At a mere two weeks of age, Namine needed heart surgery. At six months, she needed heart surgery again. She required much early in life — in terms of medical procedures as well as equipment — and she was not the independent, thriving child she is today. She had a tracheostomy, a stomach feeding tube (known as a g-tube), and more equipment than any uninitiated parent would know what to do with. (I mean that literally; my wife and I went through actual medical training before we were allowed to bring our daughter home after several months in the hospital.)
I have private insurance through my job. It had a cap of $2 million, and Namine — with her as of yet indefinite stay in the hospital, plus surgeries, scans, and doctor consults — was fast approaching that cap. And then when I received a phone call from my insurance that informed me that the cap was being lowered to $1.5 million, I didn’t know what we would do. Namine would obviously be dropped, and then what?
It was fortuitous that the Affordable Care Act went into effect when it did, because suddenly, miraculously, Namine had coverage again. There were two results, from which we as a family benefited. First was the fact that my private insurance could no longer put a cap on any of us, meaning that Namine was back on my plan. The second result was that Namine had state insurance — Medicaid — which covered everything that my private insurance did not. As long as she was considered disabled, she would always be covered*.
The end result of Namine being covered by the ACA was that no matter what procedures she needed — and she has needed a lot over the past seven years — of all our worries, that she would not be able to have any was never one of them. That, to me, was always the point of the ACA: You’ve got enough to worry about. Let us take care of the bill, while you take care of your loved one.
*Being “considered disabled” is really more complex than you’d think, even for Namine, who needs a wheelchair on a daily basis. There are also other qualifiers (and ways to get denied), and other fights to be fought regarding insurance. But that’s a different discussion for another blog post.