If you are wondering what the Affordable Care Act truly means, consider these stories from NYSUT members who know first-hand the importance of having affordable health care for themselves, their families and their colleagues:
Nancy Barth-Miller, hospital nurse, applauds coverage of pre-existing conditions
"How a day can change things," said Nancy Barth-Miller, a United Federation of Teachers nurse at Staten Island University Hospital.
Her daughter, Lindsay, pictured above at right, was at a well visit, when her doctor noticed an enlarged lymph node. A biopsy showed she has thyroid cancer. She's 28.
Fortunately, Lindsay has health insurance through her job, a small employer, which paid for her surgery and follow-up treatment. But without the Patient Protection and Affordable Care Act, her job future would be limited.
Switching jobs or careers would be "a lifetime struggle" without this national plan, Barth-Miller said. After all, what health insurance company would otherwise take Lindsay on as a new subscriber with a pre-existing condition?
"In reading over Obamacare, where it says no one will be denied or charged more due to a pre-existing condition, you have a pre-conceived notion that it's about the elderly. Then it hits me. Now I have a 28-year-old with cancer," Barth-Miller said.
Cynthia Eaton, college professor, heralds impact on women
"The success of the ACA is critical for women. It has the potential to change the lives of all women," said Cynthia Eaton, a member of the Faculty Association of Suffolk County Community College and mother of two small children.
Without the law, women pay more for health insurance and often face exclusions, such as maternity services and gynecological and newborn care.
Eaton teaches Gender and the Humanities, which covers the origins and impact of sex discrimination. "Many of my students don't realize the extent to which sex discrimination is common, but they seem particularly unaware of its impact in health coverage. Through a practice called gender rating, insurance companies legally can charge women different premiums than men (even when maternity coverage is excluded)," she said.
Research by the National Women's Law Center shows that 33 states allow insurance companies to charge men and women different rates for the same coverage and services, and more than 90 percent of the best-selling insurance plans in those states do just that, Eaton said.
Because adults cannot be turned down for pre-existing conditions under ACA, the law will help women who have been denied coverage for having a C-section, breast cancer or being a survivor of domestic violence or sexual assault, Eaton said.
The ACA requires most plans to cover direct access to gynecological care (without a referral) as well as maternity and newborn care. It includes provisions so women and their babies can be assured of well-baby and well-child visits, including pre- and post-natal counseling.
A provision of the ACA also requires employers to provide nursing mothers with mandated breaks and private places to pump breast milk at work. It waives co-pays for every type of contraceptive. Lower income women also benefit from new Medicaid assistance that covers all reproductive health services, including family planning.
Laura Van Guilder, teacher, celebrates extended age coverage
"Every semester, I see young women struggle with their coursework due to their work and family obligations; they simply became mothers before they were ready, they say. This lack of access to quality family planning resources is directly addressed by the ACA," Eaton said.
Both of Laura Van Guilder's daughters, 26 and 22, are pursuing graduate degrees.
"Being a graduate student you need to work to live, so it takes longer to get your degree," said Van Guilder, president of the South Glens Falls Teachers Association. One of her daughters went a year without health insurance because of the cost of the premiums. "It was very scary; very trying," she said. Luckily, now, with the ACA, her younger daughter and 18-year-old son will be able to stay on the family's insurance until age 26.
As a teacher, she said, "we fight hard to keep our own health insurance so we can provide for our families."
Angela Lucas, high school English teacher, Brockport
"It's absolutely a historic moment that national health care was passed," said Angela Lucas, a member of the Brockport TA.
Under the ACA, eight prevention-related health services are now covered without cost-sharing starting Aug. 1.
These changes will help lower costs and improve the health and wellness of 47 million women.
Without the ACA, said John Nichols, who teaches digital communications in central New York, everyone will continue paying the penalty for those who cannot afford health care. "We're all paying. People go to the most expensive health care there is — the ER."
Now, with ACA, his wife will not be charged more for her health care. She and their two daughters will all be able to get mammograms.
John Nichols, teacher, says plan saves money
"Women are the majority in this country. I don’t know why they’re not outraged anyone would want to take this away from them," he said.
Nichols' oldest daughter, he said, has spina bifida. "It's important that Medicare is solvent for her," he said.
Holding out his smartphone, he showed a local news report that said Excellus Blue Cross/Blue Shield had a $1.26 billion rainy day fund — yes, with a "b" — yet the company wants to hike members' premiums from $5.59 to $37 a month.
"People who are lobbying against this (legislation) are making profits off prescription drugs and health care," he said. "They are going to squeeze this sponge until there is nothing left."
As local president of the East Syracuse Minoa United Teachers, he often helps members with health care issues. As a teacher, he has seen students affected by lack of health care.
"Some of my students' parents make the decision about whether or not to take their kids to the pediatrician based on cost," said Nichols.
Mike Delaney, Faculty Federation of Erie CC, says ACA helps his family
"My 22-year-old was hospitalized for more than six weeks with a serious mental illness," said Erie Community College faculty member Mike Delaney.
"He is on my health insurance. Before ACA, I could only keep him on to age 21 unless he was in school full-time. This would have been unbelievably expensive. There was no way I could've paid for it, or he could've paid for it. I'm very grateful this law got passed when it did and did not get repealed by the Supreme Court."
Janis Bianco worked 32 years under five principals at Rondout Valley. When she had bloating, fatigue, distention, bowel irregularity and reflux, her doctor said it was caused by stress from working long hours.
Then, two teachers saw the secretary leaning against a wall in pain, so they took her for more investigative medical care. Testing showed ovarian cancer, and within a week she had surgery. That was in 1995. Last August, the cancer came back and she underwent more surgery.
Janis Bianco, retired SRP, witnesses drastic moves to get care
Bianco remains grateful for her insurance and the support of friends and family — especially after seeing others make heart-wrenching choices.
"I knew women in the hospital who divorced their husbands because their husband's insurance wasn't enough to pay for their surgery and treatment. So they became charity cases and could not be turned away," said Bianco, a member of the Rondout Valley Federation of Teachers and SRPs. The ACA provides people with health insurance and helps children receive immunization and preventative care a lot of parents cannot afford, she said.
The ACA is "based on equality," said Vickie Shantie, a rural North Country teacher and member of the Malone Federation of Teachers. "It's another civil right to me."
The two "strong women" who led her local union have now retired, and they both have breast cancer, she said. Fortunately, they had examinations early enough to find the problem, begin treatment and save their lives.
Teacher, Vickie Shantie, says health care is about civil rights
"How many women don't?" Shantie asked. "The numbers are astronomical. Women do not have to die (due to lack of treatment)."
The majority of medically underserved communities in the U.S. are in rural areas, where it is difficult to attract and retain medical professionals. The ACA provides increased payment to rural health care providers to help them continue to serve their communities.
Shantie says she sees senior citizens in the pharmacy holding bags with empty bottles that sometimes they cannot afford to get refilled.
"It's heartbreaking. That's an equality issue right there," she said.
Starting last year, seniors who reached the coverage gap — or so-called donut hole — were to receive a 50 percent discount when buying Medicare Part D-covered brand-name prescription drugs. Over the next 10 years, seniors will receive additional savings on brand-name and generic drugs until the coverage gap is closed in 2020.