Do you or anyone you know or love have any of the following health issues: Alzheimer’s, arthritis, cancer, Crohn’s disease, cerebral palsy, cystic fibrosis, diabetes, epilepsy, heart or kidney disease, mental disorder, multiple sclerosis, obesity, Parkinson’s disease, sleep apnea, or stroke? If yes, you are impacted by what the insurance industry euphemistically calls a pre-existing condition.
Three of my grandchildren have serious pre-existing conditions. Two are on the autistic spectrum and one is living with cystic fibrosis. My grandkids didn’t ask to be born with these disabilities and their parents would gladly change places with families who don’t have to pay huge amounts for insurance to cover their children’s needs. Their parents have struggled to find and afford healthcare coverage that pays for the care they require. Over the years, they have had to search for very expensive private plans and make life and job decisions based on this need. Now there is a bigger worry.
The Republicans have tried to get rid of the Affordable Care Act (ACA or Obamacare) at least 60 times in the past few years. They have come close. Remember John McCain’s famous thumbs down? On July 28, 2017, he cast the deciding vote against the GOP’s attempt to dismantle Obamacare by repealing the individual mandate. Now, there is a new plan of attack – the courts.
A Texas lawsuit, Texas v. US, is working its way through the court system. If it ever reaches the Supreme Court, there is now a 5/4 conservative majority that is likely to rule in favor of the individual mandate being unconstitutional. The argument then goes that the entire ACA must be struck down because you can’t sever the mandate from the law itself. If the mandate is unconstitutional, then protections for people with pre-existing conditions are also unconstitutional. Without the mandate, it will be impossible to attract enough healthy people to the insurance marketplace to fund protection for those who are sick or have pre-existing conditions.
That’s complicated for me, a non-lawyer or health insurance advocate, to explain. You can go HERE or HERE to read more about it. What I can tell you, however, is what it was like for my husband and me to get health insurance when we were much younger and pretty healthy. Twenty-five years ago, insurance companies were allowed to define what constitutes a pre-existing condition and deny coverage. My husband and I were healthy and in our late forties. He was a self-employed physician and I worked for a small not-for-profit that didn’t offer health insurance. We had private insurance coverage and had never made a substantial insurance claim. Yet, we were priced out of the market by the insurance industry.
I had a benign thyroid nodule since my early thirties, easily treated by taking an inexpensive medication. My husband had experienced one episode of kidney stones. Our private insurance company refused to issue a new policy and would only give us coverage that excluded me from any disease involving my thyroid and my husband from any illness involving his kidneys. And our rates were raised substantially. Thyroid or kidney cancer would have bankrupted us.
We were very lucky to be accepted for a state policy that covered people who were uninsurable. It cost us $24,000 a year, which would be $41,613 in today’s dollars. If you think you are young and healthy enough to go without insurance, or that you do not have a pre-existing condition, think again. There is a reason folks look forward to becoming eligible for Medicare.
Trump’s Justice Department has decided not to defend the key provision in the Affordable Care Act that guarantees access to health insurance regardless of any medical conditions. That’s unprecedented as the Justice Department is supposed to defend laws passed by Congress. Until Congress changes the law, our executive branch is supposed to execute the provisions of the ACA, not execute those of us deemed to have pre-existing conditions. Should the Texas lawsuit ultimately succeed, an estimated 17 million people could become uninsured in 2019.
As a just and caring society, it is our duty to make sure those who have a pre-existing condition, from newborns in the NICU to people with chronic illnesses and lifelong disabilities, receive the healthcare they need. No family should have to declare bankruptcy or create a "go fund me" page to obtain treatment for a loved one with cancer. The one aspect of the ACA that most Americans agree is worth fighting for is ensuring that our fellow citizens with pre-existing conditions cannot be denied insurance.
Regardless of your political persuasion, this effort to take us back to the era in which someone like me with a benign thyroid nodule could be denied coverage or forced to pay an exorbitant amount for insurance is wrong. If you are a healthy person who is not yet eligible for Medicare, don’t kid yourself that this could never happen to you. I hope you never get sick enough to have a pre-existing condition. If you have a child or loved one with a disability, this change will mean an uncertain future for that person.
Shamefully, the United States is the only of the top 51 highly developed countries without universal healthcare. Healthcare should be a right for all. When we don’t protect our fellow citizens, those who are sick or disabled, we are out of step with basic human decency.