You may know me as a political pundit and writer who has spoken publicly about how the Affordable Care Act negatively affected my family. What you might not know is two years ago, I was a seven-month-pregnant widow with one toddler who got a letter two weeks after my husband died, informing me I’d lost my third or fourth health insurance plan since the Affordable Care Act passed. If you’ll remember, the promise was that I could keep my plan if I liked it. I could not.
I predicted what would happen to my family’s insurance, and to much less fortunate people subjected to the exchanges with us, many of whom have seen doubled premiums and tripled deductibles. If you’ll remember, the promise was everyone’s premiums would go down. They did not. For predicting it, I was routinely called a lying hack in public. It’s a hazard of the job, but I wasn’t lying. I was right. I also thought it was improbable the federal and state governments could handle building these exchanges and that they’d likely blow up and be inoperable, thereby preventing people like me from actually purchasing the new plans the ACA required we purchase. Again, I was not lying for partisan gain.
ACA has helped people. I know some of them well! I have two friends with serious health challenges, one of whom I can say was probably kept alive by Obamacare; the other by the fact she was able to keep her grandfathered pre-ACA plan. I am not in the habit of asserting any piece of health legislation is either perfect or a tool of evil designed by hateful actors. They’re not. I will not assert either of these fundamentally shallow and manipulative things about either ACA or adjustments to it (and, yes, this piece of House legislation is an adjustment or a reform, not a repeal, which would change dramatically in the Senate if taken up and change again before eventual passage).
I’m Not The Only One Stuck With A Costly, Ineffective Plan
It has come to my attention that, even among those who should know, or assert they know a lot about health care policy and the market, many don’t know that people like me exist. But there are many of us, many with far fewer resources than I, who now have much more expensive, less effective, junkier, nearly unusable plans than we had back when our allegedly “junk” plans were outlawed. Again, we are not the only ACA story. But we are part of the story, we were sold a bill of goods, and we’re often overlooked.
There aren’t a lot of good answers, here. There are many reasons for that, which start in the mid-20th century with a fundamental distortion of health-care markets through wage-and-price controls, and then a tax benefit that incentivized employer-based health insurance. ACA was not a good answer. AHCA likely isn’t a super one either.
In any system, and any change to a system, there will be people who come out on both the good and bad sides of the deal. When Obamacare supporters denied this truth applied to ACA, it was wrong. There’s the possibility of marginal improvement to it, but not if you do nothing, as insurers and customers alike pull out of exchanges because they can’t afford to stay in them. Yet another major provider announced this week it will drop out of the Virginia exchange. Republicans were elected several elections over to address just this problem.
We Can’t Ignore The People Hurt By Obamacare
Most people who aren’t in the individual market, which is the one most affected by ACA, have no idea what the plans look like. It is a market where the costs of the bill’s mandates are more visible, even when subsidized. When I cite exorbitant deductibles, folks tell me to suck it up and pay $3,000. I laugh at a $3,000 deductible. What in the old system was considered a very high deductible is now among the lower available, and premiums for any kind of deductible are high, even with subsidies. Many families have to hit $12,700, and they’re paying a mortgage-sized premium. For many, the purchase becomes hard to justify or supplants an actual mortgage or similar outlays.
Arguing about this as if beneficiaries of ACA don’t exist isn’t right. Arguing about it as if people like me don’t is also not right. ACA was never the panacea it was sold as and it remains distinctly un-utopian in its results. Lazy characterizations of things you like as perfect—and of people you oppose as big fans of people dying—are not particularly helpful to actual people.
So if you’re weaving a utopian or dystopian scenario for Facebook, remember reality is almost always less extreme and more nuanced than you’re asserting, and you probably know a real human on both sides of every imperfect adjustment to our Frankenstein system.
One of them was a pregnant widow who had to spend her 32nd week of pregnancy and the first week after her husband’s funeral calling midwives, doctors, insurance companies, and help lines to make sure she’d still have the third plan she was promised she could keep.
My family may be the trade-off that was worth it for you to implement ACA. And I’m actually fine with you thinking that, as long as you don’t pretend we and the rest of the people like us don’t exist. We’re probably never going to stop arguing about this, but arguing responsibly and empathetically is better.