ACA Realities


It has begun. The hysterical posts on social media describing the devastation to Americans if Obama’s Affordable Care Act (ACA) is repealed. The scare tactics are typical politics. All fear, no facts. Politics aside, here are two stories of real Americans and their experiences with ACA.

Mary is a 60-year-old woman in the Midwest who retired last year due to health issues. Affordable health care through her husband’s employer was unavailable, so she purchased an ACA plan. For a household making around $40K per year, Mary’s subsidized premium was still almost $800.00 per month, with a $10K deductible before covering any services or medications. This past fall she received notification that her premium increased to $948.00 per month. Mary must pay 21K per year (premium and deductible) before anything is covered. These exorbitant premiums and deductibles consume most of the family’s take home income. Even with ACA, Mary has not had a mammogram or other preventative care. She has since canceled her ACA and remains uninsured at this time.

Keith is a full-time employee with a company that until recently provided traditional insurance. Keith’s employer recently announced a switch to a to a plan costing employees double, with an $8K deductible per person per year. His gross yearly pay is 42K and he and his spouse must pay 18K per year before they can use any services.

The ACA, while covering a select few, has allowed insurance companies to shift all of the costs of healthcare to individuals, eliminated the need for companies to compete for benefits to attract and retain employees, and acts as a form of pseudo-insurance. People are “covered” but still have no health care.

People like Mary and Keith forgo cancer screenings, skip out on important medications for diabetes and heart disease and regular doctors visits due to the prohibitive costs of ACA.

Trump has an opportunity to make a real difference. There are provisions of the ACA that were useful. Pre-existing condition restrictions and lifetime caps were eliminated. Children can now be covered until 26 years old. These changes are positive, but high deductible plans fail to provide actual care.

People making middle-class wages can not afford the ACA as it currently exists. Trump thus far as alluded to a high-deductible plan with a Health Savings Account (HSA). These plans are still pseudo healthcare for those with chronic conditions. Heart disease and diabetes affect millions of Americans. Medications and supplies for these conditions can be thousands of dollars a month. Compound this with complications and hospitalizations due to lack of access to care and the ACA is not saving money. HSA will not benefit these people in middle class American other than some minor tax benefits.

Trump should recognize the need for all Americans, not just the healthier in the group. There should be multiple types of plans available, at various cost options and a system that promotes competition and lower prices. Companies need financial incentives to contribute to the expenses of their employees on both the premiums and HSAs. Without incentives, companies will happily shift all the expenses to their employees. Above all, any plans Trump sells to the public should be the mandatory coverage for members of Congress.

President Trump, Americans are counting on you. Big Government says people grossing 40K a year must pay most of their income for health care. After taxes, these plans literally leave no money for anything else. We are counting on a practical, high-quality plan that not only meets but exceeds expectations. In the interim, mothers, daughters, fathers, and sons are going without crucial health care services, cancer screenings, and medications under the guise of being “covered.”

The ACA as it currently exists promises much but delivers little. This fallacy is unacceptable in America. We demand and deserve better.

Mr. President, do not let us down.