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Sabotaging Healthcare Reform (under Trump presidency) Affected Freelancer's Life Decisions

Theresa BrownGold's painting "Sabotaging Healthcare" for her art project, Art As Social Inquiry.

(Interview September 2017, oil on linen, 40 ins. x 30 ins.)

Update 2018

The subject sent an update as of 8/2018. After 7 months in the new job, however, he decided to strike out on his own again as a self-employed person.

The subject writes, “The ACA put within reach an end to the days when people had to work just for health insurance, to allow fear of the unexpected to govern their life choices. The Republican Party now wants to limit people’s life choices again, not to expand them as they claim. But I choose not to be limited any longer, even if that choice eventually puts me at risk. I’d rather die fighting.”

Artist’s Note (2017)

Politics matter in people’s lives.

This subject based a major life decision to end his freelance career when the voters elected President Trump in 2016 and Republicans took control of both houses of Congress. He suspected a GOP-controlled government would upend the Affordable Care Act (ACA) aka Obamacare. He was not wrong.

As a freelancer, the subject relied on the Affordable Care Act’s online marketplaces where individuals could buy health insurance. Good insurance was - and is - a must.

A staph infection nearly killed this health enthusiast. He needed surgery to implant a porcine mitral valve (from a pig) in his heart. This preexisting condition will forever be in his medical records. He expects more open heart surgery when the valve deteriorates. For now the subject is well and thriving.

“The doctors said it was the worst case of infection they had ever seen in their careers. I was hours from death.”

Even when laws are not repealed outright like the ACA – Congress fell short of the votes to do that - a US president and Congress can do much to undermine a law.

But how does sabotaging the ACA affect a single person like the subject of this painting?

It goes like this. The President uses executive power to weaken Obamacare. Those measures go from shortening enrollment periods, and practically eliminating outreach funds all the way to finding ways to inject subpar policies into the marketplace that eliminate preexisting condition protections.

Trump destabilized the healthcare law for insurers as well. When insurance companies cannot rely on the US government to get behind a law that affects their business, those companies get nervous. Companies hedge to protect profits. Market uncertainty makes premiums soar.

People like this subject foresaw market turmoil and possible ACA repeal after the Republican sweep in the 2016 election. He feared that his preexisting condition would leave him uninsurable if he did not get a corporate job with health insurance benefits.

The subject gave up a freelance career he loved at substantial personal cost. President Trump's attempts to destroy Obamacare scared this entrepreneur who absolutely had to have reliable insurance. The subject did not trust that the ACA online marketplaces -- where individuals not getting insurance through jobs could buy insurance -- would remain intact.

After all, the new president, Donald Trump, made repealing the healthcare law a priority in his campaign. With so much uncertainty ahead, the subject found a corporate job and abandoned his thriving freelance career.

The subject read the tea leaves correctly. The President is recklessly playing politics with our lives by trying to sabotage the healthcare law. This portrait story illustrates the fallout. People are making big life decisions – like whether to be an entrepreneur or go corporate –to fend off the havoc the President is causing in their lives.

Full story below.

Sometimes painting is hit or miss. A lot of misses for this portrait story.


Theresa BrownGold's painting "Sabotaging Healthcare" for her art project, Art As Social Inquiry.
A study. Oil on canvas, 24 ins. x 20 ins.

Medical Editor for a Multinational Media and Information Firm (Former self-employed writer and editor for almost 10 years), Age 47, Insured

The subject used to run 35 miles/week, doesn’t drink coffee, almost never drinks alcohol, never tried a cigarette, does not do illicit drugs. Yet, a staph infection almost killed him.

The subject acquired a near-fatal staph infection from an unknown source when he was 43 years old. He underwent emergency open-heart surgery to replace his mitral valve with a pig valve, a porcine mitral valve. The infection was so severe that the subject required close monitoring in the ICU for 2 weeks. Staph had invaded every organ except his brain. He was swollen to the point of being unrecognizable. Doctors had prepared his family and friends for his possible death.

“The doctors said it was the worst case of infection they had ever seen in their careers. I was hours from death.”

The subject lived, but the trauma still haunts him. “I had no congenital problems. I got regular checkups before I got sick. Now I have a pig valve in my heart that will eventually wear out in 10-12 years. Repeat open-heart surgeries are in my future. Repeat valve replacements are an especially high-risk operation. I may never see Medicare. Every day I am afraid of getting a cut, getting an infection. I don’t know how I picked up the staph infection.”

The subject was self-employed when he got sick in 2014. He credits Massachusetts’s trailblazing universal healthcare law (Romneycare) under Governor Romney followed by the Affordable Care Act (Obamacare) for giving him the impetus he needed to establish himself as a freelance writer and editor in 2008 for some of the country’s top medical publications.

These two healthcare reform laws enabled this subject to buy a health insurance policy as an individual who was not part of an employer’s group health insurance plan. Healthcare reform made it possible for the subject to start his own business. He grew and sustained his business for almost 10 years.

2016 presidential politics retraumatized the subject after his 2014 brush with death. Donald Trump’s candidacy and election as the US president, coupled with Republican control of both houses of Congress, so rattled the subject that he abandoned his successful freelance career to take a job at a large company that would give him reliable health insurance benefits.

The subject feared the new President and Congress would try to repeal or severely weaken the ACA, Obamacare. “I was frightened to death during the campaign. People were screaming ‘Repeal and replace.’ Trump unearthed deep misconceptions about Obamacare.”

As a self-employed worker, the subject relied on the ACA for health insurance to pay for life-saving medical care. The new healthcare law made it possible for freelancers and entrepreneurs – especially those with preexisting conditions – to buy individual health insurance policies without fear of being discriminated against because of their medical histories.

As it turns out, the subject’s fears were not unfounded. Although the current Republican president and Republican Congress failed to fully repeal the ACA, they have managed to weaken and destabilize the ACA marketplaces. Individuals buying insurance on the ACA marketplaces who qualify for financial help are somewhat shielded from marketplace volatility. Their premiums are based on a percentage of their income. Subsidies will increase as premiums increase.

But others, like this subject, who buy insurance on the ACA marketplace do not qualify for financial assistance. They still need to be able to buy health insurance as individuals shopping on the online marketplaces. The subject paid the full insurance premium and was happy to do so to get quality health insurance on the Obamacare marketplace.

Rising insurance premiums were a concern, but not the subject’s first consideration. The subject’s previous staph infection and subsequent mitral valve replacement now leave him with a preexisting condition. Without the ACA’s consumer protections that prevent insurance companies from discriminating against those with preexisting conditions, the subject would be uninsurable or could be priced out of insurance.

He could not gamble that the healthcare law would still be around under a Trump presidency, or that ACA marketplaces would continue to exist in a form that would guarantee insurance coverage for people like him with preexisting medical conditions. He knows a life-threatening staph infection and a pig heart valve are recorded in his medical records making him an easy target for insurance companies if they are no longer required to sell policies to individuals who have had illnesses.

“I went to an employer out of fear. When you have been through a healthcare trauma, you get frightened easily. I don’t want to be in a situation where I need open-heart surgery, and I go bankrupt.”

Although the subject felt comfortably insured in his corporate job, he has paid a personal price. When he was his own boss, he arranged his schedule to include activities he enjoyed like teaching math, reading and writing to adult immigrants. He also wanted to be a part-time dog-walker just for fun. And now that his mother is ill, he wishes he had more flexibility to help with her care.

The subject needs to know he has good insurance he can count on without the unpredictability and chaos the Trump administration is injecting into the Obamacare insurance markets.

“The message needs to get out that self-starters need this law.” The subject says that President Trump and the Republican-controlled Congress are “putting a knife into the economy. The uncertainty they are injecting into the system has chilling effects not just on the insurance industry, but on real people.”

The subject has a message for Paul Ryan, the Speaker of the US House of Representatives. (The Speaker’s relentless propaganda campaign helped destabilize insurance markets.)

“I have never taken a dime of help, and now I am on the ‘dole’ because I have employer-based insurance. Employers get tax breaks for my health insurance. As a small business owner, I was totally self-sufficient, but I had to abandon my small business. And now, technically, I’m on the ‘dole.’ You took a guy who has never sucked anything from the system and drove him to employer-based insurance."

"There are people who need what the ACA has allowed – freedom to be self-employed. “

The subject adds, “Sickness is not age-related. If skimpy policies come back, what happened to me will bankrupt people. You may not know exactly what you are buying then you wake up with a staph infection. You can’t go back to the insurance store. ‘Oh, I bought the wrong policy.’ You go bankrupt.”

Subject’s Follow-Up Statement

The Affordable Care Act gave me the freedom to work for myself without fearing that I might lose my health insurance or be charged unfairly for it if a major illness ever struck. I never expected one to strike - but in 2014, it did. The ACA then made me feel secure that I could at least continue to be free in my professional and personal life, even though my health trajectory would never be the same.

The 2016 election robbed me of that sense of security and sent me scurrying back to the partial protection of employer-based insurance, only to discover that living in fear is something I cannot tolerate indefinitely.

As of this writing, in 2018, I have decided to strike out on my own again as a self-employed person, even though the future of the ACA is still in peril from sabotage by a political party that merely pretends to value entrepreneurial risk-taking.

The ACA put within reach an end to the days when people had to work just for health insurance, to allow fear of the unexpected to govern their life choices. The Republican Party now wants to limit people’s life choices again, not to expand them as they claim. But I choose not to be limited any longer, even if that choice eventually puts me at risk. I’d rather die fighting.


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