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Health plan’s fall brings dread for recipients

WORRIED — In this May 4 file photo, Jake Martinez, who has epilepsy, holds his daughter Jenny, while his wife Kat, holds their son Joe, at their home in Murray, Utah. While Republicans in Congress failed this week to craft a new health care plan, they did succeed in shaking the confidence of those who rely on the act the most. Martinez said Obamacare made it possible to get affordable coverage for himself, his wife and their children. Without it, he may decide to drop out of college so he can afford insurance. “If I can’t treat my epilepsy, I can’t drive, I can’t go to work. Things that are day-to-day activities become health hazards,” Martinez said. -- Associated Press

DENVER — One American was able to afford her toddler’s latest heart operation. Another had the means to go back to college to pursue her dreams.

They and thousands of others were able to do so as beneficiaries of President Barack Obama’s Affordable Care Act. And while Republicans in Congress failed this week to craft a new health care plan, they did succeed in shaking the confidence of those who rely on the act the most. President Donald Trump’s “Let Obamacare fail” remark did nothing to assuage their fears.

Here’s a snapshot of their concerns from around the country:

‘IT’S NOT A GAME’

Matt Mason, 48, of Omaha, Nebraska, says the Affordable Care Act radically reduced the costs of treating his Type I diabetes. Before it, he had to rely on state-subsidized coverage and buy a separate policy for his wife and two children.

By the time Obama signed the law in 2010, rising costs had forced Mason to take a plan with a $10,000 deductible. His family now shares one plan that he purchased through the federal exchange. The small nonprofit that employs him does not offer health care benefits.

Mason knows the ACA has its problems: Every year it’s more expensive, and every year he’s had to change carriers and policies because fewer insurers participate in the exchanges.

“Just repealing and saying, ‘We’ll replace it in two years,’ that’s just playing like it’s a game,” Mason said. “For me, it’s not a game.”

‘THE WIND KNOCKED OUT OF ME’

Alison Chandra sobbed with relief Monday night when she heard that the Republican health care plan appeared doomed.

It meant she could still afford medical bills for her 3-year-old son, Ethan, who suffers from heterotaxy syndrome — a rare genetic disorder that causes organs to form incorrectly or in the wrong place.

But Chandra’s anxiety swept back when she heard about the GOP effort to repeal the health plan with no replacement.

“That felt like getting the wind knocked out of me,” said Chandra, a resident of Middlesex, New Jersey.

Chandra’s story drew attention in June when she shared a photo of one of Ethan’s hospital bills on Twitter. It showed a list of charges topping $230,000 for her son’s latest heart operation at Boston Children’s Hospital. At the bottom, it listed what she owed after insurance payments: $500.

Chandra worries about losing the law’s ban on lifetime limits. Before the law, many health plans capped what they would pay for an individual’s medical care over a lifetime, typically at $1 million or $2 million.

Repeal, Chandra said, “just doesn’t work for families with medically fragile children like ours.”

‘SAVED MY LIFE AND SANITY’

Dawn Erin went to her first round of physical therapy Tuesday to treat painful bladder infections she’s suffered for two decades. Her copay was $20 and her health plan covers the rest.

Physical therapy might seem mundane for some, but the 46-year-old from Austin, Texas, was ecstatic.

As a self-employed massage therapist who had hepatitis C, her pre-existing condition made it impossible for her to afford insurance before the Affordable Care Act.

“This is care I have needed all my adult life, but insurance didn’t cover it and I couldn’t afford to pay out of pocket,” said Erin, who voted for Hillary Clinton in November.

Erin relies on a government subsidy to help pay for her plan. She also was able to get expensive medication to cure her hepatitis C.

“I really wish some GOP senator would call me and explain to me how the (Affordable Care Act) is failing because this insurance reform has saved my life and sanity,” she said.

‘A REALLY HORRIFYING LOTTERY’

Alexandra Flores, 29, a library assistant at the University of South Florida in St. Petersburg, was astonished with Trump’s “Let Obamacare fail” declaration and his further insistence that “I’m not going to own it.”

“To say that he ‘won’t own it’ now when his party owns the House, Senate and White House is preposterous,” Flores said. “The president of the United States should not be treating health care this way.”

Flores is pursuing a master’s degree in library science. She credits the Affordable Care Act for her decision to go back to school rather than be locked into her previous office job. She pays $77 a month for her health plan. The government kicks in about $100.

“Trump is acting like those who currently benefit from the ACA are wrong and will be punished for the simple act of having health insurance,” Flores said, adding that she feels he’s using her health care coverage “as a bargaining chip.”

“I’m not sure there is a way to plan” for the future, she said. “It’s like we’re playing a really horrifying lottery.”

‘I’M MORE CAUTIOUS’

Deborah deMoulpied, 62, of Concord, New Hampshire, owned a small home goods store and struggled to afford insurance when she first purchased a plan through the Affordable Care Act. She has since sold the store and is “semi-retired,” though her premiums have risen about 25 percent a year.

She worries that her age and pre-existing condition — thyroid cancer — would make it impossible to pay for a plan under what Republicans have proposed. So she’s thinking about what health tests she might schedule in the next few months — and what she might do without — in case she loses coverage.

“I’m sort of watching my pennies more,” deMoulpied said. “It has made me pull back on spending. I’m more cautious.”

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‘A LOT MORE DAY-TO-DAY STRESS’

Jake Martinez, 32, of the Salt Lake City suburb of Murray, Utah, is a social work student who also works two part-time jobs. He takes medication for his epilepsy that can cost hundreds of dollars a month. The Affordable Care Act, he said, made it possible to get affordable coverage for himself, his wife and their three children. Without it, he may decide to drop out of college so he can afford insurance.

“If I can’t treat my epilepsy, I can’t drive, I can’t go to work. Things that are day-to-day activities become health hazards,” Martinez said.

He and his wife, who owns a home day care business, have been trying to create a bare-bones budget they could live under if they can no longer buy health care on exchanges with help from subsidies. It’s not easy, he said.

“We live now a life of a lot more day-to-day stress,” Martinez said.

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Associated Press Medical Writer Johnson reported from Chicago. AP writers Kelli Kennedy in Fort Lauderdale, Florida; Collin Binkley in Boston; Holly Ramer in Concord, New Hampshire; Lindsey Whitehurst in Salt Lake City and Margery Beck in Omaha, Nebraska, also contributed to this report.

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