a minor, he would qualify for that insurance with or without the ACA. That said, he still benefits hugely from having parents who are well enough to take care of him.
And now I’m almost definitely going to lose that sense of security, and it is utterly and completely terrifying. That terror is intensified by the fact that, for whatever reason, this winter has been rough on my body. I’ve been sick almost continually since Thanksgiving, with only brief breaks between illnesses before getting hit with something else. Navigating that has been rough, and it would be rough no matter what. But without insurance? It could have easily meant getting our heat turned off, or worse.
I believe that each and every person in this country, myself included, deserves access to healthcare. But obviously, plenty of people do not believe that. Plenty of people believe that, as a poor person, if I get sick, I should have to suffer the consequences of… being a poor person who dared to get an illness. But this isn’t just about me. I have a child. And again, while he likely won't lose coverage after the repeal, it still affects him.
My son deserves to know that our ability to keep a roof over his head is not contingent on our not getting the flu. He deserves to know that if something goes wrong, if any member of our family is ill or injured, we’ll be able to address it. He deserves parents who can access healthcare in a timely manner when they need it, so that they can get better and get back to taking care of him.
In all likelihood, my kid will still qualify for state health insurance under medicaid even without the ACA. Prior to the Medicaid expansion, children from low-income families were covered here in Michigan, just not low-income adults. That’s good news for him, but both of his parents (my wife and I) will certainly lose their insurance. That majorly affects him. My son deserves to know that our ability to keep a roof over his head is not contingent on our not getting the flu. He deserves to know that if something goes wrong, if any member of our family is ill or injured, we’ll be able to address it. He deserves parents who can access healthcare in a timely manner when they need it, so that they can get better and get back to taking care of him.
Losing Obamacare, and thus mine and my wife’s health insurance, means entering into a time of insecurity and constant worry for my family. It means living constantly on the edge, knowing that one illness or injury could always be the thing that sends us over. And frankly, we’re lucky in many ways. We're relatively able-bodied and able to work, our health problems have (mostly) not been horrifically dire, and we do have friends and family that are sometimes able to help out. For some people, losing Obamacare will simply mean death.
As we look to the future, as it becomes more and more apparent that many people in power simply do not care about people like me, it is hard to be optimistic. Instead, I’m a total wreck. I’m left wondering how soon the other shoe will drop, and how much medical care I’ll be able to squeeze in before I’m back on the “cross your fingers” health plan. It shouldn’t have to be like this. The ACA showed me that another world was possible, a world in which people like me could live with some dignity. But these days that feels like a pipe dream, and honestly, I’m utterly terrified.