Photo by Jenny Stronstad

Five years ago today, U.S. President Barack Obama signed the Affordable Care Act into law. The law aims to reform both our private and public health insurance systems, in order to expand coverage to 24 million Americans by 2023. Among the law’s many goals: increase benefits and lower costs for consumers, provide new funding for public health and prevention, bolster our health care and public health workforce and infrastructure, foster innovation and quality in our system, and more.

Recently in an amicus brief APHA and schools of public health urged the U.S. Supreme Court to protect the ACA in its entirety when it rules in King v. Burwell, a case that threatens the law and gains made in reforming our nation’s health system. A fan of APHA’s Facebook page and commenter on one of our posts, Kansas resident Jenny Stronstad, shared her story with Public Health Newswire. You can share your ACA story with us at newswire@apha.org. Disclaimer: The opinions, beliefs and viewpoints below are solely those of the author and do not necessarily reflect the opinions, beliefs and viewpoints of APHA.

Greetings from a recent college graduate, an early-careerist and a mid-twenties gal living in the Midwest. My name is Jenny and I want to share my health care experience on the fifth anniversary of the Affordable Care Act.

Before the Health Insurance Marketplace existed, my premiums were $180 a month. When I was making less than $19,000 a year, going to school more than full time and supporting myself, I saw that $180 as essential for other necessary life expenses: one-third of my rent, my food for the month, four tanks of gas and a book for school. To make matters worse, that premium did not provide me with an affordable visit to my physicians; I had to pay a $7,000 deductible before my insurer paid for 80 percent of my care costs. I also had a preexisting condition where my insurance plan would not cover any medical intervention related to three of my organs — ever. For example, my ovaries were blacklisted; my insurer would not cover my well-woman’s exams.

My first year with a plan purchased through the federal exchange plan was great! I qualified for a “silver plan” and paid $10.98 a month. My yearly maintenance checks and to visit my primary care provider, or PCP, were included with no additional charges and seeing a specialist did not break the bank. Getting information from the company was easy and efficient. Best of all: The plan was based on my income, age, location, and whether or not I smoked. It did not exclude organs! I was able to stay with my PCP and had no problems with billing or payments.

Year two is not so easy. I live in Kansas, a state that did not expand Medicaid to cover people who make even less than me. For the exact same plan, my premium jumped from to over $70 per month. For me, that’s food for half the month, two tanks of gas and my utilities. It is beginning to reach that uncomfortable place again where I cannot afford health insurance. I am not getting anything more for my increased cost; it is the exact same plan. While my yearly exams are the same, thanks to federal exchange standards, everything that could legally increase, did.

Health premiums have jumped throughout Kansas. My state did not expand coverage and with no additional insurance providers joining the exchange this year, current payers were encouraged to raise their prices. As of now, Kansas residents have only two insurance companies in the exchange from which to choose from.

The ACA aims to create more insurance options and opportunities for increased health education. One of the main arguments against the ACA is that it will turn our health care system into a “single payer” system where the government is in complete control. I personally find this ironic because in Kansas, resistance to the ACA is creating a limited market and higher prices for our residents to achieve health.

In my opinion, state involvement is necessary to alter the course of health insurance starts — and help us become a healthier nation.

We can turn this around. You can contact your state governors — identify yours and find contact information at www.nga.org/cms/governors — and urge them to both expand Medicaid and create a state exchange. The next biggest driver of change will be strong consumer knowledge, which is limited in America regarding personal medical care. A basic understanding can be provided in schools, but beyond that consumer knowledge will be gained by those who choose to seek it for themselves with the aid of their PCP.

While health care maintenance, cost, and consumption are growing concerns in America, it is important for us to remember that health is a commodity. While it is easy to look at our current situation and apply needs that might nurse our health care system to better economic standing, our personal health is rarely a quick fix. While we all can better protect our health in the Marketplace by choosing a primary care physician, gaining price awareness and becoming a properly educated consumer, choosing a physician, and properly educated consumers may help mend the Marketplace, the only way to heal our health care system is if our system allows Americans the opportunity to heal themselves.