Jessica Intermill relies on the Affordable Care Act to help her manage her rheumatoid arthritis (photo via subject)
Jessica Intermill relies on the Affordable Care Act to help her manage her rheumatoid arthritis (photo via subject)

“The only reason that I haven’t had to declare medical bankruptcy is because of the ACA. I didn’t ask for a disease that costs tens of thousands of dollars every single year.”

Tens of millions of Americans will hold their breath on Tuesday, as the US Supreme Court hears a case that will determine the future of the landmark 2010 law that dramatically expanded health care and has saved countless lives. 

Eighteen Republican-led states, with the backing of President Donald Trump, are seeking to repeal the Affordable Care Act (ACA), arguing that the law is unconstitutional. 

Should the 6-3 conservative Court agree with them and strike down the law, it would throw the nation’s healthcare system into turmoil. More than 20 million Americans would lose coverage, and as many as 133 million Americans who live with pre-existing medical conditions such as diabetes, heart disease, and cancer could once again be denied coverage, offered minimal coverage, or forced to pay for extremely expensive plans. 

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“If you had a pre-existing condition before the ACA, depending on where you lived and whom your carrier was, you could be denied coverage or be deemed uninsurable,” Howard Koh, former assistant secretary for health for the US Department of Health and Human Services under President Barack Obama, told COURIER over the summer. “And given the burden of chronic disease in our country, that involved millions of people.”

Over the coming week, as the Supreme Court mulls whether to take away health care from Americans, we will bring you the stories of people who rely on the ACA for coverage and protections. 

‘I’ve Never Had a Chronic Illness Without the ACA’s Protection’

Jessica Intermill is a 40-year-old mother who lives in Minneapolis, Minnesota. Ten years ago, she was diagnosed with rheumatoid arthritis, a chronic disease that requires constant treatment. Without the ACA, her condition would leave her vulnerable to discrimination by insurance companies.

“I have relied on the ACA every single day,” Intermill told COURIER.

The law has protected her care, guaranteed coverage of her chronic disease, and banned insurance companies from placing annual or lifetime dollar limits on the benefits she receives. The ACA removed those caps, which has been a literal lifesaver for Intermill, whose care has cost $496,000 over the past eight and a half years. Because the ACA is in place, she has paid a fraction of that and will continue to receive coverage for the care she needs, regardless of the annual or lifetime cost.

Without those caps, Intermill wouldn’t be able to afford the medication she needs to treat her arthritis. “Without this [medication], I can’t make a fist. I can’t lift up my kid. I can’t be the neighbor or the mom or the community member or the wife that I want to be,” she said. 

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“The only reason that I haven’t had to declare medical bankruptcy is because of the ACA. I didn’t ask for a disease that costs tens of thousands of dollars every single year. I didn’t ask to need a drug that costs more than $125 every day, every day, for the rest of my life. It just happened. And I was fortunate that when it did, the ACA was there and was able to protect my insurance coverage so that I could work with my insurance company to make sure that I could get these drugs.”

While the ACA has provided a safety net for Intermill, her constant stress over the Republican Party’s 70-plus attempts to repeal the law have taken a toll. “It’s really hard to have a chronic condition,” she said. “Adding the GOP attacks for the last 10 years just makes it harder.”

Intermill is terrified that the Supreme Court will strike down the law and what it might mean for her. “I’ve never had a chronic illness without the ACA’s protection,” she said.

In fact, she was so concerned that when she lost her job—and with it her health insurance—during the coronavirus pandemic earlier this year, she opted to maintain her employer-sponsored coverage through COBRA, which requires her to pay both her and her former employer’s shares of the premium. She could have chosen coverage through the ACA marketplace, but she said she isn’t confident it will exist much longer. 

“I know that right now President Trump and his GOP enablers are trying to strike down the law, and I don’t trust the Supreme Court to do the right thing,” Intermill said.

Republicans from Trump on down have repeatedly promised that they will protect pre-existing conditions and offer up a better alternative to the ACA. Yet, they have failed to put forth a tangible proposal. 

Intermill doesn’t know what the future holds for her if the ACA is struck down. She fears she will struggle to access the care she needs and could be left to suffer in secret.

“When you see me on the street, you won’t see that my disease ate holes into my bones before I got the right treatment,” Intermill said. “You won’t see those fistfuls of pills that keep me healthy. You won’t see that my care has cost almost a half-million dollars since it was diagnosed eight years ago. You won’t see that just one of my drugs costs more than $100 every single day. But it does. The thing about chronic illness is you can’t put it down.”

READ MORE: They Overhauled Health Care. It Saved My Life.