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Health care access in America is at a crossroads. The protections provided by the Affordable Care Act (ACA) – such as guaranteed coverage for pre-existing conditions and essential benefits such as maternity care, mental health services, and preventive care – may be lost if the ACA is repealed.
Imagine Sarah, a 41-year-old mother of two. She skipped her routine mammogram because the cost was no longer covered under her insurance. Months later, she felt a lump and a cancer diagnosis that could have been caught earlier is now life-altering. Or think about 47-year-old James, who put off his routine colonoscopy due to high out-of-pocket costs. A preventable polyp wasn’t caught in time, leading to advanced-stage cancer that will cost his family emotionally and financially. 62-year-old Janet had congestive heart failure, so no health insurance company would cover her.
These very realistic situations occurred more frequently prior to the ACA, when insurers were able to pick and choose who and what they would cover. Sarah, James, and Janet could be any one of us. And anyone with commercial insurance coverage is vulnerable to disruption of coverage due to common life circumstances, such as job change, loss of spouse to death or divorce, relocation to another county or state, aging out of coverage guidelines, or more.
The illustrations of Sarah, James, and Janet above are fictional, but represent real examples of the challenges faced by many Americans when access to affordable and comprehensive health coverage is restricted. These scenarios illustrate the harmful consequences that occur when insurers have the power to deny or limit coverage of necessary care.
Here are some highlights of what’s at stake:
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Pre-existing Condition Protections: Prior to passage of the ACA, nearly 20% of people who applied for individual health insurance policies were denied coverage based on their health histories. They, and the 82 million Americans with pre-existing conditions who have employer-sponsored coverage, are at risk of unaffordable premiums or no coverage at all.
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Essential Health Benefits: The ACA requires coverage for certain types of services for most employer and Marketplace plans, such as maternity care, mental health treatment, prescription drugs, and pediatric services. Without the guarantees enshrined in the ACA, those desiring pregnancy could have to purchase separate insurance policies (riders) prior to conception.
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Preventive Care with No Out-of-Pocket Costs: Screenings such as mammograms, colonoscopies, pap smears, and blood pressure checks save lives and reduce long-term costs by catching diseases early. Cost barriers to these services delay diagnosis and can result in higher costs for more advanced disease, worse complications, and even unnecessary deaths.
Now consider a future where every person in the United States has uninterrupted lifelong health care coverage– a system where no one fears losing access to care due to changes in job, income, family status, or residence. Health care coverage should be secure, and we believe this future is possible and necessary.
TAI’s 2022 survey found:
- Two-thirds of insured Kentuckians surveyed delayed or avoided necessary medical care or medications due to high out-of-pocket costs.
- 10% declared bankruptcy because of overwhelming medical debt.
This is a national crisis, not just a Kentucky problem. Millions across the country face similar challenges, placing them at financial and medical risk.
Your support enables TAI to:
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Conduct Educational Outreach: Create and share resources that help individuals navigate the complexities of the health care coverage system while showcasing the transformative potential of universal coverage.
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Develop Evidence-Based Solutions: Use research and frontline experience to inform communications on key health care policies and their effects on health care coverage.
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Protect Essential Safeguards: Inform communities about the importance of ACA protections while demonstrating how universal coverage can create a more secure and equitable system.
Your generosity drives change and helps us work toward a future where health care is a right, not a privilege.
The Asclepius Initiative
P.O. Box 44
Glenview, KY 40025
You can view our annual report to see what we've been able to accomplish this year. Take a look at our roadmap to see the steps TAI is taking to build demand for a health care financing system that provides uninterrupted coverage for every person in the U.S., from birth until death.
If you have any questions, please send me an email.
Thank you for supporting this vital cause. Together, we can create a healthier, more equitable future for all.
Sincerely,
Susan G. Bornstein
Founder and CEO
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