The Unaffordable Affordable Care Act

The year 2010 was the inception of President Barack Obama’s Affordable Care Act (also known as “ACA” or “Obamacare”). Each year since, November 1st has marked the start of “Open Enrollment.” Being that we are in another open enrollment season, I found it fitting to share my story 10 years later. 

Back in 2010, I was a huge fan of something that covered pre-existing conditions because I was told over-the-years that if I experienced it once, it was a pre-existing condition. I was led to believe that I had so many, despite not being treated for much other than allergies. Being young, I followed what I was told, and I bought into a plan that covered all of my pre-existing conditions. I coasted by until 2012 when I really needed to use my benefits. 

After presenting to my doctors with unexplained pelvic pain, my OB/GYN shocked me with her quick solution to remove my reproductive organs. When I questioned her recommendation, she mentioned that medical studies have shown that for unexplained reasons, removing the uterus clears pelvic pain. I was 24-years-old, and this didn’t sound comforting enough for me. I attempted to get a second opinion and discovered that while doctors may not agree with one another, they don’t want to speak badly about each other. This didn’t help me. I went back to my OB/GYN and asked if she would be open to an exploratory surgery first to determine another possible reason for this pain. Her response, “Ok fine, but if there’s nothing there, I’m taking out your uterus.” 

It’s completely understandable that this sounds absolutely crazy, but I was making a decision from a place of pain. There was no one there to advocate for me and push me to avoid these life-changing surgeries. To be clear, that exploratory surgery also included tying my tubes (tubal ligation) and of course, nothing was discovered, so we proceeded with a partial hysterectomy in December of 2012. 

My story doesn’t end here. It continues with more treatment, long-term use of pain medication insisted by several physicians (despite my objections), and on top of that tens of thousands of dollars in medical debt. But I thought Obamacare was supposed to cover everything? WRONG. Taking part in the Affordable Care Act and Health Insurance Marketplace, I was convinced that it changed the way I was treated by doctors and their administrative staff, as well as impacted the medical decisions made by my physicians. I can confidently say that it drastically reduced if not eliminated my ability to have a say over my care and treatment. My only choices were to listen or to deal with my pain. 

Fast-forward 10 years – The ACA is still in-tact. There is a tax penalty if you don’t participate and elect marketplace plans, but the penalty is $0. It is extremely restrictive, as almost all the plans are HMO plans. In some states like Illinois, you’re restricted to county hospitals and doctors. You don’t get to visit the fanciest doctors and hospitals on an ACA plan. These plans are perfect for anyone that has pre-existing conditions that need to continuously be treated or have a high chance of needing to be treated in the near future. However, it is not good for anyone that is healthy, unable to afford the high premiums and deductibles (subsidies are even more scarce for 2021), and it’s definitely not a good option for anyone that is self-employed or a young person. 

Fortunately, there are options on the individual market! While every state has their own laws and regulations surrounding health care and health insurance, the individual market still is incredibly competitive and more appropriate for most people living in America. With nationwide PPOs, lower deductibles and coinsurances, affordable premiums, and a la carte coverage options, it is truly customizable to make sure you’re not over or underinsured. 

This life experience actually motivated me to join the health insurance industry to become an advocate and patient navigator for as many people as possible, around the country. My clients can attest to my passion and mission as a health insurance broker. 
Watch to my full story here:

As a side note, I’d like to add that I was not the only one to experience the unnecessary removal of my reproductive organs. In fact, a Virginia physician was convicted of 52 counts of defrauding health insurance companies for completing unnecessary hysterectomies and tubal ligations. He is sentenced to 465 years in prison. Read more about it here.