Looking for ACA/Obamacare Stories

I was denied insurance fro four different companies due to my weight and no comorbidities, pre ACA and pre wls.

I am blessed to have good health insurance through my employer and have for my entire adult life.  So I have not had to look into ACA for myself or my family.

That being said, I have three dear friends who would be dead or in dire health straits without it.  They are either self employed or do contract work, and don't have any option for employer provided healthcare plans.  They have pre-existing conditions that resulted in them being completely unable to purchase health insurance on the open market, and the premiums from the state-run high risk pools run in the thousands per month in addition to copays, deductibles and out of pocket expenses.  One has been diagnosed with very advanced cancer, and states quite flatly that if the ACA is repealed without a replacement, he will scrape together the money to go to Mexico for hospice care, as he wouldn't even have access to pain medication so he could die peacefully here.  So this is personal for me.

I also worked as a nurse in a busy county emergency room, and have been there when abdominal pain brought a middle aged woman to the ER when she couldn't stand it any longer, only to find that she had extensively advanced and invasive ovarian cancer that was long past any ability to treat except for comfort measures.  She had not seen a doctor in years because she worked minimum wage jobs and couldn't afford insurance.  That's just one story out of many I could tell, and all of them are heartbreaking.

I also have friends who had their insurance premiums raised with ACA and could no longer afford them.  So I don't pretend that the ACA is the end-all-be-all of health insurance reform.  But it was a start.

ACA added protection to employer-based plans as well.  I have a chronic condition, for which treatment can run tens of thousands of dollars a year.  I no longer have a lifetime benefit cap to worry about, and neither does my friend who is now a cancer survivor, but if the cap had remained in place would not be able to get annual checkups to ensure her cancer has not returned because she would have hit it with the successful cancer treatment.  My college aged daughter who also has chronic conditions would not be guaranteed coverage under my plan until she was able to get into the workforce and get her own plan.  The ACA ensured that even if she lost coverage for some reason, she wouldn't be denied coverage, or have to wait a year to get treatment, because of a pre-existing condition, which was common with employer plans pre-ACA.

I fought a long appeals battle for a knee surgery I desperately needed in order to stay mobile.  In the process I did a lot of research into the insurance industry and was horrified by what I found.  The bottom line is that insurance companies have lobbied for changes in regulations and laws to the point that they have no accountability.  They have a financial incentive to NOT provide the care they are contracted to, and will use any and every weapon they can find to squeeze that extra penny of profit out of people, at the cost of lives.  They know, they do it deliberately, and they do not care.  The politicians have been setting  up the laws to allow it.  Ted Cruz even said on the record that insurance companies should not be forced to provide the care they contracted to, if it would cost them money.  Insurance companies add NOTHING but cost to the provision of healthcare.  They directly provide ZERO healthcare services.  Yet that is where the profit is in healthcare.  Physicians after costs make nowhere near what the public thinks they do.  Nurses make a decent salary, but it's not rich living.  I took a paycut to go from IT to nursing, and got a huge pay increase when my health conditions forced me back into IT on the healthcare side.  It is not the providers of healthcare that are driving up cost, it is the insurers.

Ultimately, I am in the camp who believes that healthcare is something the country should provide to its citizens, period.  Yes, it is costly, but ensuring universal coverage would remove that cost and burden from the employers where I agree it is stifling economic growth.  Benefits easily cost as much as a person's salary in many cases, and healthcare is by far the largest chunk of it.  I believe a society is only as strong as its weakest member, and all of these people who are not getting preventative care are a burden to the society both in direct costs with emergency medical treatment, but also in lost productivity and economy.  

Everyone points to long waits in Canada or the UK as reason not to have universal coverage, but I have spoken with nurses from Canada, and most people love the system up there.  There is almost never a wait for emergency care (and trust me, it can be in excess of 10 hours in some ER's here) it is usually specialists that are backed up and have waits.  And the UK is fully socialized, which I do not recommend (the doctors are employed by the government).  There are MANY other examples of ways to provide universal coverage where medical providers are not employed directly by the government, that could work very well here.  Heck, simply providing Medicare for all would be a huge HUGE start.  Not perfect, but then at least basic preventative care would be accessible to everyone.

We as a country have the means to do this, it's a matter of determining if we have the will.  Too many people argue against universal care because they resent being forced to pay for someone else's care.  Truth is, they're paying for the care now in the form of emergency care that is much more expensive than preventative care would be.  If the people fighting against universal coverage had to look every person in the eye who died from lack of access to healthcare, and every one of their family members, and say "this person doesn't deserve to live" we'd be having a much different discussion.  Because ultimately, that's the argument.  It is some oddly held belief that people are poor because they chose to be, or they didn't work hard enough to pull themselves out of it, combined with some weird form of not being my brother's keeper.

Whereas I have seen how close most people are to being without access to healthcare, and what the ultimate cost is, and I think "there but for the grace of God go I" and that there's got to be a better way.

Sorry, I know you asked for personal experiences and I got off on a political speech.  It's just a topic that is near and dear to my heart in so many ways.  We as a country and a society can and should do better.  Better than the ACA, but for the love of all that's holy better than the non-answer that's being given as a supposed replacement.

As an independent contractor I could not get insurance pre-ACA... pre-existing condition. 

Thankful for ACA was able to get labs again on a regular basis and it caught an iron deficiency (Ferritin 2) and allowed me to get 2 rounds of iron infusions.

On Soapbox: Premiums did not go up because of ACA and they won't magically go down if DJT and the GOP ax it. Don't fool yourself... and P.S. Obesity/Post WLS is a pre-existing condition so everyone better hope this mystery plan doesn't ax that. Off Soapbox.

I'm going to keep this short and simple. My wife is a Doctors dream. She alone will put his kid through college. My health care insurance went up 141% this year. I couldn't afford to keep my disability insurance or accident insurance. To be able to afford the increase in cost is had to significantly lower my 401k contribution. I'm not happy at all. ACA can kiss my sagging butt.

Did you have insurance prior to ACA?

I've had insurance withe my company for the past 13 years. 

Your private insurance went up? I'm confused. Why would you think that has anything to do with ACA? 

The reason help care cost are climbing is because insurance companies are allowed to get away with it. Most of the major private companies have made huge profits for decade (some years profits increased by 40-50%). They made slightly less under ACA and instead of cutting the profits profits to their stock holders they used ACA to justify rate increases for the people they insure. 

The ACA provided me with health insurance for the first time in 12 years. Working for a small employer she couldn't afford to provide health insurance for her 2 employees. The first year I used it copiously as I needed two surgeries for a badly broken finger (which I didn't get looked at till insurance kicked in). Got all my regular medical needs addressed that hadn't been done in 12 years (bp, cholesterol, gyn etc). Turned out I was healthy (other than being obese). Unfortunately the plan I had and that were offered in Colorado (Rocky Mountain) excluded any treatment for weight loss. I paid for some of my pre-surgery testing out of pocket because of this.  The second year on ACA I didn't use my insurance at all but I paid my premiums even though they went up. I moved to Massachusetts and all my wls stuff was covered. I'm fortunate I moved here because insurance reform was enacted into law here long before the ACA and will stay after it is repealed. During those 12 years without insurance I learned to live with untreated broken bones, infections and a general lack of knowledge as to whether I was a ticking time bomb or not. But I was lucky. Gwen M. Please messsage me if you want more specific info about my experience with the ACA. 

I have employer sponsored health insurance. My premiums increased as well as co pays for Tier 2 and 3 drugs.  I understand the increases. It is what it is. Since WLS no more diabetes. That saves $$$. Victoza, Jardiance, and Toujeo cost a small fortune. But, a big but, many medical claims have been denied and am currently fighting them. Going to get help from a medical billing patient advocate because I'm extremely overwhelmed. If it wasn't for Xanax, I'd collapse. 

Im grateful for my insurance, but these rejections are killing me, especially when the WLS was approved.