The Affordable Care Act (ACA, also called Obamacare) became a teenager this week. For many of us, its passage changed a lot of things.
It was far from a given, though.
The ACA was passed at great political cost. Not everyone in the Obama administration wanted the President to spend all that political capital on healthcare. Some of his advisors wanted him to stick to something more bi-partisan, like infrastructure. But once the President made it clear he was set on this path, everyone worked their butts off to get it passed. And here we are, despite numerous legislative attacks chipping away at the original law, both attempted and actualized.
The President was never able to replenish the political capital he spent on the ACA.
One of the most extraordinary things about the ACA is what it did to the American psyche. It’s a little hard to remember now, but until then, health insurance was viewed primarily as a valuable benefit of a private sector job. But the ACA laid out its ten essential health benefits, as well as several additional controls on the overall industry, such as caps on out-of-pocket costs for health insurance plans with high deductibles and outlawing price gouging health insurance for those of us with pre-existing conditions (that would be all of us chronic and autoimmune patients). In just a decade, Americans started viewing healthcare as a right. That is a remarkably short amount of time for such a big paradigm shift.
But aside from all that – starting to bring costs down for patients and leveling the playing field a bit – the ACA opened another kind of door. I think a lot of patients take jobs that will pay medical bills over the ones we really want. As someone who was underutilized at work for the first half of her career, I had always wondered what it would be like to work at something in which I could be truly invested. What would it be like if all patients had flexibility to choose?
But until the admittedly rather rocky launch of the first public health insurance exchanges in 2013, I was too scared and financially unable take a step away from my large corporate employers. After, though, when a pandemic-prompted opportunity to launch my own business, I was able to take it and proceed without worrying about whether I would be able to see my doctors or get the labs, medications, and durable medical equipment I need.
That’s not to say there aren’t tons of other worries and anxieties, but they are the same as anyone would have while building a business. Being a patient with expensive healthcare needs is not standing in my way.
That is a gift.