n a beautiful spring day five years ago, a blood vessel burst in the back of my brain.
I was airlifted to the hospital for emergency brain surgery. Neurosurgeons repaired the aneurysm — a balloon-like bulge in an artery that had exploded. During the operation, doctors discovered two other aneurysms, both waiting to blow.
After surgery, complications ensued. My lungs shut down from life-threatening pneumonia. Doctors suspected “superbug” contamination involving either the breathing tube in my throat or the drain in my brain. I lay comatose and near death. High doses of powerful antibiotics saved my life.
A nightmarish recovery followed. Yet five weeks later, I began rehab and re-learned how to walk, talk, feed, bathe, and dress myself. By July 4 I had returned to work.
Since my aneurysm burst, I’ve had four more brain surgeries and nine brain scans. I’ve been hospitalized 14 times, including once for near-fatal anemia caused by blood thinners too potent for my weakened body.
I’m alive today because of an amazing medical team. And also because of Obamacare.
Before that traumatic April morning, I had great health insurance and no preexisting conditions. Thanks to Obamacare, I could keep that comprehensive policy, and the insurance company couldn’t cancel it the day I left rehab. Nor could it cap my care, either annually or in my lifetime. The endovascular neuroradiologist I trusted could remain my primary caregiver. Appointments with multiple specialists did not require pre-approvals. My bank account stayed safe from out-of-control, out-of-pocket charges.
Thanks to the essential benefits mandated by the Affordable Care Act, my insurance covered the lifesaving brain surgeries I needed, along with annual brain scans. Those scans turned out to be exceedingly important because, three times in the past three years, they showed that my aneurysms were refilling, threatening to explode again.
The total cost of my care? $1.2 million so far.
The now-tabled Trumpcare plan didn’t offer an affordable way to give my brain the care it still needs. Instead of improving on Obamacare, the American Health Care Act would have returned America to its failed health care programs of the past.
It would have let insurance companies charge me, a 60-year-old woman, five times what they charge a 20-year-old. Obamacare specified only a three-to-one difference between younger and older policyholders.
Trumpcare’s cleverly named Patient and State Stability Fund would cram people like me into state “high-risk pools.” Historically, 35 states used these pools to offer health insurance for those considered “medically uninsurable.” In practice, they were toxic dumps for Americans with catastrophic, chronic, or expensive medical conditions.
Before 2010, many pools failed. Blame government underfunding, limited enrollment, lengthy wait times, high costs, and benefit limits.
Under the Republican-championed AHCA, I faced a monthly premium of nearly $1,300. The history of risk pools suggested a worst-case annual deductible of $25,000. That would have doubled my existing premiums and quintupled my deductible.
Last year, my out-of-pocket costs totaled $14,525. Under Trumpcare, those costs could skyrocket to $40,384. Also last year, my brain scan and follow-up surgery involved two procedures exceeding $204,000. Trumpcare promised tax cuts of $197,000 to the top 0.1 percent of Americans. It’s ironic that one person’s medical costs nearly equal another’s tax cut.
Just so you don’t think I’m an outlier here: Ruptured brain aneurysms affect about 2,500 Texans a year (and about 30,000 Americans). By 2018, Trumpcare would have set aside $15 billion to fund high-risk pools. Texas was due $1.7 billion. Using my experience as an example, that’s barely half the money needed to care for Texans with burst aneurysms. Translation: Just a single health condition could drain a state’s entire high-risk pool, with no money remaining for those with cancer, heart attacks, diabetes, or other medical conditions.
If a version of the AHCA comes back from the dead, who will tell high-risk patients there’s no money for their care? Should they be told in the emergency department before they are treated? Or later, when they are in intensive care?
Why do we insist on making America’s health care so difficult?
We need to rethink our country’s exceptionalism and join other nations in guaranteeing access and coverage to basic, affordable health care for all citizens. Americans now agree. Lives depend on whether we choose to move forward, or leap backward.
I’m scheduled to have my next brain scan on April 4. These days, I wonder — will it be my last?
Melanie Ormand is a Houston-based writer, former broadcast and print journalist, and crisis communications consultant.