What the ACA Means To Me (by Angela Carpenter Gildner)

Angela Carpenter Gildner [image description: a white-appearing woman with blond hair poses in a gray “Health Care Voter” t-shirt with a red cushion in the background]

On Thursday, June 17, 2021, the U.S. Supreme Court upheld the Affordable Care Act (ACA), and I breathed a huge sigh of relief. I've lost count of how many times I have metaphorically held my breath while waiting to find out if the ACA, which ensures my children and I have health insurance, will remain law.  

The Supreme Court's decision to uphold the ACA means my family of four will continue to be insured. It protects three of us from being denied coverage due to pre-existing conditions. It means I can finish my Master’s in Social Work. If the Supreme Court had not upheld the ACA, I would have had to weigh the possibility of either becoming uninsured while I finished my last classes and field work, or dropping out to find a full-time job with benefits. 

Getting my social work degree is the long-delayed answer to a professional calling to a helping profession. A calling I ignored for over a decade because good health benefits, so critical for my family, kept me tied to my old job.

In 2004, a few months before our wedding, my husband, who is a musician, voiceover artist, and audio engineer, had the opportunity to fulfill a professional dream by purchasing a small recording studio. With that purchase he left the security of a full-time position at a disability advocacy organization. I agreed my job would, for the foreseeable future, provide our family's health insurance. 

Graham and Margot [image description: a white-appearing brother and sister, each wearing t-shirt and shorts pose knee-deep in a lake with mountains in the distance on a sunny day]

That family expanded from two to four when we welcomed children—a boy, Graham, in 2006 and a girl, Margot, in 2009. During the first five years of Graham’s life, our employer-provided insurance changed carriers four times. Twice to plans not accepted by our pediatrician. Long live the myth employer-provided health care plans mean your preferred doctors will be covered year after year. 

As a mother, I wrestled with the desire to have more time with my children and the need to work full-time to maintain access to health insurance. This emotional tug-of-war worsened as it became apparent my son was not neurotypical, and my daughter, at three months old, started needing nebulizer breathing treatments several times a day. 

By the time Graham finished elementary school, he had a list of pre-existing conditions. I was grateful for the protections of the ACA—he couldn’t be dropped from our plan or max out his lifetime coverage. Thankfully, as she grew Margot's asthma improved. By the time she started elementary school she needed daily treatment only following a respiratory illness. Unfortunately, my asthma worsened significantly, necessitating two different steroid inhalers twice daily to keep it in check. 

In 2015, I added cancer to our family list of pre-existing conditions. Thankfully, my breast cancer was caught early and treated with a lumpectomy and radiation. I continue to be screened every six months, alternating between a 3D mammogram and an MRI, to ensure if the cancer reoccurs it will be caught early. 

Cancer made me hyper-aware that life is too short to waste time at a job that was no longer fulfilling. Early in 2017, I took a leap of faith and left my job of 16 years. After a couple months on COBRA, our family signed up for insurance via the DC Health Exchange, which wouldn't exist without the ACA.

By January 2018, Graham had been diagnosed as Autistic, with comorbid depression and anxiety. We had spent months, now years, working with a psychologist and a psychiatrist to find the right balance of weekly therapy and medications to ensure the playful, happy Graham who loves hugs stays present, and the angry, anxiety specter is kept at bay.

 My son will tell you, if we hadn't gotten him help when we did, he might not be here today.

In the fall of 2018, I officially entered graduate school part-time pursuing a Master's Degree in Social Work. My experiences trying to find treatment for my son, and doing citizen advocacy with Little Lobbyists to protect the ACA highly influenced this choice.

Unfortunately, as Graham's mental health stabilized, Margot's deteriorated. Margot now also has a list of pre-existing conditions including anxiety, depression, and ADHD.

Getting my children the care they need is made exponentially more difficult and more expensive by the continued disparity between reimbursement rates for behavioral health care compared to physical health care. The shortage of mental health providers who see children and adolescents means finding one taking new patients is difficult and usually involves months on a waiting list before an appointment. Finding a provider who takes insurance is nearly impossible. 

Our family's annual therapy tab reminds me the ACA still desperately needs improvement. Despite this, I am grateful for the ACA every day. Grateful for the security it provides to my family. In spite of our list of pre-existing conditions, we cannot be denied health insurance.

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Angela Carpenter Gildner lives in Washington, D.C. with her husband, children, and an assortment of pets. After graduating with her MSW in May 2022, she plans to practice clinical social work with children and adolescents, and continue her advocacy for the health of our planet and the right of healthcare for all.