Health policy is an issue to which I have long been invested, both as a scholar and as a patient. And while I have long advocated expanding health coverage, this month is the first time I have ever been on government-provided insurance.
This is not to say that I haven’t been immensely concerned amid the Republicans’ ongoing efforts to repeal the Affordable Care Act. From an early age, I have struggled with a number of health problems, whether chronic ear infections to chronic kidney inflections stemming from a kidney disorder that almost required surgery. While in college, my anemia worsened and required iron infusions, but the underlying cause of the anemia wouldn’t be discovered for a few years. While I was in graduate school, in addition to being diagnosed with a couple of stomach conditions, I was diagnosed with a rare parathyroid disorder that caused electrolyte imbalances requiring several hospitalizations. In 2012, I experienced a violent assault, after which I required extensive treatment for depression and PTSD. As a postdoctoral fellow, my electrolyte abnormalities began to cause what were thankfully only minor cardiac complications.
Long story short, while I was able to thrive in graduate school and beyond, I have a lot of preexisting conditions, which prior to Obamacare’s passage would have led me imperiled had I not been on my mother’s insurance through college.
Up until recently, I had been lucky on the insurance front. As a doctoral student at Columbia University, I had outstanding insurance to cover treatment by some of the best doctors in the country. I had to make some unfortunate changes to my career path on account of limited health care options in certain regions of the country, but otherwise have always made it work.
But amid academia’s shift toward hiring visiting or adjunct faculty, and with a laundry list of preexisting conditions, I have known that should Obamacare be repealed and my position not be renewed, I would be unable to obtain health insurance due to either outright denial (as happened to me in the past between college and graduate school) or by insurance companies making coverage prohibitively expensive. Indeed, I watched President Trump’s inauguration from my hospital room at New York Presbyterian Hospital at Columbia University, tears rolling down my cheeks as I considered the fate of the nation and more selfishly, my health care. Up until recently, this concern was merely hypothetical.
With my lecturer position not renewed, my health insurance expired on May 31st. Low-deductible marketplace plans in Connecticut were prohibitively expensive while I was job hunting, and COBRA insurance even more so. I decided to take my chances being uninsured, in hopes that it would be a short-lived state of affairs. Each time I noticed more symptoms from my chronic conditions, I felt the anxiety of wondering whether I was getting sick again. Each time I went for a run, I thought about what would happen if I got injured.
After 7 weeks of being uninsured, I called the Access Health CT number to see if there was any subsidy assistance available in light of my unemployment. Ten minutes later, thanks to Connecticut’s Medicaid expansion and the helpful woman with whom I spoke, I was able to enroll in Medicaid for the first time in my life. And I cried with relief.
Though I have long been well-acquainted with the immense benefits that Medicaid offers millions – with 1 in 5 Americans on Medicaid or CHIP and with Medicaid patients vastly more likely than the uninsured to have a usual source of medical care – I had never expected that I would be a recipient of that aid. I had aided people in getting connected with social services. I had championed its expansion and called my legislators to thank them for voting in favor of programs I was not on. Today, my Medicaid card came in the mail.
The reality is that health, as well as the employment through which many rely on health coverage, can be tenuous. While some are born into fortunate circumstances or have unusually high degrees of job and financial security, a $500 surprise (e.g., an unexpected medical bill) would for the majority of Americans require going into debt. And it goes without saying that absent insurance, medical expenses often aggregate to thousands, if not tens of thousands or more.
While I have long advocated Medicaid’s expansion and continued support, I had never envisioned myself as a recipient of its great benefits. Despite a moment of shame at my current state of seeking employment, I’m filled with gratitude to not be without insurance given my medical history. And the reality is that there’s a hubris to assuming that misfortune will never befall us, and the majority of Americans believe that the government has a responsible for ensuring health coverage for all Americans, regardless of our level of good fortune at a given point of time.
This has never been a battle over personal responsibility. People cannot accept the responsibility of full-time employment when they are faced with the “choice” of bankruptcy versus untreated illness. And those whose own health care is subsidized by the taxpayers whose care they undermine have no business voting – without so much as a congressional hearing – to decimate care for millions under the guise of “public service.”
Deepening health and economic inequality is no path to American greatness. America can and should do better.