2017-01-19 – Yesterday I attended a rally to protest Republican efforts to repeal Obamacare (and other things). It was an overflow crowd at the Central SEIU Healthcare HQ in Chicago. Speakers included Sen. Dick Durbin, a half dozen Chicago-are Members of Congress, including my own, Rep. Jan Schakowsky, the president of the SEIU, an executive from Planned Parenthood, Jesse Jackson, and various folks on both the giving and receiving end of our healthcare system who talked about the devastating impact repeal will have on most everyone.

I wasn’t there as a report, just as a citizen. So I didn’t take notes. But I was inspired by the stories I heard to try to retell some of them here. Part of this is reconstructed—but a true reflection of what Obamacare did for the nation and what its loss could mean. I’ve written in detail about the Affordable Care Act (ACA) in the past, so I know it in a fair amount of detail.

A recent poll indicated that a substantial percentage of people who want Obamacare repealed want to keep the ACA. Obamacare has become a political symbol, detached from the reality of the ACA. Obamacare and the ACA are the same thing.

The speaker who moved me to write this post was a nurse at a local hospital. She talked about how Obamacare radically changed the type of patient seen at her hospital in the emergency room. Prior to the ACA, a sizable fraction of ER visits were people with chronic diseases like diabetes who were unable to afford diagnosis and treatment of their conditions and so suffered with them until they became emergencies. They would come in for emergency treatment but often died. Since enactment of the ACA, this population has stopped coming to the emergency room. They now have insurance, so they come in for routine diagnosis and treatment. Their conditions have become manageable. They are no longer emergencies. The treatment is cheaper and much more successful.

Repealing Obamacare would eliminate that.

You may not know this, but the ACA applies to more than the individual policies purchased on the healthcare exchanges. The ACA standardized coverage across the board. So, if you have coverage through an employer policy, there are things in that policy that are required by the ACA.

The most important thing that applies to you if you have employer coverage (and this applies to individual exchange policies, as well) is that the amount you pay out of pocket each year is limited. Furthermore, your insurance company is prohibited from putting a lifetime cap on your benefits.

Now this sounds technical, but here’s what it means. Before ACA many insurance policies would poop out just at the moment you or someone in your family had a health crisis. Sure you would get reimbursement for your flu shot or your annual physical. But if you were diagnosed with cancer, they would pay up to a maximum dollar amount and then stop. Just when you needed it, you were out of luck.

That can’t happen under Obamacare.

At the rally yesterday we heard the story of a young woman whose husband was diagnosed with leukemia. She knew about benefit caps when her family got the bad news. It was doubly frightening for her. She was looking forward to her husband’s struggle with cancer and toward a possible financial catastrophe on top of that. So she called her insurance company to see how to handle the situation.

The insurance company’s response? We’ve got you covered. She and her family were lucky that the coverage rules of the ACA had just kicked in. There was no cap on benefits. Her husband was able to go ahead with his difficult treatment without having to worry about putting his family into bankruptcy.

This applies to you. If the ACA is repealed, your policy could fail you just when you need it the most. It’s amazing how few people know about this. But it is true.

Then there’s the fact that your kid can be on your policy through age 25. And the fact that you can’t be excluded because of a pre-existing condition. And the fact that insurance companies can’t sell you bogus policies. And on and on.

It’s been good for pretty much everyone.

So why are the Republicans against it? Part of it is simply that it’s been a political football for so long that they can’t back away. They’ve fake-repealed it so many time that it would be an embarrassment to not real-repeal it now that they control Congress and the White House. But not all Republicans are willing to take away all that’s good in the ACA from their constituents just to save face.

But the other, the hardliners, are plunging ahead. And as we’ve seen before, they are willing to blackmail Republican moderates to get their way. Never mind that everyone loses if they get their way.