(Disclaimer: I work at a small town hospital, in outpatient registration, in the Great Plains. Anything I write here is personal opinion, and is not representative of my employer or my employer's policies.)
On Friday, I was working my 9 hour shift at the hospital. I work hard not to discuss items of personal interest with patients; normally, my small talk tends toward weather.
But as a patient was checking in, he decided to make small talk of a different nature.
"So, what do think about this Affordable Care Act that's coming? Seems like it's going to change some things."
(I give him full credit for calling it properly as by its name, the Affordable Care Act, rather than perjorative Obamacare. In many areas, "Obamacare" isn't a perjorative, but in these parts, it is.)
I thought briefly about deflecting the conversation to something else - something safer, something completely non-controversial.
But I work only 18-22 hours per week, on average; just enough to keep me from being eligible for benefits, under hospital policy. For affordability reasons, we discontinued my COBRA coverage as of August 1st - which means my physical therapy following surgery in July hasn't been medically supervised. And I haven't done any followup visits with the orthopedic specialist. The chronic health conditions I experience are well controlled with medications, which are also not covered (but I'm fortunate in that generics seem to work acceptably for me).
I'm in need of several screening tests, but I won't do those if I have no medical coverage - they're prohibitively expensive, though designed to diagnose/rule out potentially fatal developments/conditions. If applicable, effective treatment following at least one of those tests (sleep study) would greatly improve my daily quality of life. The other two recommended tests are for conditions, for which I have a strong family history of sudden fatality.
So instead I looked at him, and replied, "I'm glad it's coming. I work part time, so I have no health insurance coverage."
(Brief pause, with no break in eye contact.)
"I work in a hospital, but I have no access to health care."
He gruffly replied, "Well, there'll be more of that sort of thing going around." (I think he meant full-time jobs being converted to part-time jobs.) But then he was ready for his appointment, and any further conversation was curtailed.
When he departed, though, I made sure to smile and say, "Take care, and enjoy the great weather!"
I think more people need to become aware that their neighbors and friends will benefit from the ACA - even if it's people they never met before. Even if these people have no visible health problems. Even if it's hard-working, middle class Americans. It's somehow harder to demonize other people as being unworthy, when they look like you, sound like you, and are people you encounter in your everyday life in a small town.
(And there's at least one life-saving or life-extending surgery I qualify for in medical terms, but for which I've not had an insurance policy that would even partially cover the procedure.)