Two stories in the traditional media in two days show if and how the passage of the Affordable Care Act has affected the lives of a handful Americans so far. For some, it's made all the difference, a few still fall through the cracks, and some remain largely untouched by the new law, but that might change when the law is fully enacted.
The New York Times story reports on what could be the most important of the reforms that have already gone into effect: the end to lifetime limits on coverage. Since this helps the people with the most serious chronic and expensive illnesses, the benefits to the individuals--while not a large percentage of the population--are the largest.
For example, Hillary St. Pierre, a 28-year-old former registered nurse who has Hodgkin’s lymphoma, had expected to reach her insurance plan’s $2 million limit this year. Under the new law, the cap was eliminated when the policy she gets through her husband’s employer was renewed this year.
Ms. St. Pierre, who has already come close once before to losing her coverage because she had reached the plan’s maximum, says she does not know what she will do if the cap is reinstated. “I will be forced to stop treatment or to alter my treatment,” Ms. St. Pierre, who lives in Charlestown, N.H., with her husband and son, said in an e-mail. “I will find a way to continue and survive, but who is going to pay?”
As judges and lawmakers debate the fate of the new health care law, patients like Ms. St. Pierre or Alex Ell, a 22-year-old with hemophilia who lives in Portland, Ore., fear losing one of the law’s key protections. Like Ms. St. Pierre, Mr. Ell expected to reach the limits of his coverage this year if the law had not passed. In 2010, the bill for the clotting factor medicine he needs was $800,000, and his policy has a $1.5 million cap. “It is a close call,” he said.
At one point when nearing her lifetime cap on a policy, St. Pierre considered divorcing her husband so she could qualify for Medicaid, or moving to Massachusetts where the state plan would make her care more affordable. She was saved from those decisions by pure luck. Her husband's company was acquired, and they could enroll in a new plan, with a new cap. Some of the people in St. Pierre's or Ell's position have been lucky enough that circumstances allowed them to enroll in new plans, with reset caps, but many more just dropped off edge, reaching the limit of what their plans would cover and being unable to enroll in new ones because of their pre-existing conditions. Eliminating those the caps is something even Republicans support, though they tend to gloss over the fact that the reform is out the door with repeal.
The AP revisits five individuals written about a year ago, finding more of a mixed bag of results. One man, Glenn Nishimura, is four years away from retirement. He's self-employed and has been uninsured for two years and has pre-existing conditions. He considered the the high-risk pool set up in his state from funds provided by the program, but it was too expensive.
He would have paid $7,500 a year in premiums and there was a $1,000 deductible, meaning he would have had to pay the first $1,000 out of his own pocket before benefits kicked in.
"It's just not affordable," he said. "It didn't suit my circumstance. I'm happy about the health law and I'm sure it's doing great things for some people, but it didn't fit me."
On the other hand, David Zoltan from Chicago has relatively low payments to participate in Illinois' high-risk pool, $250 monthly, and thus can manage his diabetes. His message: "It's life to me. I can get my medicine now," he said. "I can stop worrying about what's going to happen if I can't get my medicine. I can concentrate on living a nice, long, healthy life instead of going day to day.... Don't take my Obamacare away because I need it."
That's echoed by David W. Brown, general manager of a radio station and president of a marketing agency, who wants to be able to provide benefits to his employees, and is hoping to qualify for the tax credits offered in the law. "Brown feels frustrated by the continued battle in Congress over the health law and worries that it will hurt 'people who are vulnerable.... This kind of political wrangling doesn't help us in business,' Brown said. 'If you're waiting to see if something will happen, you can't plan.'"
Then there's 69 year-old Carol McKenna who's not buying any of the scare tactics lobbed at seniors over the new law, and Republicans making it "the scapegoat for everything.... They are adults and they need to grow up and stop playing the games and actually listen to their constituents," she said. "Instead of playing politics, listen to the people who put you there."
One thing echoed throughout these stories is the frustration caused by the uncertainty of where this is going to go, which could turn into a problem for the GOP as they continue this pander to the teabaggers. WaPo's Greg Sargent pondered this week just what it was that the GOP had gotten themselves into in promising repeal and having gotten so deep into it that they can't back out. Judging by the handful of people represented in these stories, they're doing themselves no favor with the American public as a whole.