Pre-existing Conditions Can Happen to Anyone
I heard voices asking if I was okay, and foggily opened my eyes to find myself lying on the floor near the back of an airplane. A flight attendant was asking if there were any doctors or nurses on board after finding me unconscious, partly in the bathroom and partly in the aisle.
I had suffered a concussion, which I don’t remember, after having gone to the bathroom because I suddenly felt dizzy and nauseous. I didn’t know it at the time, but my life as a 31-year-old healthy marathon runner was about to change forever. I developed a 24/7 migraine (having never had a migraine before) for nearly two years, suffered pain so strong that I sometimes couldn’t sleep for days despite prescription strength pain and sleep medication, had to hold a railing on stairs due to balance issues, and even developed such severe memory problems that I sometimes wouldn’t remember how to get home from work — this a year after graduating with two master’s degrees from the University of Pennsylvania. The constant migraine and traumatic brain injury ultimately combined to cause a mild stroke.
And just like that, I went from young and healthy to somebody with a dreaded pre-existing condition. And now, I am terrified that I might lose my guaranteed access to health insurance should Donald Trump win his re-election campaign.
The Trump Administration is currently suing to overturn the Affordable Care Act (ACA), which guarantees access to comprehensive health insurance for all Americans with no surcharges for people with pre-existing conditions. Trump has no plan to replace the ACA, despite promising for years that one is coming in two weeks. The Department of Health and Human Services in 2012 found there to be up to 129 million Americans with pre-existing conditions, some of those relatively minor conditions such as acne or, high blood pressure; conditions that pre-ACA could result in an insurer charging higher rates or excluding that condition from coverage. More recently, the Kaiser Family Foundation estimated that 54 million non-elderly adults have a declinable health condition, something that would render them (us) “uninsurable” on the individual insurance market without the ACA, with these running the gamut from cancer or stroke history to epilepsy to severe obesity to arthritis. And quite possibly, COVID-19.
I am one of those “uninsurable” people, should the ACA be overturned. I am a healthy 40-year-old single white woman who has run six marathons in the last six years, five of them under four hours. But I have a pre-existing condition with my stroke history. So, I, like millions, am utterly terrified that guaranteed access to health insurance would be eliminated with a second Trump term. We are the only country with an advanced economy where this is even conceivable. All others provide health insurance to everybody.
Losing health insurance in a best-case scenario means having to pay a lot more for medical care, treatments, test and medication, but still having the money to get it. In many cases, however, it means something far worse. It means rationing medication that keeps your diabetes or chronic pain under control. It means rolling the dice that going an extra year between cancer screenings won’t cause you to miss detecting cancer while it is still treatable. It means mortgaging your home, taking on loans or filing for bankruptcy when a significant medical event happens.
And in the worst cases, which are no small number, it means skipping lifesaving treatment for you or a family member because you can’t afford it — and then having to bury that loved one a year or five or 50 too soon.
For those of you who think people should just pay for their own health care as they need it, you are out of touch with reality. A relative told me that people should just pay their $20 or whatever when they go to the doctor, like back in the day.
I’ve got news for you — it doesn’t cost $20. Even with insurance (pre-ACA), due to exclusions on coverage and the length of time I was on medical leave following my stroke diagnosis, it took me six years to pay off the money I had to borrow (some at 11% interest) to pay for my medical care.
Late this spring, I had to get MRI and MRA of the head, brain and neck done due to intense migraines and visual disturbances that caused my doctors to consider a stroke or aneurysm among the possible causes, given my medical history. Thankfully, they didn’t find anything serious, but the charge for those tests — done as an outpatient — would have been more than $18,000 without health insurance. Instead, the cost was negotiated down by my health insurer to ~one-third of that, and I paid 100% until hitting my $3,500 deductible, then 20% above that.
And for those of you who think, I’m healthy and young, nothing will happen to me … I was healthy and young, a 31-year-old marathon runner when I suddenly fell ill on an airplane in June 2011.
I am incredibly fortunate to have made an outstanding recovery. I’ve studied Portuguese and learned to read Catalan. I’ve run six marathons. I only rarely have migraines. I no longer have basic memory problems. And yet, I deal with the long-term effects of my medical history every day, whether in managing chronic pain, dealing with sleep problems or recognizing my higher risk for a severe case of COVID-19 should I catch it.
My biggest current issue by far, however, is the fear and anxiety over possibly losing health insurance. I have a great job now with excellent health insurance. But counting on your job being secure in order to maintain health insurance is a terrible strategy, as the 22+ million Americans who lost their jobs since the start of the pandemic can attest.
The richest country in the world shouldn’t be the only advanced economy that fails to guarantee health care to all its residents. GoFundMe campaigns shouldn’t be people’s backup plans. Please vote for Joe Biden and Kamala Harris, whether Biden was your preferred candidate or not. Not voting is the same as voting for Donald Trump, and it’s the same as voting to take away health insurance from your friends and relatives and neighbors and colleagues who have pre-existing conditions.