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NORTHJERSEY.COM: N.J.'S VOICES OF OBAMACARE: HOPE, DREAD, UNCERTAINTY

NORTHJERSEY.COM: N.J.'S VOICES OF OBAMACARE: HOPE, DREAD, UNCERTAINTY

 

What will happen to Obamacare?

For hundreds of thousands of New Jersey residents, the answer to that question is personal.

Musicians, entrepreneurs, freelance writers, hairstylists, temp workers, the self-employed, the out-of-work – each has a stake in the former president's signature health care law. Some 800,000 in New Jersey buy their own coverage or have gained it through the Medicaid expansion.

Tuesday was the final day to sign up for coverage this year, but President Donald Trump and Congress have already taken preliminary steps to repeal the Affordable Care Act, as the law is officially known. With no plan ready to take its place, it is unclear whether the subsidies and federal funds, which allowed those people and millions more nationwide to enroll, will continue.

Few brag about having Obamacare. It is controversial and hard to understand, almost stigmatized in the national discourse. But now that it is imperiled, it looks a little different to those whose coverage it provides or regulates. Some were saved by coverage; some were stung by costs.

And they are finding their voices.

They are people like Chiara D'Agostino, 45, a former high-school teacher who lives in Montclair and is covered by Medicaid while she undergoes treatment for metastatic breast cancer, and Courtney Duva, a 26-year-old from Midland Park, whose debilitating heart condition is manageable because of Medicaid-covered prescription drugs. They are people like Jorge Rodriguez of Clifton, who shed 90 pounds and turned his life around when he finally could afford health insurance, and Emily Manz, a young entrepreneur who moved to Newark and started two businesses.

But they also are people like Elaine Finn, forced onto the individual market when the small business that employed her husband dropped coverage. Now, insteadof a $350 monthly premium, the Oakland couple pay $1,450 monthly without subsidies – "like a small mortgage," she said.

And they are people like the 61-year-old Garfield woman, whose boss doesn't offer insurance to his few employees. She has simply gone without since her bare-bones policy was canceled when the law took effect. "It's tough to live without health insurance," she said, "but it's insane to be penalized because you cannot afford it."

They all wonder what happens next.

Will Congress repeal and replace the law with something that offers plans most people can afford? Will it continue to fund the subsidies that reduce premiums for 250,000 New Jerseyans, or eliminate some required benefits to reduce the cost of coverage? Will it provide the state with the funds that have allowed more than 500,000 to enroll in Medicaid?

Thousands rallied in Newark last month to try to save the health care law. Hundreds held candlelight vigils outside the offices of Republican congressmen. Their hand-lettered signs proclaimed "This is the Face of a Pre-Existing Condition" and "Don't Make Us Sick Again."

They added their names to petitions. They tweeted, with an easy hashtag: #CoverageMatters.

And they called lawmakers. A "sustained torrent," numbering in the thousands, has deluged Sen. Bob Menendez's offices since Election Day, spokesman Steven Sandberg said. The callers run 20 to 1 against repeal, he said, and they are "terrified that they or their family member is going to lose their coverage."

Republican Rep. Rodney Frelinghuysen, on the other hand, said thousands in his Morris County district had told him "the ACA is hurting more than helping."

Rep. Josh Gottheimer, the Wyckoff Democrat who took office in January, said he had received "more calls and emails from 5th District residents concerned about the impact of repealing the Affordable Care Act without a replacement than I have on any other issue."

In the summer of 2010, the Tea Party movement gained momentum at congressional town-hall-style meetings where opponents assailed the health care law, propelling Republicans into the majority in Congress and eventually into the White House.

Now, in the winter of 2017, those against the law's repeal are hoping for similar momentum. The fight over health care is the first battle in what they hope becomes a national movement to slow the Republican repeal train, protect entitlements and advance other Democratic causes.

Trump's first official action, on Jan. 21, was an order to loosen or waive the health law's "burdensome fees, penalties and regulations," within legal limits. It's not yet clear whether that means an end to the individual mandate and its penalties for going without coverage.

"We are paying through the nose to have coverage that would only prevent us from going bankrupt if something catastrophic were to happen," said one Morris County mother of four, who buys a policy for herself and her children through the law, while her husband is insured through his job.

This issue determined her vote on Election Day, she said. "I sincerely hope the new president can fix this mess."

Lives hang in the balance.

Chiara D'Agostino is waiting.

She waited on a recent Monday for her doctor to call to report on her latest scans and the spread of cancer, which – after two mastectomies and chemotherapy – was detected again in August in her lungs, sternum and liver. She is waiting to learn how effective her recent experimental immunotherapy treatment has been.

And she is waiting to hear whether New Jersey's expansion of Medicaid, which provided the coverage that paid for the disease's detection, staging and treatment, will continue.

Gov. Chris Christie was one of 16 Republican governors to take advantage of full federal funding to enroll low-income adults in Medicaid, beginning in 2014. Half a million signed up, and $3 billion annually now flows into the state's economy. Christie said last week that he's not worried about the repeal of the law, and would welcome a change to federal block grants – as Republicans have proposed – because it would give the state more flexibility.

D'Agostino, 45, left high-school teaching to get a graduate degree. She enrolled in Medicaid via Healthcare.gov as her master's program was ending in the summer of 2014. Now she blogs at "Beauty Through the Beast" about surviving breast cancer.

"Medicaid has saved my life – is saving my life," she said, as her cats played nearby. "I don't know how I would be paying for my cancer treatment if it wasn't for Medicaid."

Yet now she feels powerless, as if her life is not hers to control: "It's in the oncologist's hands, or the researcher's hands, or God's hands, or luck's hands, or whatever clinical trial is open at the time," she said. And also, perhaps, in the hands of the president, Congress and the governor.

D'Agostino pauses, then asks the question that most bothers her: Will there come a day when she can't get care? Could new eligibility rules knock her out of coverage?

"Can my doctor really say, 'You can't come in, you're not covered'? That can't happen, can it? But could it?"

Read the full article at NorthJersey.com

Written by Lindy Washburn

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