By EMILY WEST
Sitting in Sen. Lamar Alexander’s office, Franklin’s Jennifer Alvey thought she had made some headway. She at least thought she had been heard when she asked that the Tennessee senator have a replacement in the pipeline before voting on any type of repeal of the Affordable Care Act.
Fast forward a little more than 24 hours later, and the political atmosphere had changed from when she walked out of his Nashville office.
At nearly 1:30 a.m. on Thursday, the U.S. Senate pushed forward with legislation that could repeal the Affordable Care Act, but nothing equating to a replacement has entered the picture. Previously on Wednesday, Jan. 11, Sen. Alexander had presented a three-step plan to repeal the ACA but also have a component of reconstruction. He said that would have to happen before March 1 before insurance companies had to make decisions about entering the markets.
That could come weeks sooner than the desired March deadline.
The U.S. Senate passed legislation – on a 51-48 vote – that could become the blueprint for dismantling a system that provides millions of people with healthcare. Those in Tennessee and Williamson County would be included.
The Senate and House have also given themselves a deadline of Jan. 27 to repeal the ACA. President-elect Donald Trump has nothing short of demanded a hurry-up attitude from Congress on addressing the issue.
“There’s been no concrete proposals for what happens in the future,” Alvey said. “This uncertainty keeps me up at night. I’ve been walking around with a lot of anxiety the past month or so. I don’t understand what the plan is except to score political points. This is an issue of decency and a basic human need.”
So what would the ACA repeal without a replacement look like for Alvey?
Something along the lines of “unsettling” for the Type 1 Diabetic, a condition she can’t change. Three days without insulin would place her on her deathbed. Prior to the ACA, she could have no discussion with companies without the discrimination of her pre-existing condition. With the ACA provision, companies can’t discriminate.
“In real terms that means without any replacement, I could easily look at $1,500 to $2,000 a month for medication,” she said. “The price of insulin is very high. It’s $600 for vile of insulin, and I need two a month. Without insulin, I will die. I don’t make any insulin, and you need that in order to live.”
It also doesn’t address the attitudes other Tennesseans have when it comes to the ACA. A poll commissioned by The Alliance For Healthcare Security on Jan. 5-6 showed a majority of Tennesseans oppose repeal of the ACA without a replacement plan that provides many of the same benefits the insurance system has.
The Alliance for Healthcare Security is a national coalition of nurses, caregivers, patients and healthcare advocates that has worked to educate consumers on the ACA. The poll surveyed 840 Tennessee voters and had a 3.4 percent margin of error.
According to the data from the North Carolina company, 57 percent of those polled would most like the Congress to keep what works in the Affordable Care Act and fix what doesn’t. At least 68 percent also opposed reducing the current protections for people with preexisting conditions, and allowing insurance companies to deny them coverage or charge them more if they had a lapse in their coverage for some reason.
The majority of those who participated in the poll were 46 to 65-years-old.
“It’s rare to see a consensus on any issue,” pollster Jim Williams said. “But these numbers are a clear signal that people are very concerned.”
Sen. Alexander in a long blog post yesterday – prior to the vote – said those with pre-existing conditions wouldn’t be affected. Those under 26 could still stay on their parents’ insurance.
But if those provisions will come to fruition has yet to be seen. Tennessee state government is in a holding pattern until the federal government makes its decision, meaning the state can’t currently help its own constituents.
“When I heard the news that the senator had voted to start removing the budget authority for funding, that means by the end of 2017 I will have to double or triple my business income or close my business,” Alvey said. “I am not sure how that helps. It doesn’t help me or my family. I am not sure how it helps the state overall.”
What will ultimately happen to the ACA remains to be seen.