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U.S. President Barack Obama delivers remarks alongside Human Services Secretary Kathleen Sebelius (R) and other Americans the White House says will benefit from the opening of health insurance marketplaces under the Affordable Care Act, in the Rose Garden
Last year, TIME published a massive special report, "Bitter Pill: Why Medical Bills Are Killing Us," detailing just about everything that is wrong with the nation's health care system. Central to that story were Stephanie and Sean Recchi, an Ohio couple with two kids who had just started up a new business, and who had just been struck by Sean's aggressive and expensive cancer. The author of that story, Steven Brill, has a an update to their story in the current issue of TIME. Sean Recchi's now in remission, but only after the underinsured family (their $469/month policy was worthless at the MD Anderson Cancer Center in Houston) borrowed from family and maxed out their credit cards. Here's Stephanie Ricci last October:
I don't think Obamacare will help us. I don't want anything to do with it," Stephanie Recchi told me a week after the launch of HealthCare.gov on Oct. 1. "I hear a lot of bad things about it—that it doesn't cover pre-existing conditions and it's too expensive," she added, referring to what she said were "television ads and some politicians talking on the news. Just a lot of talk that this is a bad law."
Did I mention she's an Obama hater? Nonetheless, she tried and tried again to navigate HealthCare.gov, to no avail. That made her hate the whole idea of Obamacare even more, but she needed health insurance, and so went to her insurance agent.
"When they came to my office, Stephanie told me right up front, 'I don't want any part of Obamacare,' " recalls health-insurance agent Barry Cohen. "These were clearly people who don't like the President. So I kind of let that slide and just asked them for basic information and told them we would go on the Ohio exchange"—which is actually the Ohio section of the federal Obamacare exchange—"and show them what's available."
The upshot? Because they're still in basically start-up mode in their business, their income for the family of four qualifies them for expanded Medicaid. If a big contract they are anticipating comes through for them this year, they'll be bumped off Medicaid, but will still qualify for a subsidy that will put their monthly premiums at $566.
What Stephanie soon discovered, she told me in mid-November, "was a godsend." [...]

"Here I get full protection for $566, compared to no protection for almost $500," Stephanie says, referring to her old plan that had cost $469 monthly and that MD Anderson had scoffed at. "This is wonderful. [...] No, we don't get MD Anderson, but we do get the Cleveland Clinic and lots of other good care," Stephanie says. "We understand that." Amid the likely attacks from his opponents that he's taking away patients' favorite doctors and hospitals, Obama has to hope that others come to share her attitude.

As Brill points out, if the Recchis had been living in Texas, where Sean got cancer treatment, or in any of the other states that refused Medicaid expansion, they'd still be screwed. They'd be in the Medicaid gap that millions of Americans, many with health issues as critical as Sean Recchi's, have fallen into. That's the kind of situation that the Affordable Care Act was supposed to end for everyone.Thanks to the Supreme Court and an intractable Republican party that has invested more into fighting Obama than into fighting for their constituents, being able to access and afford health care is still a matter of luck.

Originally posted to Joan McCarter on Fri Jan 17, 2014 at 01:07 PM PST.

Also republished by Daily Kos.

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