Steve Gepner's story illustrates the importance of one of
the Affordable Care Act's key provisions.
Steve Gepner
almost died four times.
His health care
saga began mundanely enough, as many do. After all, how many of us expect we
could be hours or days away from life-threatening illness?
Steve and his
wife, Sue, live in Colorado Springs. He's an auto mechanic. His wife works as a
paralegal secretary, and the two were attending her office get-away event in
Vail. After returning to their hotel room, Steve felt sick. He thought maybe it
was something he ate, or perhaps he'd had one glass of wine too many.
It was neither.
Steve had been stricken by necrotic
pancreatitis. He was quickly airlifted
for specialized care in Denver. There doctors assumed he wouldn't make it — his
condition was so far advanced that he was given only a 20-percent chance of
survival. His wife was told four different times that she should say her
goodbyes.
Before we get to
the rest of Steve's story, let me be clear as to why I'm sharing it. Millions
of Americans have benefited from the Affordable Care Act. As people see how
President Barack Obama's landmark health reform is benefiting their friends and
relatives, support for it is bound to grow.
USAction, my
organization, collects stories. We ask our members how the new health care law
has helped them and their loved ones. We have almost 2,000 stories so
far.
Steve's story,
submitted by his brother Michael, a USAction member, is one of them.
Before the law
took effect, most Americans with private insurance plans — 105 million people
in all — had lifetime caps on their benefits. Some 70 million Americans with
caps were in large employer plans, 25 million in small employer plans, and 10 million
in plans they'd purchased individually.
Steve didn't know
the specifics of his plan. But his insurance company, Humana, routinely placed
a lifetime cap on benefits. The cap was eliminated two years ago when the
Affordable Care Act became law.
Before the
Supreme Court upheld most of the law on June 28, Humana, Aetna, and
UnitedHealth, three of the largest carriers, announced that whatever the court
decided, they wouldn't reinstate the lifetime caps.
That's nice. But
it should be required by law.
We all know, many
from personal experience, that to increase the bottom line, insurance companies
will cut back on coverage. We can't assume that insurance companies will
continue to be "nice" to us with regard to lifetime caps if they are
not required to do so. That's one reason why Congress must not repeal the
Affordable Care Act.
Steve estimates
he has run up $2 million in health care costs. He has undergone numerous
surgeries. He spent more than seven months in the hospital. Future
complications are possible — Steve has lost internal organs, making him
susceptible to diabetes, which, to add insult to injury, runs in his family.
Still, in some
ways, Steve is lucky. His employer kept him employed and insured even through
the long months when he was hospitalized (and even today, Steve is only able to
work part-time). He got the care he needed. Who is to say that without that
care, he would be alive today?
There are so many
reasons to support health care reform. That 105 million Americans no longer
face lifetime caps on benefits is clearly one of them.
David Elliot is the communications director of USAction, a federation
of 21 state groups that organize for progressive change. USAction
co-founded Health Care for
America Now, a coalition of more than 1,000 groups that helped lead the
fight for health care reform in the U.S.