Diane Benefiel almost died from the H1N1 virus in 2010.
After being in a coma for three and a half weeks, fighting a powerful spine infection and ending up with a severely compromised immune system, Benefiel spends six hours — and $20,000 — every 30 days for expensive biological infusion treatments to stay alive.
She’s a high risk patient who costs a lot of money to insure — and one who was extremely worried about the prospect of the repeal and replacement of the Affordable Care Act, also known as the ACA and Obamacare.
“I am one of the people that people don’t like about Obamacare,” Benefiel said. “Until it happens to their family, it’s a very abstract concept.”
Benefiel is one of almost 3,000 people in Teton County covered under the ACA.
The proposed replacement, the American Health Care Act, died, for the time being, on Friday. Speaker Paul Ryan of the U.S. House of Representatives pulled the bill when it became apparent that it didn’t have enough votes to pass.
“The decision to keep Obamacare, at least temporarily, makes more of a difference in Teton County than it does almost any place else in the country,” said Joe Albright, a health care navigator and St. John’s Medical Center trustee.
He referred to the ratio of people covered under the ACA locally compared to nationally. Albright said the number of people who combine several jobs and don’t have employer-provided health care coverage in the valley might be why our average is so much higher than the nation’s.
1-in-9 in county are covered
Based on U.S. Department of Health and Human Services data for the period of Nov. 1, 2015, through Feb. 1, 2016, 2,812 Teton County residents enrolled in the Affordable Care Act’s federal health insurance marketplace. The U.S. Census Bureau estimated that Teton County’s population was 23,191 in July 2016.
“That means about 1 out of 9 people in Teton County are covered by insurance plans in Obamacare exchanges,” Albright said. “If you look at it nationally, about 10 million people signed up out of roughly 325 million people in the United States. That comes to about 1 out of 33 people nationwide.”
Without her $10,000 deductible under Obamacare — paid in the first month of her treatments — Benefiel could have been on the hook for $240,000 a year.
“I’d be dead without it,” Benefiel said. “But in the first year, there goes all my savings. The next year, there goes my house. After that, I’d probably have to move out of the state somewhere that had expanded Medicaid or go down to Colorado where assisted suicide is legal. I don’t want to bankrupt my husband.”
Benefiel said her health expenses have driven her to think of ending her own life.
“When I woke up, I sometimes thought it was harder to live than be in my coma,” she said. “The despair is so bad that suicide is an option.”
Without coverage, Benefiel would have to quarantine herself in a place where being with other people couldn’t compromise her immune system.
The coverage at stake isn’t just people with cases as extreme as Benefiel’s. Wren Fialka was diagnosed with melanoma almost 10 years ago. She had the mole removed and is healthy now, but she now has a black mark on her record.
“Obamacare saved me,” she said. “And there are so many more people that have worse situations than I have that losing health care could be seriously life-threatening to the point of being just terrifying.”
Fialka said after her health care costs increased after her surgery, and because she has always been self-employed she pays for her own insurance.
“I couldn’t not pay it because then something else could happen to me,” she said. “But I was paying the equivalent of my rent in health care every month.”
Fialka’s $5,000 annual deductible wouldn’t pay for itself unless she had a “major health crisis.”
“Obamacare wasn’t perfect,” Fialka said, “but it worked for a lot of people. And it saved the quality of my life.”
And Fialka said she knows she isn’t the only one who depends on it. Through her nonprofit, Spread the Love Commission, she often interacts with the homeless population.
“There are so many people out there who had to foreclose on their house due to a major medical emergency,” she said. “I hear it all the time. We would have a much bigger homeless population if there wasn’t Obamacare.”
Congressional delegation wants it gone
Wyoming politicians aren’t encouraging anyone else to sign up for the ACA and firmly believe it should be axed.
“Obamacare is failing hard-working families in Wyoming and across the country,” said Rep. Liz Cheney, Wyoming’s woman in the U.S. House “It has put our health care system into a death spiral. Costs are skyrocketing and choices are plummeting. We must repeal and replace it.”
Cheney was unhappy with how the fate of the American Health Care Act played out in Washington, D.C.
“I’m disappointed that there was no vote last week in the House of Representatives,” she said, “but I am absolutely dedicated to rescuing our citizens from Obamacare’s collapse.”
Saved from ‘Obamacare’
Wyoming U.S. Sen. John Barrasso also wasn’t happy with the lack of vote.
“This is a step back from replacing the failing law,” Barrasso said. “It does not change the fact that Congress must act to help the many families struggling under Obamacare. The law’s skyrocketing premiums and deductibles are putting health care out of reach for too many patients.”
And U.S. Sen. Mike Enzi thinks the American Health Care Act was motivated by the right goals, and that the ACA isn’t serving Wyoming residents well.
“Obamacare is failing the American people,” Enzi said. “Insurance markets are collapsing, premiums are out of control. For more and more Americans, including my home state of Wyoming, there is only a single insurer from which they can select health plans. This means surging premiums for hardworking families who now have to choose between unreasonable insurance rates or an unreasonable fine.”
Enzi also believes health care reform has been a long time coming.
“Health care reform has been something that was needed long before Obamacare was even debated,” he said. “And Congress has an opportunity to make progress on important reforms that will truly fulfill the promise of providing access to affordable, high-quality health care.”
House Republican leaders and the White House announced Tuesday that negotiations to repeal the Affordable Care Act had started again. But for high-risk patients like Benefiel who depend on the health care system as is, the prospect of losing insurance isn’t just scary.
It’s a matter of life or death.
“You have to have health care for everybody,” she said. “Everybody should have some security. Without it, I’ve thought about dying to spare people’s expense.”