Fighting cancer and the repeal of Obamacare
By Saul Gonzalez
When Maryann Hammers follows the political debate in Washington about repealing and replacing the Affordable Care Act, she gets scared.
"I am scared on every level," said Hammers. "On a very personal tangible level, I am terrified because I don't know what is going to happen to my health care."
Hammers, who was diagnosed with ovarian cancer in 2013 at the age of 58 has depended on comprehensive health care insurance. A freelance writer and editor, Hammers was unable to get insurance through an employer and obtained her coverage through the ACA. She said it literally saved her life.
"In so many ways the Affordable Care Act has enabled me to get the care I need to survive," said Hammers. "I'm doing well right now. And without insurance I would just be dead."
But Hammers fears the recently released House Republican alternative to the ACA would threaten her coverage, which enabled surgeries, doctors visits and chemotherapy sessions. She's relied on federal health care subsidies and said she's concerned about the GOP plan to replace them with tax credits.
Hammers doesn't think a tax credit would come close to covering her medical bills, which she said totaled over a million dollars.
"Cancer is expensive. It's expensive," she said.
Repealing the ACA will also have an effect on those who became eligible for Medicaid. John Baackes, CEO of L.A. Care Health Plan, a non-profit that provides affordable health coverage to low-income residents of Los Angeles County, saw what that did for many Californians.
"With expanding Medicaid by raising the income level to 138 percent of the federal poverty level, we took in hundreds of thousands of additional people, primarily adults without children, but also adults with severe medical conditions," said Baackes. L.A. Care provides insurance through its own low-cost plan and Medi-Cal, California's version of Medicaid; it now insures over two million people, or about a fifth of L.A. County's population.
Although the House Republican health care plan would keep Medicaid funding for the time being, it calls for eventually giving each state a fixed amount of money annually to help cover low-income residents. Many health care advocates fear that would eventually leads states to cut back on coverage for poor people.
Baackes' greatest worry for those insured through L.A. Care is a complete repeal of the Affordable Care Act without any kind of replacement ready to take its place, as some conservative Republican lawmakers and activists have advocated.
"If there was no replacement, all of those people above 100 percent of the federal poverty, in the absence of a replacement, they would be gone," said Baackes. "They would be back to being uninsured, and they would have to rely on free care in community clinics and county clinics, and probably would resort to using the emergency room as their last line of defense to get coverage."
The repeal would also affect community. Paula Wilson, CEO and president of Valley Community Healthcare in North Hollywood said her job is to figure out how to adapt. "I have to figure out what's the worst case scenario and how we would deal with that," she said. The ACA boosted funding for community clinics like this one, so they could provide services to more people. Wilson's clinic got $4 million.
Community health care clinics provide care for more than six million Californians a year. With many of their clients now insured through the Affordable Care Act, that's allowed the clinics to get paid back for a lot of treatment they once provided for free.
"We doubled what are past capacity was," said Wilson. "We built an additional site, we almost doubled our staff, the budgets doubled, and our patient increase is almost on track to be doubled. We went from about 16,000 patients in 2010 to 25,000 today."
Wilson said the clinic was planning to do even more, but the uncertainty over the health care law threatens that.
"I personally have to go back and believe that we'll find a way to continue what we do in a meaningful way, and sustain what we do," said Wilson.
Since the debate began in D.C., Maryann Hammers has taken up the fight to preserve the Affordable Care Act. She's started attending town hall meetings, has marched in protests and contacted legislators to fight for the ACA's preservation.
"For 2017 I still have my insurance with the Affordable Care Act," said Hammers. "I can't tell you how terrified with 2018 coming because I don't know if I'm going to have insurance when 2018 arrives."
As lawmakers move to repeal the Affordable Care Act, the stakes are high for people who gained Medi-Cal coverage under the ACA. L.A. Care CEO John Baackes sat down with KCRW reporter Saul Gonzalez to discuss the consequences of repealing Obamacare.