Sunday, January 22, 2017

I'm bipolar.

Before the Affordable Care Act, I was completely uninsurable -- no special considerations, no gray areas -- if I was unemployed, which I was for over a year before the ACA was enacted ... though I did qualify for relatively expensive COBRA coverage through my former employer that very fortunately filled that time gap.

But COBRA eligibility expires after a fixed time, and without the ACA -- and until I could get stabilized enough to hold a job -- my expanding schedule of doctor visits and my compounding and perpetually evolving psychotropic prescriptions and my surprise hospital visits would rapidly drain me to bankruptcy and eventually relegate me to living on expensive federal disability coverage.

I now have a job but I'm staying with my ACA-sanctioned plan because it specifically covers the entire network of doctors and specialists and pharmacies and hospitals I've managed to assemble and sign release forms for and ensure are thoroughly and reciprocally sharing my complete medical history. Plus I'm not 100% stable and I'm still -- and definitely not without precedent -- spooked about becoming unemployed again, and my ACA-sanctioned plan gives me tremendous peace of mind about maintaining a reliable continuation of coverage.

Let me clarify for the sake of precluding any tedious welfare-state arguments that might arise that I am paying the full premiums and co-pays and deductibles for my coverage and am receiving no federal subsidies. U.S. households with incomes between 100% and 400% of the federal poverty level are eligible to receive federal subsidies for policies purchased through the Affordable Care Act exchanges, as they should be. For me, the ACA simply allows me to purchase coverage through a broker or directly from an insurer just like anyone else, with no restrictions or refusals for having a pre-existing condition.

Four weeks ago, I started taking a powerful psychotropic that within a day caused me to black out, slam my head into a tile floor, shred my face with my shattered glasses, bite deep into my upper lip, suffer a concussion and not fully come to until I was holding the side of my face together with a bloody cloth in my sister's car on the way to the emergency room.

We just got the bill for that little adventure, which if I'd still been uninsurable would have struck an immense financial blow. And it doesn't even include the cost of an ambulance since my sister drove me to the hospital. But as this photo shows, my ACA-sanctioned insurance helped save my face, my brain and my finances.

The Affordable Care Act is a vital, grossly overdue federal program that provides medical care and financial protection for millions of citizens in a spectrum of medically and economically challenging situations. Our new president and our newly Republican-controlled congress continue to work noisily and patronizingly and almost belligerently to repeal or dismantle or destroy -- or whatever the spin-certified verb du jour is -- the Affordable Care Act without providing a consistent or sometimes even plausible justification for their efforts and after months and years of chain-rattling still failing to provide even a shadow of a shred of a consensus -- much less a foundational set of proposals over which to negotiate -- on what to enact or not to enact in its absence.

The whole exercise stinks of political theater and desperate partisan grandstanding and manipulative demagoguery that cruelly continues to waste time and resources and patience while the health and solvency and even dignity of millions of sometimes desperate citizens and their families and dependents hang in the balance.

And I can personally attest that it's costing our country immeasurably more than just money.

No comments: