• Medicaid Matters Florida

Without the ACA, My Patients Will Die

Updated: Apr 9


I am a primary care doctor who sees, every day, the impact that the Affordable Care Act (ACA) has on my patients. I am here to speak for them.

The recent CBO rating estimates that 22 million people will lose health insurance under the proposed Senate health care plan. This means 22 million more people without regular access to mammograms. This means 22 million more people who will wait until catastrophe strikes before seeking out medical care for their heart failure, diabetes, and high blood pressure. This means 22 million more people without birth control, pap smears or vaccinations. This means 22 million more people without access to insurance for maternity care. This means 22 million more people who will end up in the emergency room instead of in my office.

I have too many patient stories to count. First, I think of a patient with ACA coverage who recently came to me because she found a lump in her own breast. Within a week, she was able to get a mammogram. The next week, she had a biopsy; and then a few days later, an appointment with an Oncologist. Now, she is in the process of starting chemotherapy. It’s been about six weeks since she first came to my clinic. For someone without insurance, this process would have taken months, and likely would have resulted in astronomical bills that her family could not afford, financial stress and anxiety, and ultimately a more advanced disease with worse outcomes. Thanks to the ACA’s preventative care mandate, insurers are required to cover mammograms not only when someone finds a lump but also simply for screening—which enables us to detect cancer when it is so small and localized that it can’t even be felt. Without this preventative health care, people will die.

I think of another patient who had a test showing that she had gastrointestinal bleeding, which requires a colonoscopy. She’d been hesitant to have a colonoscopy, as many people are, but, given that our test had found blood in her stool, she was now willing to have the procedure. Within a month, she had the colonoscopy and several polyps removed. Without the ACA, she would, undoubtedly, still be waiting for that colonoscopy.

My patients are just some of the more than 1.7 million Floridians who have gained insurance coverage under the Affordable Care Act. In Florida, we have the most ACA enrollees of any of state. But many of the patients are people who can just barely afford their insurance co-pays, deductibles and premiums; even with the assistance of subsidies. They will not be able to afford higher deductibles under the Senate’s proposed bill. They will lose their access to preventative services, which the senate bill is now proposing as optional coverage, to be determined by individual states. And we all know Florida does not do well when things are optional.

I am facing exam rooms full of questions now. What will happen to my insulin? What will happen to my cardiologist? My pulmonologist? My endocrinologist? I am here so that my patients have a voice and so that I can look them in the eye and tell them that I did everything possible to preserve their essential human right to health care coverage. Our policymakers, who have the privilege of turning away when they don’t want to listen, must realize that, with their proposed legislation, my patients will die.

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