Arizonans Amanda Shelley and Steve Gomez Describe How the Affordable Care Act Has Helped Them and Their Families.

Photo from Sky News

As President Biden remarked to then-President Obama at the White House following the passage of the Affordable Care Act (ACA,) “this is a big f—king deal.”

And it still is. 

For 14 years, the ACA, or Obamacare, or Romney Care before the one-time Republican Massachusetts Governor and current Utah Senator disowned his health care plan for the federal level in 2008, has helped millions of Americans across the country. 

Thanks to its provisions:

  • The poor can get affordable and quality health insurance through their States Medicaid Program. Recent expansions with pandemic relief funding have helped those programs expand in recent years. Last month, Arizona Governor Katie Hobbs, after gaining approval from the Biden/Harris Administration just expanded KidsCare to allow more poor children to get insurance.
  • People with preexisting conditions can no longer be denied health insurance.
  • The Healthcare Marketplaces, with recent subsidies from the Biden/Harris Administration, are allowing people to get affordable and quality private health insurance, saving people an average of $800 a year.
  • Health Care Marketplace Access has been expanded, resulting in “a record low uninsurance rate and record 21 million people enrolling in ACA marketplaces this year. Black and Latino Americans have seen particularly large increases in coverage.”
  • Young Adults can stay on their parent’s insurance policies until they are 26 years old. 

The Biden/Harris Administration has also signed into law, a Prescription Drug Benefit that reduces medicine costs for seniors like a $35.00 maximum to purchase insulin. The Administration has also adopted executive actions that “improve contraception access and affordability – including for over 1.4 million Arizona women.”

In celebrating the 14th anniversary of the passage of the ACA, President Biden issued a statement, saying:

“The Affordable Care Act is without a doubt, the most consequential piece of health care legislation in decades, providing millions of Americans with the freedom and security to live the life they want without the fear that one accident or illness will bankrupt them and their families.

“When I ran for president in 2020, I promised the American people that I would protect the Affordable Care Act from partisan attacks and build on it. That’s exactly what I’ve done: getting more people affordable health insurance, lowering prescription drug prices, and giving families more breathing room. Now more Americans have affordable health insurance than ever before, premiums are down, and enrollment is at an all-time high. We took on Big Pharma – and won, capping insulin at just $35 per month and out-of-pocket prescription costs at $2,000 per year for seniors.

“We can’t take this progress for granted. Extreme MAGA Republicans have voted over 50 times to repeal the Affordable Care Act. Just this week, Trump’s allies in the House proposed a budget that would gut this life-saving legislation. Donald Trump was just one vote away from getting it done the last time he was in power. Now, he’s determined to try again, running to ‘terminate’ it – and to cut Medicare and Social Security while he’s at it. 

“Trump wants to take us back to a time when health insurance companies could deny coverage to Americans with heart disease or diabetes or asthma. When you couldn’t leave a dead-end job because you couldn’t risk losing your health insurance. When a 22-year-old kid could be kicked off his parents’ plan because he graduated from college. When insurance companies could cut people off halfway through chemo because they’d reached the limit of what they were willing to pay. I won’t let that happen.

“I am fighting to build on our progress, not take us backwards. Let’s lower more prescription drug costs, cap insulin costs for everyone, and expand health care coverage so more people can get the care they deserve. It’s not hyperbole to say that affordable health care for millions of people is on the line in November. I am more determined than ever to beat back MAGA Republican attacks and make health care a right and not a privilege in America. I know that we will.”

Unfortunately, Donald Trump, if re-elected in 2024, wants to attempt again to take away the ACA from the American People. If he and a Republican Congress came back into power:

  • “More than 100 million Americans with pre-existing conditions, including as many as 2.8 million Arizonans, could be denied coverage or charged thousands of dollars more for health insurance coverage, such as $4,300 for asthma and $143,000 for metastatic cancer.
  • Millions of Americans relying on coverage from the ACA marketplace will have to pay thousands of dollars more each year. A middle-class family could face over $13,000 more in annual premium costs. 350,000 Arizonans could have to pay more, with a middle-class family facing premiums over $9,000 more. And, patients could be charged full, out-of-pocket costs for basic services like mammograms and mental health visits.
  • 150 million people, including over 3.6 million Arizonans, will no longer be guaranteed free cancer screenings, annual check-ups, cholesterol tests, and other preventive care services. And, more than 58 million women, including almost 1.4 million in Arizona, would be at risk of losing access to free birth control.
  • Prescription drugs will skyrocket by hundreds of dollars more each year for tens of millions of seniors as Trump allows drug companies to charge as much as they wantTrump’s allies are planning to repeal President Biden’s annual cap of $2,000 on prescription drugs for seniors and his $35 monthly cap on insulin. While Big Pharma only pays $13 to make and package insulin, they will be able to raise the cost back to $400 or even more per month  for 1.4 million Arizona seniors and other Medicare beneficiaries. “
  • “Over 45 million Americans benefiting from the ACA marketplace insurance and Medicaid expansion could lose their coverage, including over 1 million in Arizona
  • 67 million seniors and people with disabilities, including 1.4 million in Arizona, could lose the Medicare benefits they rely on, as Trump says there’s “a lot you can do . . . in terms of cutting [Medicare].” 
  • Young adults up to age 26 could be kicked off their parent’s health care plan.
  • Black, Latino, AANHPI, and Native American uninsurance rates would skyrocket, increasing by 84% for Black people, 41% for Latinos, 76% for Asian Americans and Pacific Islanders, and 75% for American Indians and Alaska Natives.
  • Millions of people could lose access to mental health care or substance use treatment.
  • More of the over 500 rural hospitals at risk of closure could close without Medicaid expansion. “

The thought of the ACA, a personal and economic lifeline for millions, being stripped away if Donald Trump and a Republican Congress return to power is alarming and distressing to millions of Americans who have had the benefit of health and economic security for years now, thanks to the health care law’s provisions, for themselves and their families. 

Two Arizonans, Physician Assistant Amanda Shelley (a person who was a guest of President Obama at his 2014 State of the Union Address) and Telecommunications Construction Manager Steve Gomez graciously took the time to discuss how the ACA has helped them and their families (In Mr. Gomez’s case, his eight-year-old son, Anthony.)

They also described their dread at the prospects of Donald Trump and Republican Congressional Majorities returning in 2024 and taking away their health and economic security. 

The questions and their response are below. 

  • Please tell the readers the ways the Affordable Care Act has helped you and your family.
Amanda Shelley with President Obama.

Amanda Shelley: “So in 2013, I decided to move from my urgent care practice to a very small practice, taking care of patients in assisted living and memory care units. The practice was so small that it didn’t offer insurance and I had pre-existing conditions that would prohibit me from having access to coverage on the open market. So, I decided to pay for COBRA for the rest of that year knowing that I’d be able to get coverage in 2014 under the ACA.”

“I started my coverage on the first of 2014 and it turned out it was just in time because on January 3, I started having some pretty severe abdominal pain and ended up going to the emergency room. Thanks to a kind of strange presentation and complications took a few days to figure it out but I ended up having surgery on the 6th of January.”

Had I not had the coverage, (because I had exhausted Cobra and actually went a month without insurance) I definitely would have thought twice about going to the emergency room because “I am a healthcare provider, I can handle this,” thinking. Also, the financial implications were huge.”

As a single mother, even with a great profession, I was always just one major illness or injury away from having the rug pulled out from under me financially. And so that kind of coverage allowed me to seek care when appropriate thereby literally saving my life based on what the outcome was and saved my financial stability as well.”

“I had seen this pattern of waiting until things were truly an emergency in my patients for years prior to the passage of the ACA. Not only with regards to acute problems, but I’ve also seen many, many patients put off screenings and routine care for things like diabetes, high blood pressure, mammograms, and colonoscopies. So, I know that the ACA has saved many lives beyond just my experience with it. And so, for me, that is one of the reasons that I feel that Biden is our only option as far as the two candidates are concerned. We need to have him back in office for another four years so that we can continue to get affordable access to care for millions of people.”

Steve Gomez holding his son, Anthony.

Steve and Anthony Gomez: “Our reason for this just arrived home for school. In September of 2015, this little man was born and shaped where we are and what our fight is. He was born with a heart condition called transpositions of the greater arteries. They went in to try to repair it. Unfortunately, the surgery was not successful, and we ended up having to list him for a transplant. The transplant was successful. He’s a thriving eight-year-old little boy now. Unfortunately, he had to receive some amputations as well as a result of his treatment in the PCH CVICU.  At that time, we were fortunate we had employer healthcare at that particular time. My wife’s practice that she was working at provided us with great healthcare. But we saw what this was coming in and in the first ten weeks of his life, his entire stay at Phoenix Children’s Hospital, with surgeries and everything else amounted to well over $3 million in EOB’s that came through in 10 weeks.”

“Beyond that, it isn’t like they you know as the transplant team continually says it’s like transplant is not a full-on cure. It’s just an abatement and it’s another symptom. It’s another disease, unfortunately. He has care. It wasn’t that everything was right. We have had therapies. We’ve had follow-up appointments. One year we spent every other week from Christmas Eve to St. Patrick’s Day in the ER like clockwork. So, we’ve had therapies, you know all kinds of solutions things that we’re working on because of those amputations and his limitations. And those expenses continued to grow and the point that my wife was kind of forced to transition out of her employee role because they couldn’t cover our family anymore. It was a very small practice, and they were just basically at the point where they had to make a decision about how it was going to impact the rest of the employees, so we transitioned and we’ve been getting our insurance, through the marketplace. As expensive and as costly as it is, it’s still so reassuring to know that because of his pre-existing conditions, he can’t be denied coverage. Again, the three million dollars for ten weeks would in a lot of times we looked it up at the time that would have blown the benefit cap at the time for the plan that we were on and because of the ACA, those things don’t affect him anymore and doesn’t affect families like us. We would be in financial ruin if we had had to figure out another way to cover his healthcare or would definitely would have been a picking-and-choosing lifestyle changes. Whatever we would have had to do because his care is not an option. It’s something that we know we need to do. We want to keep him around. We enjoy this little boy. We like having him around. Knowing that the ACA will provide that protection will provide that coverage for those with pre-existing conditions he will not have to worry about that as he eventually leaves our insurance as eventually, he leaves our coverage and goes and does his own thing to become a productive member of society. That’s how it’s impacted us. We know that it’s the biggest impact is going to be down the road when it comes time for him to do his own thing, but he will not be denied because he was born with a condition that you know necessitated additional care.”

Anthony being able to stay on your health insurance, per the ACA, until he’s 26 is very helpful. 

“That’s huge. It’s huge and we would definitely cover him as long as we possibly can. It’s great that it covers up to that point. But even beyond that as being an adult being and having his own family and not having to worry about his own health care as a man is something that we look forward to and making sure that the ACA not only stays in place but is strengthened and continues to be expanded. We’ve taken advantage and I hate using that term of the Medicaid expansions because of his conditions. The State of Arizona AHCCCS system will pick up some of this as a secondary. It took a lot of mind-shifting for me because I can take care of mine. Those things and those expansions are in place to help families like ours across the state in this case and other Medicaid are there to help families across the country, so they do not have to, as my wife loves to say, living under a bridge because of medical insurance and medical costs.”

  • Would you or your family member be alive today If it was not for the Affordable Care Act?

Steve Gomez: “Yeah. He would still be here because we would have found a way. 

I’m not going to give up. We went the first year plus not sharing our story and dealing with a lot of things. Family wise and friends wise get people in and out of our lives because a lot of people couldn’t handle it but my wife and I refused to give up and we still refused to give up so he’d still be here if the ACA wasn’t in place. We just might not be here. We have a beautiful home. We have a beautiful lifestyle, and it would change things then. We would make the adjustments. We’d have to. We’d find a way, but not having to scratch and claw and figure out if I am going to sacrifice paying the electric bill? Am I going to sacrifice a little bit of groceries because we have to pay for his prescriptions that were at one point between 400 and 700 dollars a month respectively for an infant? 

It’s not having to have those worries to keep us up at night and put us in the poorhouse. 

 Please tell us how you can cover your son’s prescription drug costs?

“Because of the Medicaid expansion, the secondary insurance; most of that stuff has been done under the Arizona emergency care services.”

The expansion of Kids Care has been helpful to your family in that regard. 

“Yes”

Amanda Shelley: My answer is much like Steve’s. I would have found a way. I most likely would had to file bankruptcy. I would not have been able to live where I don’t have my son who just turned 18 come up through the great schools that we have. I would have had to choose parts of town that I would not feel as safe in and not have as good of opportunities for him because of the financial component.”

Mr. Gomez: You didn’t file bankruptcy either, right? 

Steve Gomez: “No, we did not, and kind of as Michelle was saying, we were fortunate. We’ve put our son in a smaller private school because the community aspect and the ability for them to build and work with his challenges has been so huge. And it’s something that he is such a beloved member of that school community, and we would have been able to do something like that. We had a fairly bad interaction with the public school system when it came to his care and his education, and we were very thankful that we didn’t have to go that route. And I would really attribute that to the fact that we were not placed in financial turmoil and we did not have to look to file bankruptcy in order just to meet the medical costs.”

Amanda Shelley: “Right, and I would hope that I would have come to the decision that okay, yeah, you really have to go but I have seen many of my patients wait until it’s too late and either pass away or you know having much more severe heart disease after ignoring a heart attack. So, it is definitely a lifesaver..”

  • What do you think of Mr. President Biden’s efforts to expand enrollment access to the ACA Marketplace?

Amanda Shelley: “I think it’s incredible work that needs to be supported. I don’t understand why it’s not being supported from both sides of the aisle. It’s saving lives. It’s trying to increase access and really make the playing field fairer for all Americans when it comes to going up against these huge insurance companies. So many of us have been victimized, essentially by insurance companies, whether it’s because of the pre-existing condition thing prior to the ACA or things like the surprise billing things like that. Those are all things that the President has really stood up for the American people for and so of the two candidates, he is the only option that we have to make sure that continues.”

Steve Gomez: “What she said. I think that the efforts of President Biden and the Administration have been great, especially with as much opposition that he received from the Republican Party. I don’t understand why this isn’t a commonsense deal. There is one thing that Trump did say during his candidacy the first time was that yes, we have the smartest people. Yes, we should be able to do better than the rest of the world does as far as health care. Then why didn’t he when he had full control of government? Why was that an issue then? And the progress President Biden has made now I think is astronomical and you know should be lauded. There should be even more. We should be looking at what this can not only do for health care and saving lives but if you going to go the economic aspect, like Ms. Shelley said, is that getting those checks early on and getting things taken care of now which a lot of people don’t do because they are afraid of the health care expenditure. That saves money in the long run. If you take care of yourself in the long run, then my favorite examples for myself have been my dental work. I am horrible at going to the dentist. I’m horrible at doing the checkups.

Great to have you know avoid that hundred dollars a year to go to the dentist or whatever. It is 50 bucks for the fluoride a year. I think that so much work to be done. President Biden is the only one who is going to do it between the two candidates. He’s the only one who has a logical plan and has a desire to continue moving forward. I mean just taking at that and to help the American public with making sure that healthcare remains a top issue and then knowing that they’re taken care of.”

  • What do you fear will happen to you and your families if Donald Trump and Republican congress come to power after the 2024 elections? Please explain. 

Steve Gomez: “I don’t want to think about what can happen to be honest. There’s no plan. There’s no plan on that side of the aisle and I strongly feel that way. I am nervous for people like my son, for Miss Shelley, and for a number of people that I’ve met throughout this journey. They could lose coverage. The pendulum could swing back, and the insurance companies could hold all the cards again and just decide you know what, It’s not in our best interest to cover you anymore. It’s not in our best interest to offer plans through the marketplace not in our interests to hold the marketplace open any longer. It’s undoing not only what the work that’s been done in the legislature but it’s undoing the work that people have been doing and taking care of themselves and care of their own health care. That’s what keeps us up at night. That’s what makes us concerned. Literally every two years because you have the midterms that are just as nerve-racking for us and I got a joke, but it’s a comment that I made to a friend of mine. I posted my story to Facebook and something on commemorating the anniversary of the ACA passage and he’s like, oh I saw your health care story. I’m like, yeah, 

it’s fighting season again. It’s time to go and the thought of having to start over and to start from scratch and start from less than square one for families like ours is just terrifying.” STOPPED AT 20:29

Amanda Shelley with her family and First Lady Michelle Obama.

Amanda Shelley: “I don’t think about the impact as much for myself personally as I do for my patients. To watch patients, pull away from healthcare is heartbreaking and causes so much distress both in their personal lives, but also time lost at work and the cost to the family members that are taking care of them. I really feel like Steve says they have no plan. If they were to pull the ACA, we would as a country, certainly be paying the cost for decades to take care of all these people that no longer have insurance.”

  • Is there anything not covered in the first four questions that you would like to readers to know about the importance of the ACA for the American people in the country? Please explain.

Steve Gomez: “The ACA, when presented as the Affordable Care Act and not Obamacare, is truly supported by a very large majority of the people of the country because I think people are starting to understand what it’s doing for families and how to put this nicely, how many of them are so against the thought of receiving help from Obamacare. But once you explain to them that they’re getting help from the Affordable Care Act, they love that.”

“It can only get better. I mean one of the things that that I’ve stood by is that nothing gets passed in my world in construction. Rev Zero is your first revision of anything. Nothing gets built by Rev Zero. There are always changes. There are always improvements. As the ACA has started and evolved into where it is now and where it can go, it’s a system that’s in place to help so many people and to make our country healthier. It’s not just about keeping people alive. It’s about the fact that it can make our country so much healthier, and they can really improve the lives of so many. And It’s something we’re fighting for. It’s something that we’ve been fighting for since 2016 when we joined. Since we have our story out there and have met a lot of great people, it’s something that I think a lot of Americans would fight for if they knew more about the fight and it means so much to so many and it needs to continue to grow.”

To remind Arizonans and the American People about the perils of a second Donald Trump Presidency to their health care, the Biden/Harris Campaign released a new ad called “Flatline.”

The theme of the ad is to be afraid. Be very afraid of what will happen to your affordable and quality health care if Donald Trump and the Republicans return to power. Also, remember to vote this November and stop the MAGA Republicans from turning the clock back on health care reform and security. Someone in your family or you may depend on it. 

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