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upworthy

pre existing conditions

Angela Eilers wanted to believe the push to upend the Affordable Care Act was finally over.

While "skinny repeal," the GOP's last attempt to gut the law, failed in July, she sent a handwritten thank-you note to every senator that voted against it. She saved the most elaborate and effusive for John McCain, Susan Collins, and Lisa Murkowski, the senators who broke with their own caucus to vote the bill down. Eilers was relieved for her daughter Myka, who was born with pulmonary stenosis, a congenital heart defect that required open-heart surgery to treat, and for her family, which she says can afford private market insurance thanks to the law.  

Still, she couldn't relax.


"I never let myself think that they weren’t going to stop," Eilers says. "I knew that they wouldn't stop until they got this done."

Her fears have come true with the most recent GOP push to replace the ACA. Eilers finds herself feeling disheartened and, perhaps most ominously, "defeated."

"Yesterday was the first day that it hit me really really hard," she admits.

With Senate Republicans taking another shot at Obamacare, many parents of children with chronic medical conditions are at their wits' end, trying to cope with having to fight, once again, to preserve their access to treatment.

What began as resolve has, for many, evolved into a growing sense of powerlessness — and anger.

"If these people lived on a pediatric cancer floor for weeks, months, or longer, they would reconsider their positions on health care because it is gut-wrenching," says Karen Lee Orosco, whose daughter was diagnosed with embryonal rhabdomyosarcoma, a rare form of childhood cancer, when she was 15 months old. Even with an intact ACA, Orosco had to crowdfund her daughter's surgery and is incensed that the new bill penalizes her home state of California with deep funding cuts.

Kate Greene, whose son Eddie suffers from severe hemophilia A, worries about returning to a time when those with the disease had to change jobs and move across state lines to afford, or even receive, coverage. Despite having visited her member of Congress with her family, she now makes 10 calls to them a day.

"I want Eddie to know I did everything I could to protect him," she says.

The most recent proposal, dubbed "Graham-Cassidy," includes drastic cuts to both Medicaid and the ACA's subsidies.

An NPR analysis found that the bill would allow states to permit insurers to omit the Affordable Care Act's essential health benefits from plans and deny or significantly upcharge consumers with pre-existing conditions.

The potential new law could also permit plans to bring back lifetime caps on coverage, a major fear for parents whose children have already exceeded them.

Frustration at the proposed cuts extends beyond the parents of young children.

Pat Nelson, whose 33-year-old son suffers from an aggressive form of brain cancer, says that calling her senator, Marco Rubio, which she does daily, feels like "hitting my head against a brick." She and her retired husband help her son cover his already sky-high medical bills, which she worries will explode if the bill becomes law.

"We would have to come up with more to pay for his healthcare," she says.  I'm not sure how we will be able to do that.

The fate of the bill continues to hang by a thread, as the key swing votes from July have yet to commit one way or another.

While Collins is seen to be leaning against the measure, neither McCain nor Murkowski have given more than a few clues about their vote.

On Sep. 20, a spokesperson for Mitch McConnell's office announced the majority leader's intent to hold a vote soon, leading some observers to believe the holdouts could be convinced to support the new proposal.

Until then, many say they have no choice but to keep fighting for their kids, exhausted as they may be.

Despite her despair over the bill's return, Eilers was buoyed when Jimmy Kimmel, a fellow "heart dad," used his opening monologue to rail against the bill Tuesday and accused bill co-author Louisiana Senator Bill Cassidy of lying "right to his face."

"He was angry, like us, like the rest of us," she says. "He was angry that this could impact his child. And I appreciated that."

Next week could bring relief or more fury.

In the meantime, Eilers plans to keep sending her representative a picture of Myka every day until the bill is either dead or law.

After all, she wonders, what else is there to do?

The American Health Care Act could pass the House today — and people are scared.

Photo by Win McNamee/Getty Images.

With the addition of a last-minute amendment, Republican leaders are confident just enough moderate Republicans are on board to push the bill through to the Senate.


Despite the ostensibly moderating changes, the bill remains as potentially destructive as before.

As a result, thousands of citizens are hurriedly telling their representatives in no uncertain terms that they'll be voted out of a job if they pass it.

Here's why they're not waiting:

1. The Congressional Budget Office hasn't scored the current version of the bill, so we don't know how many people will lose coverage or how much it will cost.

A running congressman works to pass a bill very few people have even seen. Photo by Win McNamee/Getty Images.

When the CBO scored the old draft of the bill that was tabled back in March, it found that, under its provisions, up to 24 million people could lose insurance coverage by 2026. The new version of the bill has been amended several times, but the score hasn't been reissued yet.

The updated law could cover more people. It could cover fewer. It could be less expensive. It could be more expensive. The problem is — nobody knows.

The House still plans to vote on it.

That's terrifying.

2. If you have any number of common pre-existing conditions, the bill could massively spike your premiums.

Despite Republican assurances that the proposed law "protects" people with pre-existing conditions, a recent amendment allows states to choose which health benefits they require insurers to cover — meaning maternity, mental health care, and more could be out depending on where you live — and to permit insurance companies to charge based on health status rather than age.

A Center for American Progress analysis concluded that this amendment would raise premiums by thousands — and in some case tens of thousands — of dollars for individuals with asthma, pregnancy, autism, kidney disease, cancer, and more.

3. Rape and sexual assault could be considered pre-existing conditions under the new law.

Prior to the ACA, insurers were largely free to deny health coverage to those who had suffered sexual violence.

Under the new law, insurance companies in some states could charge survivors much more than they're currently paying.

That's shockingly cruel.

4. Lifetime limits could make a comeback.

Before Obamacare, insurance companies could cap the amount they agreed to pay out over a customer's lifetime, forcing even insured people with expensive medical conditions to go deep into debt or go without care.

Allowing states to apply for waivers for essential health benefits could mean that insurance companies start setting those limits again, which would be devastating for people with chronic, lifelong illnesses.

5. The bill could cut funding for special education programs.

As if the heretofore illustrated level of cartoon villainy wasn't enough, the bill's giant Medicaid cuts would probably spell the end of many school services for disabled children who rely on that funding.

Clearly on a roll, the bill's architects figured they might as well throw in gutting care for poor, sick old people too while they're at it.

6. It could even mess with the health coverage you get through your employer, like most Americans do.

If you work for a big company with a presence in many states, your boss could choose to set up shop in the one with the skimpiest essential benefits standards, saving the company some money and gutting your coverage in the process.

That could mean you lose your mental health care, your mammograms, your vaccinations, or even your prescription drug coverage.

7. It could cause massive, unknown damage to the U.S. economy.

Over 12 million Americans work in health care. It's our country's fourth largest industry by GDP. No one knows for sure what impact the bill might have on all those jobs and all that market value because the bill has yet to be released publicly in its final form.

And the House seems like it's just going to roll the dice with it.

The vote is dangerously close.

Representatives leaning no as of now seem to include Mario Diaz-Balart, David Joyce, and Michael Turner.

Still undecided representatives presently may include Justin Amash, Paul Cook, Carlos Curbelo, John Faso, Darrell Issa, Steve Knight, Erik Paulsen, Bruce Poliquin, Peter Roskam, Ed Royce, Elisa Stefanik, Rob Wittman, Kevin Yoder, and Don Young.

If any of these people represent you, and this bill freaks you out, do yourself and your fellow Americans a favor, light up their phones this morning.

Emotionally, spiritually, and — perhaps most crucially — physically, we might all feel a lot better if this thing goes down.

Becca Atherton first saw the operating room when she was a baby. Over the next 24 years, it became a familiar sight.

Atherton, who suffers from Tetralogy of Fallot, a congenital heart disease, and pulmonary atresia, a respiratory disorder, estimates that she takes 50 pills a day and has endured four open-heart surgeries in her young life. Together, she and her mom watched Jimmy Kimmel's monologue detailing his newborn son's health emergency.

"We looked at each other when he started talking about pre-existing conditions and we were both like, 'Finally!'" Atherton says.

After Kimmel's monologue went viral, hundreds and Americans whose lives have been touched by chronic childhood illnesses took to social media to thank the talk show host for giving voice to their stories — and speaking up for their rights.

The speech captured an experience familiar to millions of families from all walks of life — from the terror of finding out your child has a life-threatening illness, to the gratitude for the work of local hospitals and medical professionals who treat those illnesses, to the importance of funding the National Institutes of Health.

It was Kimmel's emotional plea to save affordable insurance coverage for people with pre-existing conditions, however, that struck the strongest chord with his audience.

"If your baby is going to die and it doesn’t have to, it shouldn’t matter how much money you make," Kimmel pleaded at the end of the emotional monologue.

The Kaiser Family Foundation estimates that more than 1 in 4 Americans under 65 have conditions that would render them uninsurable under a pre-Affordable Care Act insurance model.

Kimmel's speech came as congressional Republicans are considering changes to their health care bill that could allow insurers to charge patients with pre-existing conditions higher rates. A recent amendment to the bill would allow states to wave provisions of the ACA that forbid insurance companies from factoring health history into plan pricing.

Atherton, who received the same diagnosis as Kimmel's son when she was a baby, believes Congress could do more to demonstrate they believe their plan is right for their constituents.

Becca Atherton. Photo via Becca Atherton, used with permission.

"If your new health care plan is so amazing, then prove it by giving up your government funded health care plan and join the rest of us on your new plan," Atherton says.

A Virginia performer, who goes by Jolene Sugarbaker, says they don't understand "people saying they don't want their tax money going towards people getting care, but don't mind it going towards a wall."

Sugarbaker, who had Tetralogy of Fallot surgery at 8 years old, worries that under the new plan, poorer Americans with chronic childhood illnesses won't be able to give their children the kind of care Sugarbaker received or will go bankrupt trying to pay for it.

Andrew O'Brien, a Maryland father whose 2-year-old daughter Keely nearly died from a congenital heart defect when she was an infant, said Kimmel's monologue "brought back feelings and memories," from the most difficult weeks of his family's life.

O'Brien, a Republican, believes the ACA needs "real changes," but doesn't want to see protections for patients who require intensive, ongoing care through no fault of their own scrapped.

"To go backward now and deny people the ability to obtain insurance based on a pre-existing condition would be really harmful," he says.

Andrew O'Brien (R) with son Liam, daughter Keely, and wife Jenny. Photo via Andrew O'Brien, used with permission.

He would like to see Congress craft a new bill that fixes the things that don't work with the current law, while keeping its most popular and effective provisions — like the backstops for customers with pre-existing conditions — in a way that isn't "overly partisan."

While the health care debate continues to rage in D.C., for people with such conditions and those who love them, Kimmel's contribution might wind up being invaluable.

Atherton, who will eventually need another heart surgery, hopes Kimmel's monologue will raise awareness of people like her — and what they stand to lose if their health coverage goes away.

"These are people's lives you're dealing with," Atherton says. "We have worth."

More

Jimmy Kimmel thanks hospitals for saving his son, slams Trump in teary opener.

The late-night TV host's story might change how you think about our health care system.

His voice breaking and tears welling up in his eyes, Jimmy Kimmel delivered the most compelling 13-minute monologue of his career.

"I have a story to tell about something that happened to our family last week," he said at the top of his show on May 1, 2017. "Before I go into it, I want you to know it has a happy ending."

On April 21, his wife gave birth to a baby boy, William John Kimmel. Three hours later, an attentive nurse noticed the infant wasn't as healthy as he had seemed before. Three days later, Kimmel's newborn son underwent surgery to repair a congenital heart condition.


Images via Jimmy Kimmel Live/YouTube.

The most powerful and poignant part of Kimmel's monologue comes at the end.

"We were brought up to believe that we live in the greatest country in the world," Kimmel said, choking back tears about 10 minutes into the clip.

"But until a few years ago, millions and millions of us had no access to health insurance at all. You know, before 2014, if you were born with congenital heart disease, like my son was, there’s a good chance you’d never be able to get health insurance because you had a pre-existing condition."

Kimmel is a millionaire many, many times over, and as such, he can afford just about any medical treatment in existence. But whether or not a newborn baby deserves to live shouldn't hinge on that baby's parent's paycheck.

"If your baby is going to die and it doesn’t have to, it shouldn’t matter how much money you make. I think that’s something that whether you’re a Republican or a Democrat or something else, we all agree on that, right?"

Kimmel continued,

"We need to make sure that the people who represent us and people are meeting about this right now in Washington understand that very clearly. Let’s stop with the nonsense. This isn’t football. There are no teams. We are the team. It’s the United States. Don’t let their partisan squabbles divide us on something every decent person wants."

"We need to take care of each other," he concluded. "No parent should ever have to decide if they can afford to save their child’s life. It just shouldn’t happen. Not here."

As Congress considers a major health care overhaul that could leave those like Kimmel's son vulnerable, his emotional message has the power to change everything.

"We need to take care of each other. No parent should ever have to decide if they can afford to save their child’s life. It just shouldn’t happen. Not here."

As Kimmel said through tears, this isn't about him or his son, but those less financially fortunate. It's a truly must-watch piece of TV.