Oregon Man Worries ACA Repeal Could Deny Him a New Heart

Oregon Man Worries ACA Repeal Could Deny Him a New Heart

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Last March, when Nick Tran was told by his doctor in Bend, Ore., that the shortness of breath he had been recently experiencing was because he had congestive heart failure brought on by a viral infection, he was stunned.

All of his 46 years, the Vietnam native had enjoyed relatively good health and there was no history of heart disease in his family.

Tran’s condition worsened rapidly and within a couple of months of his diagnosis he was put on a heart transplant list. He could no longer work as an attorney in the law firm where he was a partner, and went on disability.

Now Tran is among the 52 million U.S. adults under 65, or about 27 percent of that population, with a pre-existing health condition that would have made him uninsurable in the pre-Obamacare, aka Affordable Care Act (ACA), days. A provision in the 2010 law – arguably its most popular -- banned insurers from denying coverage to people because of a pre-existing health condition.

At the time of his diagnosis, Tran was on a so-called “bronze plan” purchased through the state insurance exchange. He has since moved to a silver plan. With federal subsidies, his monthly premium rate is a mere $114, which Tran describes as a “godsend.”

Since he was diagnosed with his heart condition, Tran believes the total cost of his hospitalization, pacemaker surgery and medications that keep his heart pumping could have run him around $400,000. But because he has insurance, all he’s responsible for is his out-of-pocket expenses, around $6,500.

“That’s a manageable amount,” he said.

Acccording to a Kaiser Family Foundation poll, 52 million of the 55 million people with pre-existing conditions are covered by employer-sponsored health insurance or a public option like Medicaid. But the Foundation also points out that because the survey didn’t include questions about such conditions as HIV or hepatitis C, that figure is very conservative.

U.S. Senators have already started making good on President Donald Trump’s threat to repeal Obamacare, which has helped more than 20 million people get health coverage, some of them for the very first time.

Trump has said he wants to keep the provision that would protect people like Tran with pre-existing conditions. But given his habit of backpedalling, health advocates aren’t sure what direction he will take.

“To what extent people with pre-existing health conditions are protected is likely to be a central issue in the debate over repealing and replacing the ACA,” the Kaiser Family Foundation observed in its poll report.

By a 51-48 vote, the Senate last week approved a budget resolution that has set the stage for large chunks of Obamacare to be repealed through a process known as budget reconciliation. A reconciliation measure cannot be filibustered, which means it allows the chamber to pass a bill with a simple majority, unlike needing 60 votes to overcome a filibuster.

Parts of Obamacare that do not directly cost the government money or raise taxes -- such as banning insurers from denying coverage (or charging higher premiums) because of a person’s pre-existing condition, or requiring insurers to allow parents to keep children on their policies until the age of 26 -- can’t be repealed with a simple majority vote. So any move in that direction would be subject to a filibuster in the Senate. Democrats have said they are ready to do that.

Tran, like the estimated 3,000 people who are currently waiting for a heart transplant, might have to wait several months before he can find a suitable donor, whose blood and tissue type match his.

He said he’s taking it one day at a time. In the meantime, he has set up a gofundme fundraising website called Nick’s Medical Fund as well as a Facebook fundraising page. People wishing to send a check or money order should make it payable to Nick Tran and send it to Attn. Trish Sewell, Mike McCord, Attorney at Law, New Heart for Nick Tran Fundraiser, 65 NW Greeley Avenue, Bend, OR, 97703.