Guest Post, Obamacare — December 23, 2013 at 8:22 am

GUEST POST: What the Patient Protection and Affordable Care Act means to people like me


Obamacare provides more than affordable coverage. It protects patients and their rights, too.

December 23 is the last day you can buy health insurance at that kicks in on January 1, 2014. You can continue to buy coverage for 2014 through March 15.

As people enroll for coverage, there’s been an emphasis on the “affordable” aspects of the Patient Protection and Affordable Care Act (PPACA), also known as the ACA and Obamacare. But it’s important to remember how the law protects patients in ways they’ve never been protected before.

We’re pleased to have Emily Todebush return for a second guest post. She previously submitted a powerful open letter to Michigan Senator John Pappageorge on Medicaid expansion in July.

Here, she shares her personal story once again, to underscore the importance the patient protection aspects of the PPACA. It’s also a reminder that even the healthiest young people might find themselves needing insurance.

We thank Emily for her advocacy, and wish her good health and happiness in the year to come.

A lot has been said about the Patient Protection and Affordable Care Act (PPACA) in the last few months. Some of the criticisms are valid, particularly the catastrophe that surrounded the website in October and November. Luckily those issues were able to be remedied, and thousands of people are accessing the website now without incident and signing up for their new health insurance coverage.

We lost sight of what this bill is all about over these last few months of dealing with those technical issues. It’s time to refocus our attention on what this bill means to folks like me.

Just one year ago, I was an extremely healthy young adult who rarely got sick. That changed late last year while I was working on President Obama’s reelection campaign. I started noticing little issues that began going wrong in my body. It started with a pain behind my right eye in October, which I brushed off because I was uninsured and didn’t think it was anything serious. Given my health history, I didn’t think that was an unreasonable assumption. I had started a new job in July and had a gap in my health insurance coverage until November 1 and thought I could easily wait until then if the eye pain did not clear up on its own. Unfortunately, that eye pain did not go away. Soon it was accompanied by numbness and tingling along my right arm and leg. That tingling slowly radiated outward until I reached a point where I was experiencing total numbness in my abdomen and the entire right side of my body. I was terrified, but I knew I had to hold out until the beginning of November.

November 1 arrived and I was finally covered by my company’s health insurance plan. I had an appointment that day with my internist. From there, I was sent to a neurologist and ophthalmologist. Naturally, because of the holidays, it took every connection I had to get into these doctors before the end of the year. I knew something was horribly wrong, and I wasn’t going to take no for an answer.

After many visits to specialists and dozens of tests, I was eventually diagnosed with Relapsing Remitting Multiple Sclerosis.

The PPACA has been under the microscope lately regarding what it does and does not do. For someone like me, who now has a preexisting condition and a disease that will require a lifetime of care, the PPACA is a game-changer. Before the PPACA, my insurance company could have kicked me off of my insurance policy once I reached my “lifetime maximum.” Many folks look at a $1,000,000 limit and think that they will never, ever hit that mark. I suspect those folks have never faced a significant health event, because the costs are staggering. For example, I am not even through my first year of care and my insurance policy has been charged nearly $100,000. Because it is a nice round number, let’s use that figure as an annual benchmark for the cost of my health care. Given the $1,000,000 lifetime maximum of my policy, that would have meant my insurance carrier could kick me off of my policy (before the PPACA went into effect) in roughly ten years – at the ripe old age of 38. That lifetime maximum doesn’t seem so high anymore, does it?

Let’s continue with our thought experiment. Imagine for a second that I was kicked off my insurance policy for reaching my lifetime maximum and was now required to look to the private market for a policy. Before the PPACA, insurance companies had the ability to deny me coverage because of my preexisting condition. So at 38 years old I could have been removed from my existing policy for hitting the lifetime maximum and would have been unable to get health insurance from any other provider simply because of that preexisting condition. So, to those of you who roll your eyes when you hear someone on the news saying that there are people who might die without the Affordable Care Act: please, remember this story. MS does not provide a quick death, instead causing a slow breakdown of function and body processes that is heartbreaking to watch and agonizing to experience.

Luckily, though, that thought experiment is not reflective of the world we live in today.

Thanks to the enactment of the PPACA, I have peace of mind knowing that my preexisting condition is no longer a potential barrier to my healthcare. I don’t have to worry whether I may or may not hit some arbitrary “lifetime maximum” set by my insurance company. I am able to get high-quality care that helps me live an amazingly fulfilling life. Sometimes after you have been diagnosed with a chronic and incurable condition, you feel like you’re now on borrowed time. Every day that I am able to move around normally and symptom-free is a gift. Without proper medical care, that wouldn’t even be a possibility because this disease that I did not ask for — and did nothing to prompt — would have the ability to take over my body at will.

I am the first person to recognize how incredibly fortunate I am to have an employer who takes pride in the commitment of providing excellent benefits to their employees, but not everyone is that lucky. The Patient Protection and Affordable Care Act gives everyone the peace of mind of knowing that we can go to the doctor, we can get sick, and we don’t have to face financial ruin because of it.