Lifesaving Law

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.

Rachael Moore/Flickr

Rachael Moore/Flickr

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.