The Effects of Repealing Obamacare on the Chronic Illness Community

With Donald Trump stepping back into office as the 47th president of the United States, many people especially in the chronic illness community are scared of what’s to come. Trump has berated “Obamacare” also known as The Affordable Care Act (ACA) and has threatened to weaken or repeal it. "Obamacare," has been a cornerstone in providing accessible healthcare for millions of Americans since its enactment in 2010.

For those with chronic illnesses, its protections have been monumental. If repealed, the consequences for the chronic illness community would be one of the biggest health disasters in recent memory.

Access to care. Affordability. Good health outcomes. Financial Stability. Without the ADA, millions will lose all four.

One of the most praised provisions of Obamacare is the protection for individuals with pre-existing conditions. Before the ACA, insurers often denied coverage or charged expensive premiums to people with chronic illnesses like lupus, diabetes, multiple sclerosis, or cancer. Many don’t realize that a short term condition like back pain or even pregnancy is a pre-existing condition as well.  

Repealing the ACA mean that these protections could vanish overnight and health insurance companies would have free reign on how they would approve or deny or charge individuals. Over a hundred million Americans would find themselves uninsurable or face premiums so high that insurance becomes effectively unattainable.

Many what if scenarios come into play. Insurers could reintroduce coverage exclusions for certain condition like cancer or lupus. Some states might establish high-risk pools to cover individuals with pre-existing conditions. Employer sponsored plans could bring back lifetime or annual limits on coverage. For those already managing debilitating conditions, the inability to access routine care, medications, and specialist visits would worsen health outcomes, potentially leading to life-threatening situations.

Increased financial hardship is yet another burden placed on the chronically ill by the death of the ACA.

Being chronically ill is expensive as is. Seeing multiple specialists, ongoing treatments, unexpected hospitalization, prescription medicines, mobility aids, etc all add up. Obamacare established out-of-pocket maximums to cap the amount individuals could be required to spend a year. Without these in play, out-of-pocket costs for essential care and those with long-term illnesses would balloon up even more. There would be no limit on out-of-pocket expenses.  

If the ACA is repealed, instead of saving up for a vacation or a down payment on a new house many of us would be forced to choose between basic needs like housing or food or lifesaving treatments.

Obamacare's expansion of Medicaid to 40 states has helped to cover and established subsidies through health insurance marketplaces to help many families avoid financial ruin. If the ACA was repealed many would lose coverage entirely and many people in the lower income bracket would not be able to afford private insurance. Medical debt, is already a leading cause of bankruptcy in the United States and if the ACA is repealed it, would likely soar even higher, disproportionately affecting individuals with chronic illnesses.

There’s another scary possibility — reduced access to preventive care. Preventive care is vital for managing chronic illnesses and preventing further health deterioration. Under the ACA, preventive services like screenings, vaccinations, and annual wellness visits are provided without cost-sharing. These helped detect and managed potential problems before they escalated which ensured a proactive approach to health care. Repealing Obamacare would likely reinstate significant out-of-pocket costs for these services, discouraging people from seeking the care they need.

For example, if they dropped cancer screenings such as mammograms or colonoscopies, many might not go through with these procedures and delay getting a diagnosis or the proper treatment because they don’t want to pay for the costs for these necessary tests. But delay in a diagnosis leads to more costs down the road. A routine mammogram is a couple of hundred dollars, but if diagnosis is delayed, the untreated cancer can lead to surgery, chemotherapy and extended hospitalizations which would cost even more money.

People with lupus rely on frequent screenings to monitor for signs of organ damage. Without these preventative measures, irreversible complications might only be discovered when it’s already too late. A person who is pre-diabetic who cannot afford glucose tests may not realize they have developed type 2 diabetes until it is too late.  For the chronic illness community, delays in early detection and intervention could mean more advanced disease stages, reduced quality of life, and higher overall healthcare costs in the future.

This goes even deeper. Living with a chronic illness often comes with a mental health burden, including anxiety, depression, and stress over financial and medical uncertainties. Obamacare expanded access to mental health services, recognizing their integral role in overall health. Obamacare required insurance plan to cover mental health care and substance use treatment at the same level as physical health service. Mental health is health.

But, if the ACA is repealed insurers could exclude mental health services or attach a higher premiums for coverage making therapy sessions or counseling expensive. Making many feel like they have nowhere to turn leaving them isolated and unsupported. Repealing the ACA would create a devastating gap and leave the chronic illness community vulnerable.

Millions of patients will be left in the dust without support at a time when they need it most. The resulting mental health crises would only compound the challenges of managing chronic illnesses.

Another major problem exists. Caregivers play an important role in those in the chronic illness community by providing others with physical, emotional and financial support. When access to care is restricted, the burden will fall even harder on family members and friends. Obamacare introduced measures that indirectly helped caregivers. But, if this repealed this added strain could negatively impact their health, relationships, and financial stability, creating a ripple effect within families and communities.

For the chronic illness community, Obamacare is more than a healthcare policy—it is a lifeline. Without its protections, people within the chronic illness community will lose so much.  Millions of Americans rely on this and with the uncertainty of this in question our health, financial stability, and well-being is up in the air.

Policymakers: please consider all the implications of dismantling the ACA would do and prioritize the health of all Americans, especially those living with chronic conditions. Retaining and strengthening this legislation is a matter of compassion and justice.

No one deserves to lose their coverage. No one.