Before the Affordable Care Act (ACA) took effect, I personally experienced discrimination in the individual health insurance market and struggled to get coverage for a pre-existing condition. So when an email from Rep. David Schweikert bearing the subject line, “Myth vs. Fact on Healthcare” landed in my inbox, I opened it with a healthy dose of skepticism.
Schweikert writes, “Attempting to stay well-informed on healthcare policy given the volume of information can be a full-time job in itself.”
Yes, my skepticism was well founded. But to fully appreciate the irony here, we need to travel back in time.
May 4, 2017: the U.S. House of Representatives is poised for a vote on the American Health Care Act. A last-minute scramble to secure additional votes has resulted in changes to the bill that haven’t yet been scored by the Congressional Budget Office. So lawmakers will cast their votes without knowing if the bill would insure more people or provide more affordable coverage. But for the first time since the Affordable Care Act was passed in 2010, Republicans now have a lock on the legislative and executive branches of government – and their dreams of obliterating the ACA won’t wait. As then-Rep. Martha McSally famously says, “Let’s get this f*cking thing done”.
Meanwhile, Schweikert takes to the House floor and begins a slightly less salty speech, surrounded by his usual assortment of charts and graphs:
“Since 1986…we in the United States have statutes that say if a sick person walks into a hospital, they have cancer, they’re bleeding, they’re going to get health services. …there’s no such thing as not receiving care in this country. It may not be the care you want at the place you want, but it’s the law and it’s been the law for 30 years.”
Now, the Emergency Medical Treatment and Labor Act does require hospitals with an emergency room to screen all patients and to stabilize those with an identified “emergency medical condition” before transferring them. But this doesn’t mean that people like me can show up in the ER and get free lab tests, a free endocrinologist appointment, free prescription medication, or free surgery.
Someone who was serious about his full-time job of staying well-informed on health care policy would have known that. Which brings me back to the present – and Schweikert’s email.
“I want to set the record straight: I support protecting individuals with pre-existing conditions.”
What follows can only be described as AHCA fan fiction, cherry-picking the bill’s meager protections – while failing to mention that the law would have been a devastating setback for people like me who live with pre-existing conditions. But don’t take it from me.
Take it from the American Medical Association: “We are deeply concerned that the AHCA would result in millions of Americans losing their current health insurance coverage.”
Take it from the American Psychological Association: “…we oppose the American Health Care Act due to the adverse impact it will have on Americans with mental health, behavioral and substance use disorders.”
Take it from a coalition of patient advocacy groups, including the American Heart Association, March of Dimes, and Cystic Fibrosis Foundation: “Weakening protections in favor of high-risk pools would…undermine the ban on discrimination based on health status.”
And take it from the final CBO analysis, which was released on May 24 (almost three weeks after Republicans pushed the AHCA through the House on a party-line vote) and predicted that the law would reduce coverage and increase prices in the individual market, with over 23 million more Americans uninsured by 2026.
If Republicans had cared in 2017 about providing a robust set of protections for people with pre-existing conditions, they would have met with key constituencies before drafting the AHCA. They would have incorporated key policy components like Community Rating, Cost Sharing, Essential Health Benefits, and bans on annual and lifetime caps. They would have kept the ACA’s 3:1 age band. They would have done better research on the historical performance of high risk pools.
And if Republicans care today about protecting people like me, they’ll put the brakes on the lawsuit that currently threatens to dismantle the ACA with no backup plan. I’m not optimistic.
I am optimistic, though, about the November election. Arizona’s 6th Congressional District has an opportunity to ditch the “free care in the ER” guy and elect a representative who’s actually worked in an ER: Dr. Hiral Tipirneni. While Schweikert wants to rewrite history about a piece of legislation that was universally rejected by patients, doctors, and hospitals, Dr. Tipirneni understands the challenges in our health care system and wants to build on the ACA with a public option.
The contrast is clear. And so is our choice.
Kimberly Dorris is a Scottsdale resident.