How the Health Care Bill Puts Iowans at Risk: Dealing with Diabetes

IHA opposes congressional efforts to replace or repeal the Affordable Care Act (ACA) through the recently passed American Health Care Act (AHCA), which threatens to roll back coverage obtained through ACA and Medicaid expansion, putting thousands of Iowans at risk. This is the story of one such Iowan. (We have changed this person’s name to protect his privacy.)

“Thomas” is a Cedar Rapids resident who jumped at the chance to sign up for health insurance on the Affordable Care Act insurance exchange as soon as it became available. He has Type 2 diabetes – a diagnosis he’s had since he was first diagnosed in 1997.

When ACA came along – it wasn’t totally the tax credit that was as appealing for Thomas so much as it was the pre-existing condition that was waived. Up to that point insurance companies would not cover him on because, quote, “they knew they were going to lose money on me.”

Thomas went through a divorce and lost his health insurance. It was during his years without insurance his diabetes went unmanaged. He now has kidney dialysis three times a week for three hours a day.

“Between paying for health care and all my other responsibilities in life – lights, water, gas, mortgage – there wasn’t a whole lot of money left to pay for health insurance,” said Thomas. “During this time I would squirrel any medicine I had for my diabetes away and take the medications one day here and there and just try to bounce my way through it and survive. It was cost-prohibitive most of the time. Had I been vigilant and kept up with managing my health – I might not be where I am now.”

Today Thomas, who is in his early 40s, is in stage four kidney failure. He hopes to soon get on the transplant list for a new kidney.

“Without affordable health care – I might as well cash out,” said Thomas. “It’s my safety net and without it I would either be dead of financially buried.”

Thomas estimates he would pay $2,800 a month for his diabetic supplies, which is $33,600 a year without his insurance through ACA. Right now he pays about $240 a month for his health insurance with a $5,500 deductible.

“That’s reasonable,” said Thomas. “I can handle that. I am a contract employee and am not able to obtain insurance through my employer – so this allows me to get treatment and stay alive. I probably could go on Medicaid but I want to work. I am able to work but what about the individuals who are unable to work because they are too sick – they didn’t ask for their illnesses. Having a pre-existing condition is the worst because I can’t change myself. I’m able to work and find a way to pay the premium but if that pre-existing condition clause comes back then no one will insure me. I can’t expect any health care provider or hospital to work for free. (His physician) has gone above and beyond in getting me as many samples as she can but I can’t live on samples forever.”

“Maybe the people at the top making these decisions should go without health care for a year and see what that’s like. What would they do? I know for me – without dialysis, I wouldn’t make it.”