Fear or relief? Possible loss of Affordable Care Act sparks differing emotions

Jan. 29--With President Donald Trump and congressional Republicans vowing to repeal and replace the Affordable Care Act -- and finally having the power to do it -- opinions vary widely about what potential changes will mean for health care consumers.

Trump showed the high priority his administration places on dismantling the ACA by signing an executive order his first day in office allowing the Health and Human Services Department and other federal agencies to delay implementing any piece of the law deemed to impose a "fiscal burden" on states, health care providers, families or individuals. The Jan. 20 order, considered the first step toward getting rid of the law often called Obamacare, was his first official action as president.

The reaction to the promised dismantling of the ACA among several Chippewa Valley residents contacted by the Leader-Telegram who have been affected by former President Barack Obama's signature health care law ranged from fear and dread to relief and optimism.

Retirement fears

Debbie Williams of Eau Claire, who retired two years ago when she became eligible for Social Security, worries about the possibility of losing the affordable policy she carries now through the ACA -- the reason she was able to retire in the first place.

Williams, 63, said she previously paid more than $700 a month for health insurance -- and endured premium increases of at least 20 percent annually -- through her former employer despite being a healthy person with no prescriptions.

When her sister and mother died within eight days of each other from cancer, it prompted Williams to re-evaluate her life. After consulting with a financial adviser, she decided to retire from full-time work, dramatically cut her spending, start taking Social Security and switch to a subsidized policy through the ACA costing $39 a month.

Williams has been pleased with her decision despite the condition that she is limited to earning $16,920 a year from her part-time tax season job with a certified public accounting firm while accepting Social Security. Fifty percent of any income she earns beyond that limit would go to the federal government.

But now she fears whatever plan Republican leaders come up with to replace the ACA could require her to pay much higher premiums again, although now she doesn't have the ability to increase her earnings to make up for such a change.

"If the Affordable Care Act is repealed and I have to pay high premiums again, I'll be really in a hole," she said. "It will leave me financially strapped."

Limiting work

UW-Eau Claire student Ryan Ring said the ACA has a negative impact on him because of the regulations attached to the law. In his case, requirements for some employers to offer health insurance benefits to employees who work more than 30 hours a week prompted the university to limit student workers to 25 hours a week.

"I could have the opportunity to work 30 hours per week or more while going to school, but I can't because of Obamacare," said Ring, who works as student building manager for Davies Center and as an office assistant for the Student Senate. "The extra money I could earn would go toward groceries, rent and the things I need to attend school." He acknowledged he could exceed the limit if he took an off-campus job with a different employer but said that would be less convenient.

Ring, a sophomore accounting and finance major from Howard who also is fundraising director of the UW-Eau Claire College Republicans and an officer for the political group's state chapter, said he also was affected by the ACA when his mother's health insurance premiums went up so much that she had to switch to a worse plan, prompting Ring to switch his coverage to his father's plan.

As a Republican, Ring said he supports a more free market-based health insurance system and doesn't think health care is a right, but more a privilege that goes along with employment.

Asthma attack

Steve Hanson of Downsville said the affordable insurance he gets through the ACA enables him to be an entrepreneur. The 63-year-old owns Cruiskeen Consulting, a web development and web hosting firm he runs out of his home.

Before the ACA took effect, Hanson was considered uninsurable because of his chronic asthma and sleep apnea, forcing him to obtain insurance through Wisconsin's high-risk plan. That policy cost about twice as much per year as his current policy and covered fewer services, he said.

Going without insurance, even just until he turns 65 and is eligible for Medicare, wouldn't be feasible, as his prescriptions alone cost about $650 a month.

"I'm really uncomfortable with what's going on, especially because the emphasis seems to be on repealing the Affordable Care Act and nobody seems to know what it will be replaced with. All of the suggestions so far are pretty disheartening," Hanson said, mentioning high deductible plans and health savings accounts. "I guess I just have to eke my way through the next year and a half until I can get Medicare."

It's frustrating, Hanson said, that all the talk about health insurance rates soaring under the ACA ignores the fact that they were going up even faster before the law was implemented.

"I'd be the first to admit there are some flaws with the Affordable Care Act, but I think it would be better to improve it than throw it out," Hanson said.

'My choice'

Jessica Bertoni, 39, an Eau Claire barber, would be a candidate for coverage through the ACA but is convinced she can't afford it, even with the available subsidies. So she hasn't carried health insurance since her 2012 divorce.

As a result, she pays the penalty for not complying with the law's health insurance mandate -- an aspect of the law particularly irksome to conservatives even though advocates maintain expanding the pool of insured people is necessary to control costs.

"I have to pay a fine every year, and I don't like that," said Bertoni, who opposes the mandate. "I think it should be my choice whether to have insurance or not."

When she needs medical attention, Bertoni, who characterized herself as in good health, goes to a local pay-for-service doctor. Thankfully, she added, her three sons have insurance through their father's plan.

While she hasn't researched policies available through the ACA, Bertoni said, she has talked to others with similar incomes and determined the penalty costs less than the coverage. Still, she is bracing for the penalty to rise to $695 this year.

In her experience, Bertoni said, "The Affordable Care Act is not very affordable."

Safety net

For Tammy Rinholen, who owns a farm near Meridean in Dunn County, the ACA's benefit was never more apparent than just before Christmas when she was forced to go to a hospital emergency room after developing a painful infection.

Having already reached her deductible for the year, the health insurance she received through the ACA covered the entire cost of the visit. The bill, which just arrived, totaled $15,000.

"I could never have paid that on my own," said Rinholen, 56, whose premium cost after federal subsidies is $300 a month, compared with the more than $800 she and her husband paid monthly before the law took effect. "The insurance I got through the Affordable Care Act has really saved me."

But now, Rinholen said, she worries about what will happen if the law is repealed and if she will lose the comfort of knowing she can go to a doctor when health problems arise.

Pre-existing condition?

As a cancer survivor, Sue Dahl, 64, of Rock Falls is uneasy about the health law changes being discussed in Washington.

"It's very unsettling," said Dahl, who was diagnosed with breast cancer in 2008. Though she is cancer-free, Dahl fears she could get kicked off her husband's plan for having a pre-existing condition.

Dahl got married in December 2013, the timing in part because she could get coverage through her husband's policy under the ACA.

Since that time, she has taken comfort in one of the law's most popular features: guaranteed access to coverage.

"I haven't had to worry about it, and now all of a sudden it's a huge concern again," she said. "It's not cheap, but a least I have coverage."

That all changed after the election, leaving her -- and many other Americans -- with more questions than answers about the future of their health insurance.

"What will happen if they repeal the Affordable Care Act?" Dahl asked. "Will I be able to get follow-up care? What are they going to do with people like me?"

Contact: 715-833-9209, [email protected], @ealscoop on Twitter

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