What the ACA Has Meant to Me: The Statistics

Part I of a three-part series.

Diagnosed with Rheumatoid Arthritis (RA) at the age of 22, I’ve spent my adulthood figuring out ways to maintain health insurance. Even with insurance, some months I’m only able to pay the premiums, copays, and out-of-network expenses involved in my healthcare by pulling out my credit card. RA is a very expensive chronic condition without a cure. Unfortunately, it’s also a degenerative disease. This means if I forego medical treatment I will not only experience increases in pain, swelling, and fatigue, but also increase my risk of permanent damage to my joints as well as to my muscles, tendons, tissues, and organs (even my heart).

Unpleasant Choices

Choosing between spending thousands upon thousands in medical-related costs each year and being in so much pain that I can’t function is not the set of options anyone wants. That said, I’ve been incredibly fortunate that I’ve been able to afford, one way or another, the care I need. That is because I’ve always had health insurance. Without it, my care would cost me thousands of dollars per month instead of per year; without health insurance, I simply wouldn’t be able to afford the care that enables me to have a decent life.

I am not alone in facing the high costs of an expensive disease. In the United States today approximately 1.5 million people have Rheumatoid Arthritis.1 There are at least 23.5 million Americans with one or more autoimmune conditions2 (some experts estimate an accurate figure is closer to 50 million3). When taking into account all chronic health conditions, approximately half of all adults in this country, or 117 million individuals, have one or more.4 I obviously have a lot of company when it comes to requiring ongoing medical care. However, unlike me, many have had to face their conditions without health insurance.

The Catch 22 of Coverage

Before the Affordable Care Act [ACA] was passed in 2010, approximately 17.8 million Americans with pre-existing conditions were uninsured.5 Indeed, in early 2010, just before the passage of the ACA, as many as 19% of applicants for health insurance were denied coverage based on health status. Put another way, nearly one in five people trying to get health insurance were told they were too ill to get the coverage they needed to treat their illnesses. Millions of people were caught in a healthcare catch-22 where they couldn’t get care because they were so in need of care.

With the ACA, which prohibits insurance companies from denying coverage based on pre-existing conditions, there was a 23% decrease in the number of people with pre-existing conditions going without healthcare coverage. That translates into 3.6 million Americans with chronic health conditions gaining insurance coverage.

Tweaking the ACA

Although the ACA has provided insurance to 20 million Americans who were previously uninsured6, the law remains controversial. Premiums and out-of-pocket expenses have continued to go up for many people, (although increases greatly depending on whether one’s state of residence opted for Medicaid expansion7). While the law was named “The Affordable Care Act,” medical care for chronic conditions such as RA remains unaffordable for many.

Most people agree that the legislation needs tweaking. I am all in favor for any improvements that can bring down costs while continuing to provide coverage to the millions of people like me who have expensive chronic conditions. That said, the current form of the ACA has been personally beneficial for me, as I will outline in parts II and III of this series.

Have you been impacted by the Affordable Care Act? What changes would you like to see in a possible replacement for the law?

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The RheumatoidArthritis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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