Dear Congressman – A T1Ds Concerns with The American Health Care Act

I never intended Travelbetic to be a platform to share my political opinion, but with the release of the GOP’s first draft of legislation to repeal and replace Obamacare I feel compelled to share far and wide why I believe this bill is not an adequate replacement of the ACA, especially not for those of us with type 1 diabetes. Below is a letter I drafted and sent to all of my federal representatives, the committees who have approved the bill as well as the authors of the bill. In it I share my personal situation and how exactly the new legislation would limit my ability to access and afford adequate health care. 

Dear Representative,

I write to you today as a young American with grave concerns for the future of health care in this country, namely concerns with the GOP’s proposed American Health Care Act (AHCA). My situation forces a more elevated interest in the current health care debate compared to many of my young peers, because I have type 1 diabetes. My fellow diabetics and I (who number around 30 million in the US) rely on access to affordable prescriptions and health care for our very survival. When I say my concerns are grave, I am not exaggerating. The AHCA’s inadequacy in awarding all Americans viable options to afford vital prescriptions and care could leave many people with diabetes unable to afford their insulin, putting them at risk of death. I agree that our nation is in need of health care reform but the AHCA is a hasty, ill planned response that ignores the root issues concerning health care in the US. I would like to offer you my and my fellow diabetics’ detailed concerns pertaining to the major policy changes in the AHCA in hopes you will consider voting no on the bill and encouraging legislation reform that awards affordable health care options to all Americans. 

I would like to begin by commending House Republicans in their efforts for preserving patient protections previously established by the Affordable Care Act. As someone living with a pre-existing condition I appreciate our Government stepping in and preventing health care providers from denying me coverage. I also believe it is important to allow young adults to remain under their parents coverage until age 26. With college tuition rates sky rocketing and a difficult job market for new graduates, affording health care is extremely difficult for many in their young 20’s. 

That is where my kind sentiments for the AHCA end. 

As a self-employed, 25 year old, type 1 diabetic, my current health care situation can be compared to a ticking time bomb. I currently receive top notch health care under my father’s corporate coverage and am able to manage my diabetes very well. But my 26th birthday is in December, when I will lose my health insurance and be forced to enter the market for a health plan that covers the astronomical costs of living with type 1 diabetes in the US. The solution proposed by the AHCA seems to be health care tax credits awarded to those who do not receive care from work or government programs such as myself. While I appreciate that I cannot be denied coverage for my pre-exisitng condition, the proposed tax credits of $2,000 – $4,000 a year simply will not be enough to allow me to comfortably afford the care I need to survive without somehow greatly increasing my income. 

According to the American Diabetes Association, People with diagnosed diabetes incur average medical expenditures of about $13,700 per year, of which about $7,900 is attributed to diabetes.”

Furthermore, by adjusting the awarded tax credits based on age instead of income, the AHCA is severely neglecting individuals like myself who are young but require increased medical expenditure. 

Some may suggest I seek out work which offers health coverage in order to afford health care but the AHCA would succeed in eliminating this as an option by dropping the mandate requiring employers to offer health insurance. The current job market is already highly competitive which is what led me to become self-employed. Restricting employment options to companies that offer adequate coverage would leave me with next to 0 options. Even if I were to find a job that offered insurance, if the policy offered does not award me the care required and I chose to refuse it, I would not be awarded the tax credits under the AHCA. 

Because of Republicans insistence on limiting government mandates, I fear the AHCA will not succeed in balancing out the health insurance risk pool causing premiums to continually increase. The Affordable Care Act’s individual mandate failed to balance the risk pool and was widely unpopular but the AHCA’s proposed solution will also fail and cause financial strife for many. Allowing insurance providers to increase rates by 30% for 12 months for anyone with a break in coverage of 63 days or more is not a great enough incentive to encourage healthy people to buy insurance. If insurance is unaffordable now, most will wait it out in hopes they can afford it when they need it. Then when they need it, they will not be able to afford it. This leaves Americans in my similar situation paying ridiculous premiums in order to keep care providers’ share holders happy. 

Also, many may have breaks in coverage of 63 days or more simply because they cannot afford coverage at the current rate. To then penalize them for seeking healthcare is not a solution but a direct gut punch to middle and low class American families. Many with diabetes cannot afford consistent coverage as there are often unexpected, out of pocket expenses. The AHCA’s proposed solution to balance the risk pool will only hurt those that health care legislation is supposed to help and in turn raise premiums for everyone. 

This bill quite obviously benefits those who can already afford coverage by awarding tax breaks for health savings accounts and cutting taxes meant to help fund healthcare expansion. Isn’t the purpose of health care legislation to ensure all Americans have affordable access to the care we need to survive? Is saving a few tax dollars really worth putting your fellow Americans at risk of death? 

I mentioned before that the AHCA ignores the root issue with health care in the US. That issue is the criminally high prices of prescriptions and care in this country. Instead of going back and forth on whether to rollback medicaid, or how to balance the risk pool, action needs to be taken against large corporations who are profiteering off of sick Americans. 

Look at the price of insulin for instance. The hormone type 1 diabetics must inject themselves with on average 4 times a day just to stay alive.

From 2002 to 2013 the price of insulin increased 197% in the US. From January 2013 to October 2016 the price of Lantus, a popular insulin (one of two I take daily) increased 60% from $240 to $380. The US ranks first in the world in out of pocket costs for insulin and diabetes supplies, overtaking even war-torn Syria by a wide margin. Take a look at this survey conducted by T1International comparing cost of insulin in the US to other countries. 

 If the AHCA passes, I am out of options. The reality of this situation has forced me to seek out care in other countries so that I can afford to survive. That fact is absolutely crushing. That I may have to leave my home, a place I am more than proud of, so that I can afford a medication that keeps me alive. I feel abandoned and neglected by my Government. There is no justifiable reason for insulin and vital prescriptions and care to be twice as expensive here than in other countries. By directing legislation towards lowering these criminal prices we would solve most of the issues the AHCA attempts to solve. If Americans could simply afford the care they need to survive then we wouldn’t be having such a monumental health care debate. In a country as great as ours, no one should be without health care. 

As I am sure you are aware, I am not alone in my concerns with the American Health Care Act. Below are a list of health care associations and organizations who have spoken out against the AHCA with links to letters expressing their concerns.

I appreciate your time and hope you will work towards fair health care legislation that controls costs and provides affordable coverage options for all Americans. 

Zachary Toth

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