| Perspectives on Texas

Dear Sen. Cornyn and Sen. Cruz,

When I was twenty-three, my mother had a brain aneurysm. One day she was a forty-nine-year-old woman in perfect health, and the next day she was beginning nearly a year of hospitalizations, surgeries, rehabilitation and finally, out-patient care. Luckily, she had excellent health insurance; if not, she would have had to declare bankruptcy from under a mountain of medical bills. I learned that anyone not carrying quality insurance coverage was courting disaster. I made sure I never once went without insurance, even if it meant paying for expensive COBRA coverage between jobs. I had heard horror stories of privately secured insurance, how easily things were declined under the guise of pre-existing conditions and so I only looked for employment that offered health care benefits.

Then I was faced with a hard career choice. I could continue my adjunct teaching job at Texas State University, which offered full-time hours with great health insurance but had a salary of only $24,000 a year. Or, I could teach classes online for Stanford University at double the pay per class — with courses more suited to my specialty — and supplement my income with freelance editing (Stanford doesn’t offer full-time contracts for these positions). I would no longer have to live paycheck-to-paycheck and I would gain more relevant career experience, but I would have to get insurance on my own.

With the help of a private broker, I found insurance that I could afford. But that coverage wouldn’t cover my pre-existing condition of Polycystic Ovarian Syndrome. PCOS is a syndrome with no cure. It brings with it a collection of possible complications that can also occur without PCOS — heart disease, diabetes, depression and anxiety. I was lucky in that my PCOS wasn’t severe and that I could do without treatment for it, but I constantly worried that if one of those other complications were to arise, my claims would be denied.

When the Affordable Care Act passed, I felt enormous relief. My experience with the ACA hasn’t been perfect: I’ve had to change plans twice and the costs have risen each year. However, even though my income has been too high to receive tax credits towards premiums, the ACA has felt life-changing in that it has given me true economic freedom. I can pursue my best career path while still being assured of coverage for any health issue that may arise.

Sen. Cornyn, Sen. Cruz, I bet you’ve never worried about health insurance. As you pursued your careers in law and government, you’ve had ready access to excellent benefits. But I doubt you chose law and public service to be prudent about your health care coverage. You pursued them because they were your passion, and you were lucky enough that your passion also came with full coverage. America is supposed to be a country where a person’s economic position isn’t dependent on luck; we are taught that hard work and perseverance are all we need to succeed.

Because of insurance and health care costs, this fundamental part of the American Dream is no longer true. Unless you are a multi-millionaire, you cannot be sure the bad luck of a car accident or a cancer diagnosis or a brain aneurysm will not bankrupt you. Our shifting economy grows more and more reliant on small start-up businesses, freelance work, and workers like me who hold down multiple part-time jobs rather than one full-time job. These still allow livable incomes for many, but offer no insurance. The ACA met this growing issue and allows those Americans who were not lucky enough to have career ambitions that aligned with benefits to still pursue their American dream.

The ACHA option the House has presented would let states decide whether they will require insurance companies to cover pre-existing conditions. You and I both know, senators, Texas would not be one of the states that continues this mandate. The Senate version of the bill, which you both are working on, is rumored to not include this waiver. (I say rumored because Republicans have so far refused to publicly release their plan.)

However, this new version will be equally devastating. By allowing states to waive the ACA’s essential health benefit requirements, any coverage that is within our financial reach is unlikely to cover the services we need. Rather than gut the ACA, Congress should keep it and improve on its shortcomings. Otherwise, we cannot say America is still a place where dedication and perseverance will allow for economic stability for everyone, and not just for those as lucky as my mother and you.

Yours truly,

Stacey Swann