The Democratic National Convention is resurrecting the Affordable Care Act as the centerpiece of the party’s healthcare policies.
Yet there are other stories that should be told, stories about the families that “Obamacare” failed. These should come as no shock to the Democrats. Nearly all of their presidential primary candidates also viewed the ACA as insufficient, advocating some form of “Medicare for all.”
One of us has such a story — Mark Jay and his wife, Erika. At 39, Erika was diagnosed with a rare stage 3 sarcoma in 2016, a type of tumor in the small intestine. In addition to surgery, this type of cancer requires an indefinite daily oral chemo treatment. Last August, the sarcoma came back. In addition to the daily chemo fight, Erika has endured seven major surgeries, countless PET scans and MRIs, regular lab work, and many other procedures.
Many families know this struggle all too well, but the Jay family was also feeling the financial pressure placed on them by insurance costs, even with the ACA rules in place.
Over the last five years, Mark and his family have seen their health insurance premiums increase 282%, and the maximum out-of-pocket health expenses have soared 415%. These increases do not even account for money spent on the prescription drugs Erika needed, drugs that health insurance companies dropped because they no longer fit into their formulary. The drugs had been covered in previous years and even continued to be covered under Medicare.
In other words, the ACA’s promise to protect families with preexisting conditions proved hollow — and not just for the Jay family. Despite pledges from Barack Obama and the Democrats, they were not shielded from exorbitant hospital bills, runaway prescription prices, or financial ruin.
Prior to this cancer fight, the Jay family never had credit card debt, but by averaging $30,000 per year in out-of-pocket healthcare expenses, they couldn’t keep up as bills went to collection agencies. In an effort to avoid damaging their credit scores, they begrudgingly paid bills in full with credit cards. When their credit card debt was mounting, they applied for a home equity line to pay down their debt.
Eventually, Mark and Erika were forced to sell their home. As the cost of health insurance again increased for 2020 and the number of quality individual plans available again decreased, the Jays had to move to a state with a cheaper cost of living in an effort to get back on their feet financially.
Their story isn’t unique, and it lays bare the broken promise that “Obamacare” would protect patients with preexisting conditions. While it’s true the Jays did not lose their insurance, they still faced the choice of losing care or financial ruin. Studies show the ACA did not decrease bankruptcies related to medical bills, nor did it result in better health outcomes as measured in mortality rates among the nonelderly.
The battle for the Jay family has been overwhelming. The Jay kids, ages 13 and 14, have been hit not only with the weight of their mom fighting cancer but also with the devastation of having to leave their home and their community because of insurmountable medical expenses. For the Jay family, the ACA has resulted in unaffordable healthcare.
There are several solutions to fix what “Obamacare” has broken. Policies that aim to put patients and doctors in charge of healthcare decisions instead of the government or the insurance companies would bring down costs, increase access to care, and restore faith in our system.
For example, it should be mandatory for medical providers to give patients the price for nonemergency procedures and treatments before performing them. It would put an end to the disgraceful practice of surprise billing and allow patients to shop for services that fit their budget.
We should also expand how people can use their health savings account dollars and encourage patients to take preventative care, which lowers overall healthcare costs. And we should remove barriers to options like telemedicine, which has become critical to maintaining patient health during the COVID-19 pandemic.
Remember the Jay family’s story as the Democrats double down on the ACA. Its broken promises affect real families like Mark’s, mine, and yours.