Since it passed in 2010, the Affordable Care Act (ACA) gave millions—an estimated 20 million, to be exact—of people the opportunity to get insurance, either through their employers or purchased individually through state exchanges, through Medicaid’s expansion or the ability to stay on their parents’ plans. It was, for many, a lifesaving law.
Of course, the Affordable Care Act also came at a high cost—quite literally. With monthly premiums that could rival the cost of rent in many small cities and reportedly poor coverage, it’s understandable that many people remain skeptical.
Now, the Affordable Care Act in in danger. Yesterday, the Senate voted down a Republican proposal to repeal and replace it. But today, the debate to overhaul the act will continue—even though a finalized replacement bill doesn’t exist. The Senate could also vote to repeal the act without a replacement. This fight has been going on for months.
Republicans are determined to change the law; after all, they’ve campaigned on that promise for the better part of a decade. To win a vote, Republicans could propose a bill that would repeal some provisions of the act—such as removing the penalties imposed on employers who do not provide insurance to employees.
As Lauren G. shares, “I’ve seen the ACA change the lives of so many people who used to avoid going to the doctor at all costs but very much needed to for the sake of their health.” Here, eight women share exactly what the ACA has done for them—as they cross their fingers they can keep their coverage.
1. Having insurance through the ACA gave me a chance to chase my dreams.
“In 2015, I decided to walk away from my full-time position and start my own business. Something that had always hindered me in going out on my own was access to benefits, but the ACA allowed me to walk away without being worried about being able to get health insurance—first, by helping me stay on my parents’ plans while I was starting out, and later having access when I started my own business.
Luckily, I have been pretty healthy throughout the years, so I was able to enroll in catastrophic insurance, which was an inexpensive option that still allowed me to have access to preventative care and two doctor visits per year if I got sick. It is because of the preventative care requirements that I was able to get a less expensive plan—$300 a month cheaper than the next plan up. While the deductible is still high, the plan serves my needs and I know that if something really bad happens, I will still have access to care if needed without going into debt.
Without the Affordable Care Act, I may not have taken a chance on my dreams or opted to not get insurance, which could have put my health at risk.” —Anna Osgoodby, 28, New York
2. The ACA saved me thousands of dollars on essential medicine.
“I got insurance through ACA because I have a life-threatening illness called paroxysmal nocturnal hemoglobinuria, and my medication is $90,000 a dose. I was thrilled because prior to ACA…I had to bankrupt myself and not gain an income so that I could stay on disability to pay for the medication.
The ACA’s preexisting conditions protections—coupled with the expansion to Medicare—allowed me to gain access to health care. Up to that point, I had been trying to secure private insurance, but there was nothing near affordable or that would allow me onto a plan because of my condition. I was able to get insurance through Medi-Cal, when they [the ACA] opened up the income threshold.
When the ACA was passed, I was able to move to a better medical facility, receive an income, and get off disability so that I could become a contributing member of society again. And my medications, doctors’ visits, and hospital fees were all free.
Now, I am able to focus on all the other aspects of managing my illness and not worry about whether I will be able to afford my medication or have the ability to receive care.” —Olivia Colt, 33, San Leandro, California
3. Without the ACA, I would have had to stop taking antidepressants.
“I left a full-time job to pursue freelancing. I also had a part-time job, which doesn’t usually offer health insurance. I’m clinically depressed, and it’s difficult for me to function without my medication. In the one-month gap between my previous employment’s health insurance ending and my ACA starting, I had to pay over $500 out-of-pocket just for antidepressants. There’s no way I could afford that on a monthly basis.
When I first got insurance through the ACA and estimated my income, it was much higher than the income I was actually making because I had to factor in the money that I made from my salaried position from the first half of the year—even though that wasn’t really relevant because I was no longer making that amount of money. So, for the second half of last year, I paid about $300. But now that my income is calculated based on what I’m actually earning, I only pay about $40 a month.
I also have a congenital birth defect that required two surgeries to remove 15 centimeters of my colon. If something happened with my weird digestive problems requiring hospitalization, I would be making a choice between bankruptcy and completely refusing care. It really comes down to whether affordable health care is a basic human right. I happen to think it is.” —Katie Macbride, 32, San Francisco
4. I’m a single mom, and the ACA allowed me to get insurance for my child.
“After having insurance through an employer for more than a decade, I turned to the Affordable Care Act for insurance when I decided to leave office life and become self-employed. My three-and-half-year-old son and I are both covered on my ACA policy, and it has been great. We have been able to keep all of our doctors, and I was given a pretty large variety of plans to choose from. I can afford to pay for health insurance, but I can’t afford to pay out of pocket for a policy.
The ACA gave me the green light to choose a career path that meant I was more available to my son, who is my priority above anything else. My son and I both have preexisting breathing conditions that require expensive treatments and multiple visits to the doctor and urgent care. My son was also born 11 weeks prematurely. The insurance policy I have through the ACA has covered most of the physical and occupational therapy he’s needed to catch up to the other kids his age.” —Sarah Netter, 36, New Orleans
5. I paid for shingles, surgery, and a birth in one year—with the ACA’s help.
“I had recently quit my job and had a two-month gap where I was uninsured. I’d always been insured through my employers before and was planning to enroll in an ACA plan anyway since I was going to be self-employed, but I was afraid that because I was pregnant, it would be hard to get insurance.
I can’t claim to have had a legitimate reason for being so anxious—I’d just heard that pregnancy had long been a disqualifying preexisting condition, and I was afraid that even with the ACA there might still be some loophole I’d fall through. Despite having done my homework about the ACA and how it treated pregnancy, I was worried I’d be denied from the time I applied until I had my insurance card in hand. What a relief when I found out that the ACA truly did permit me to easily get insurance while pregnant.
In that one year, I got shingles, had to have my gallbladder removed, and gave birth, and while my premiums were not cheap at $905 a month—I didn’t qualify for subsidies simply because I make too much money—I could afford them. I could not have afforded to pay the $70,000 in medical bills I’d have had to shell out if I hadn’t had insurance.” —Lauren Gard, 39, Wayne, Pennsylvania
6. I could afford a necessary gynecological surgery thanks to the ACA.
“I am self-employed and was previously on my fiancé’s insurance plan. While I had decent coverage, there weren’t many plan options and the deductibles and co-pays were high. I enrolled in the ACA through the Health Care Marketplace website in early 2016, and I love it. I had so many options on plans to choose from as well as the addition of a dental plan. The rates went up for 2017, but I am still paying less than I was before enrolling in an ACA plan. Now I pay $142.49, but before I paid $254.
Plus, I have a $0 deductible and co-pays for a doctor’s visit is just $2—and a seeing a specialist only costs $10. I needed to have an outpatient gynecological surgery last year, and my out-of-pocket cost was only $200. Being able to be enrolled in this plan is very comforting, knowing that whatever health situation that I may come across, I am able to pay for my portion without incurring any medical bills.” —Dawn Mims, 43, Bradenton, Florida
7. The ACA covered my preexisting condition, and I’m scared to lose it.
“When I got divorced a few years ago, I was on COBRA. I’m self-employed and I have a preexisting condition, ulcerative colitis, so I was really afraid to go off COBRA. I didn’t know if I could get my preexisting condition covered on a new plan, or if I could afford one that would. Luckily, the ACA kicked in literally at exactly the time I needed new health care coverage, and it kept me from lapsing in my insurance.
Because of my ulcerative colitis, I have to have insurance. I have to take medication daily so that I don’t have a flare-up. I also get colonoscopies every other year—and colonoscopies are expensive. But I can afford them with the insurance I have now.
Having my preexisting condition covered through the ACA was a huge relief, but I was following the politics of the issue in the first place and was aware that that was huge part of the legislation. I am really worried about any changes that might be made to it to eliminate or punish those with preexisting conditions, so much so that I went to a rally at my local Republican senator’s office. I didn’t vote for him.” —Tracy Bagatelle-Black, 49, Santa Clarita, California
8. The ACA saved us a lot of money—and then it saved my life.
“I am self-employed, and while my husband works for a company that does provide insurance, the cost of insuring me and our son would have cost us more than half his paycheck. When the ACA came on, we were struggling financially. The 2008 crisis hit us really hard. The ACA policies are more expensive than what was available on the private market prior to the ACA, but they are also real insurance policies that really cover you being sick and they can’t rescind your coverage either, so you don’t end up paying and then not getting the benefits. We would not have been able to afford a policy without the subsidy. As it is, our health care costs are still about 42 percent of our take-home income, but at least they aren’t 70 percent of our income.
Two months after I got a policy with the ACA, my gallbladder died and I almost died. I am alive because I had insurance. Not an exaggeration. I had a weeklong stay in the hospital as I was being treated for sepsis. I would have delayed going to the hospital if we did not have insurance and that delay would have killed me. I would be dead if the ACA had not been passed. And if I had gone to the hospital without insurance, it would have bankrupted us. We are still active working, contributing members of society because of the ACA, because it saved our lives and our finances.” —Jennifer Hancock, 51, Manatee County, Florida
Quotes have been edited and condensed for clarity.