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Sara’s story

Sara Kahn-Troster is concerned for the future of health care.

“I am a 38-year-old cancer survivor. I am lucky enough to have excellent health coverage through my husband’s job, but I am all too aware of the many pieces of the Affordable Care Act that were designed to protect people like me, and that we now risk losing,” said Sara.

It’s widely known how the version of AHCA passed by the House could affect people who get coverage through the marketplace and Medicaid. But sometimes overlooked are the ways in which the American Health Care Act (AHCA) could affect those who obtain health coverage through their jobs.

One way the Republican bill would affect employer-based health coverage is by dismantling key consumer protections put in place by the ACA. The Affordable Care Act banned insurers from imposing annual and lifetime caps on coverage.  Before the ACA, people with serious medical conditions could have coverage pulled out from under them once they reached their insurance limit. Roughly 431,000 Mainers saw their lifetime limits on coverage disappear thanks to this part of the ACA (Department of Health and Human Services).

A return of ‘lifetime maximums’ would mean that somewhere down the road, Sara’s family could be shouldering the costs of expensive medical treatments on their own. “My cancer treatment was successful, but it left me with a permanently damaged immune system that only expensive infusions keep functional. Before I started these infusions last year, I was hospitalized three times – without these infusions, I could literally die from the routine infections my son brings home from preschool. These infusions cost tens of thousands of dollars each year,” said Sara.

The ACA also capped the annual amount that an individual ever has to pay out-of-pocket for health care. This provision has been instrumental in safe-guarding families from serious medical debt. Millions of people with employer-provided insurance have benefited from these protections.

Under the version of the AHCA that passed the House, states would be able to eliminate or severely diminish their own lists of “essential health benefits.”  These benefits, currently regulated by the ACA, determine the services which employer-based plans cannot impose coverage caps.

The Affordable Care Act protects consumers like Sara from paying too much for their health care, regardless of whether they obtain insurance through the Marketplace or through their employer.

“I am 38 years old, and I am staring at years of medical uncertainty, doctors’ visits, and treatments because of my chronic illness. Still, I am one of the lucky ones. I am able to work most of the time. My husband’s job is stable, and his employer is unlikely to change our benefits no matter what happens in Washington. But I am terrified by the what-ifs. What will happen to all of us who have pre-existing conditions and expensive treatments, who did not choose to be in our position? Who will stand up for us?

“I call upon our senators and Congressional representatives to remember the real people who the Affordable Care Act protects. Don’t leave us without hope, without protection. Don’t repeal the existing law without something better to replace it. Millions of Americans will get sicker and some will die without health insurance. I do not wish to be one of them,” said Sara.

What does the Affordable Care Act mean to you? Share how the ACA has helped you or someone you know by emailing mystory@mainecahc.org

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