I Have an Expensive Chronic Illness, and My Life Truly Depends on This Election’s Outcome

Photo: Getty Images / W+G Creative

Vote like your life depends on it. For many, this isn’t just a rousing call to action—it’s real life. In this series, people from different jobs, backgrounds, and viewpoints share the impact this election will have on them, and the exact reason they’re voting in 2020. Because politics and wellness can’t be separated, especially this year.

It’s certainly no secret that, since the first day of his presidency, Donald Trump has longed for the opportunity to repeal Barack Obama’s Affordable Care Act. What’s his beef with the ACA? Maybe he wants to settle his Obama Inferiority Complex by ripping his predecessor’s signature legislative achievement to shreds? Maybe he hopes to appease the hard-line fiscal conservatives in Congress? Regardless, he’s managed to push his ACA grievances all the way to the Supreme Court, and if he succeeds in appointing a right-wing justice to replace Ruth Bader Ginsburg (likely, given Amy Coney Barrett's nomination)—and if he wins a second term—then there will be nothing to stop him from abolishing the Affordable Care Act, kicking almost 30 million Americans off of their insurance plans.

In doing so, he'll put people like me, who deal with chronic illnesses with enormous maintenance costs, at risk of bankruptcy, huge medical complications, and even death.

I’m a Type 1 diabetic, which means that my pancreas doesn’t produce any insulin at all, so I require multiple daily doses of insulin medication every day to keep my blood sugar within a “normal” range. No cure for Type 1 diabetes currently exists, so I’ll be contending with this disease (and its costs) for the rest of my life. Thanks to the protections put in place by the ACA, insurance companies can’t discriminate against me (or charge me exorbitant monthly premiums) on the basis of my preexisting condition, and the insurance plan I purchased through the New York State of Health marketplace (which operates in partnership with the federal government) gives me just a $45 copay for a three-month supply of insulin vials. As a freelance journalist, I’m not eligible for employer-provided insurance, and the options available through the exchange make it possible for me to afford necessary meds even with the modest means of a writer-for-hire.

If I didn’t have insurance through the Affordable Care Act, I would need to pay over $2,000 for a medication supply that I quite literally need to survive.

The last time I went to the pharmacy to pick up my insulin, I spotted the “retail price” of the vials. And that’s when I discovered that, if I didn’t have insurance through the ACA, I would need to pay over $2,000 for a medication supply that I quite literally need to survive. My insurance also largely covers my equipment needs for diabetes management, like my insulin pump and my continuous glucose monitor. Without that financial support, those expenses would add several hundred dollars to my monthly costs.

It’s true that some pharmaceutical companies offer discounted rates to chronically-ill people with inadequate insurance coverage. But without the level of accountability demanded by government programs like the ACA, what’s to prevent those companies from scaling back or eliminating their reduced-cost initiatives to boost their bottom lines?

When Type 1 diabetics can’t afford their insulin, the negative consequences come quickly and dramatically. In just a couple of days (and possibly even less), a diabetic without sufficient insulin can go into diabetic ketoacidosis (DKA), a condition that forces the body to break down fats for energy instead of sugars, which then makes the blood acidic. All of this can ultimately lead to kidney failure, cardiac arrest, and death.

I’ve experienced DKA before, and it’s a memory that still haunts my nightmares. If Trump wins, serves a second term, and gets rid of the ACA, then there’s no doubt in my mind that DKA rates will skyrocket—and easily preventable diabetes-caused deaths will be a far more frequent sight throughout the country.

I’m the first to admit that Joe Biden’s plan for healthcare isn’t ideal. In my dream world, we’d all have Medicare for All, and copays and premiums would be a thing of the past. But during the primary season, I also felt a deep sense of dread when I considered the grueling, difficult, potentially-impossible path that Medicare For All would undergo if put to a congressional vote in the year 2021. I need a plan that can pass, because any lapse in my coverage could prove life-threatening. Joe Biden has a strategy, he’s committed to preventing discrimination against pre-existing conditions, and he’ll expand the program set into motion by the ACA, giving even more people the opportunity to find coverage that works for their needs and their budgets. For this reason (and for many, many others), there’s only one option for me this election season.

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