Author’s Note: Opinions expressed by the author do not necessarily reflect the opinions of this organization. Just Believe Recovery does not have any political affiliation.
According to some estimates, as many as 18 million people may be faced with the loss of health insurance if the Affordable Care Act is repealed. And because addiction is considered a pre-existing condition, even people who are well-established in recovery could have limited access to healthcare.
Trump’s most recent address did little to mitigate concern, leaving millions of Americans more unsure than ever about future access to healthcare. Indeed, changes proposed are unlikely to make insurance more accessible or affordable.
Here are just a few different ways people may be impacted by repeal of the Affordable Care Act:
Persons With Pre-Existing Conditions May Be Denied Coverage
An important component of the Affordable Care Act was that it disallowed companies to deny coverage due to pre-existing conditions. A pre-existing condition is defined as past or current health conditions for which you have received treatment.
For example, if you were previously a cancer patient, you could be considered high-risk and ultimately denied coverage. In some cases, this may also be true if you are overweight or obese.
Moreover, a history of alcoholism or addiction treatment, including just a diagnosis, could be reason enough to deny coverage. For these people, high-risk pools, if reestablished, may be their only options. These pools tend to be expensive, have high deductibles, and limited benefits.
Patients with pre-existing conditions can also get locked out of the traditional insurance system permanently. For example, say that you have a substance use disorder and your treatment is covered by healthcare provided by an employer. But if you become unemployed and do not purchase COBRA, or find another job within 90 days, your only option may be to purchase insurance through a state high-risk health pool
If that insurance is too costly and your coverage lapses, it is nearly impossible to get back into the regular insurance system. As a result, people end up unhappily tied to a job, unable to own their own business because their family depends on employer healthcare, or they are forced to be uncovered.
Lifetime Expenses Could Be Limited
Before the Affordable Care Act, lifetime limitations on how much money an insurance carrier was willing to spend on a person was a common occurrence. However, the ACA changed all that.
Imagine, if you will, that your child has a serious or rare medical condition. Health coverage could hit a cap and reach its limits for your child at a very young age.
Or say you were badly burned in a fire, and require several years’ worth of constructive surgery – there are so many possibilities that a patient could encounter that would blow through coverage caps.
Also, insurance plans also pay lower rates for services – that is, if you pay cash to a hospital or medical group, you may be paying more than your insurance would pay.
No Obligatory Participation
The reason why there is money to help those with pre-existing conditions and others in dire circumstances is that participation in the ACA is mandated. Everyone is required to have insurance or face a penalty.
Thus, healthy young persons are also paying into the system although they may not yet need it. Simply put, without mandatory participation or transition to a single payer system, premium costs would probably not be affordable for many people.
Are Health Care Savings Accounts Viable?
Trump and other leaders posit that we could replace the ACA with health savings accounts (HSAs.) These accounts are used to deposit funds before taxes, and those funds can be used to pay for medical expenses.
Unfortunately, these don’t work well, because many Americans can’t save enough money to fund a major medical emergency or serious health condition. The cost of medical care is incredible; healthcare is said to be a leading cause of bankruptcy in the U.S.
The average income for the American family is around $73,000 per year. Sure, this can pay for something like a child’s broken bone, but could reasonably pay for cancer treatment? Residential inpatient treatment for addiction?
Our best resource right now is to be vocal about our concerns. Congress members have what is perhaps some of the best health insurance in the country, and yet they are in a position to remove ours.
Activism is helping, however, and advocates for the ACA need to continue to attend town hall meetings and contact state and local representatives en masse.
We must demand to keep our healthcare. You may be young and healthy now, but you won’t always be. People can work hard and fall on tough times, and you can never know what the future holds.
~ G. Nathalee Serrels, M.A., Psychology