This Is What the Affordable Care Act Looks Like

When I had Jackson, John and I knew we wanted me to be able to stay home with him. I did alright at my job but once you factored in what was coming out of my paycheck for health insurance and what we would pay for daycare for an infant, there wasn’t a ton leftover. But I carried the family’s health insurance and at the time (2010) there was no other option for my family to get health insurance.

John was able to work out getting us health insurance completely covered through his employer. It wasn’t the best health insurance but we were covered and I would be able to cut my hours and be home with Jackson more.

I worked in healthcare so I understood the ins and outs of health insurance, I had been watching coverage deteriorate for years (long before President Obama). I spent most of my days explaining benefits to doctors, nurses and patients as part of my job. I regularly explained to people that they couldn’t get treatment due to preexisting conditions or that the medication or therapy they were prescribed wasn’t covered.

I spent hours going in circles with insurance companies about what was and was not covered, I answered “yes”, every time I was asked if I heard the prerecorded message that, “verification of benefits is not a guarantee of coverage”, meaning that I could verify that you had coverage for a therapy and your insurance still had the right to deny payment for it.

It was challenging because insurance is made to be confusing. It’s made to be hard to understand. It’s made that you buy it and hope that you won’t have to think about it. I spent hours explaining what it meant to have a deductible, an out-of-pocket and a lifetime max and how all of those worked or didn’t work with your co-pay or your co-insurance, two totally different things. And I had people get angry and frustrated and yell at me, “they had insurance, they shouldn’t have to pay for anything” . But that wasn’t the reality of insurance then or now.

When the affordable care act came about things changed. More people had access and control over their health insurance and people couldn’t be denied for preexisting conditions. I loved hearing that policies no longer carried pre-ex clauses, it made my job easier. There were few things worse than telling a patient that health insurance they were paying into didn’t cover what they needed treated. The ACA wasn’t perfect but it was an improvement.

In the summer of 2015,  John and I had been trying to have another child and it hadn’t happened. Jack was going to be 5 and we had reached the point of, now or never. In July, John decided he wanted to leave his job and start his own company. This wasn’t news and I had been against it. I didn’t want to increase my hours at work,  I hated my job (no one wants to call insurance companies all day long) and I thought the timing was bad. But what I firmly knew was that if he was intent on leaving his job and the stability that it brought, then I was intent that we stop trying to have another baby.

So he left his job and it turned out that I was already pregnant with Grace. Excitement quickly turned to panic because we didn’t have health insurance anymore. Being pregnant and in between policies I worried about getting coverage fast and being denied for being pregnant, I worried about waiting to see my OBGYN and what that could mean for the baby. I worried so much that I would lie in bed and cry thinking about how much my labor and delivery with Jackson cost and wondering how we would ever afford it.

I took on more hours at work. John did some research and signed us up with an affordable care act policy. Even with me knowing everything I know about insurance the process was confusing but I liked that it laid out exactly what was covered and what services like labor and delivery would cost us (actually a lot less than our previous policy). We were able to get a subsidy which helped keep costs down during those first few months. When reenrollment came we were able to drop the subsidy because John’s company was doing well.

I would love to say the ACA was all roses and sunshine, it wasn’t perfect, but it was necessary. Sure there were times I argued with the insurance company on the phone (though I’ve done this with other insurance policies), when I was shuffled between the market place and the insurance company. There was confusion and annoyance, but for my family it gave us an option that previously hadn’t existed. It took care of my children’s health and my health while my husband built up a business. We are lucky that his business has grown and the business can now provide healthcare to our family and his employees.

The ACA got me through my pregnancy, it allowed me to take my son for check-ups and sick visits without panicking about the cost, it got my husband treatment for a few chronic health issues, it was there when I went into labor and after when I needed an infusion, it was there when my daughter needed weight checks multiple times a week and when I needed a breast pump, it covered that. It guarantees that if we need to change policies that my husband’s eye issues and my sons hernia will be covered. It ensures that my family can’t be denied coverage because they have been treated for something in the past.

The ACA allowed my husband the freedom to start a company, make it a success, and hire more employees. Without it he would have had to stay at his old job because there was no other healthcare option for us.

Health insurance in America is far from perfect, and the ACA was progress and we shouldn’t go back, it’s about people’s lives not politics.