You Don't Actually Need Affordable Health Care — Until You Do

Photo via @Apedelman.
The author at 41 weeks pregnant.
“Don’t worry; I’m the healthiest person in my family!” is what I cheerfully say to every doctor to assuage her fears as she scans the “yes” check next to every item on my family history form in alphabetical order: addiction, arthritis, drug abuse, heart disease, hypertension, lung cancer, melanoma, mental illness...
But really, don’t worry. Despite the genetic cards I was dealt (or, more likely, motivated by them) I’m a healthy pescetarian yogi whose blood test results have made medical professionals applaud. I’ve never so much as broken a bone, let alone had surgery, and I hardly even get colds. Because of this rare and absolute luck and privilege — that of being completely healthy for 30 years — I tempted fate: In my 20s, I went without health insurance for five years.
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And actually, it was fine. (Again: absolute luck and privilege.) I didn’t get sick, I didn’t get into an accident; there were no surprise diagnoses that turned my life upside down and emptied my bank account. Sure, I had to shell out a couple big bucks for dental fillings. But it was fine! And good thing, too, because not only did I not have health insurance, I also earned a whopping nonprofit salary of $33,000 per year. In Manhattan. In 2010. I was in that miserable sweet spot well above the poverty line and well below being able to afford NYC rent plus the likes of $500 per month for health coverage. I don’t know what I would have done if I had been hit with any substantial medical bill, but it probably would have involved GoFundMe.
By the time I found myself facing that oh-so-common “preexisting condition” known as pregnancy, it was 2015, post-ACA, and I had affordable healthcare coverage for myself, my domestic partner, and my fetus. Again, absolute luck and privilege, because my 30 sickness-free years were rapidly coming to an end. In the very early weeks, I was amazed to see what Pregnant Amelia could do. 12,000-foot hike? No problem. 20-mile bike ride? On it. But Pregnant Amelia was having a really hard time doing one thing: eating. All of a sudden, I couldn’t keep a thing down. My body had started on a months-long deprivation diet without my permission.

Life is full of surprises. You never know when a diagnosis or a layoff or an accident or an expense or a friendly case of hyperemesis is going to show up.

Morning sickness, of course, is super common, and can sometimes last all day, so I figured this had to be normal. When I dropped five pounds, I thought, this is fine! But the more of my old favorite foods I tried to coax my stomach into accepting, the more it rejected. I threw up half a dozen times every day, without warning — in every corner of my apartment, on the street, at the office, and on the subway. I soon started working from home and skipping social events. I was nauseous every waking hour of the day. I couldn’t face people; I hated pretending to eat, or owning up to why I wasn’t eating, or eating anyway for normalcy’s sake and then enduring my body’s inevitable, dramatic rejection of any “food” that wasn’t iced tea. I could actually feel myself growing weaker by the day; I remember needing to sit down after a shower, because standing up for 10 minutes had exhausted me.
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As the months went on, I watched my arms, legs, and face shrink, while the small, hard ball in my belly swelled just barely. I dreaded waking up in the morning. It was a suffocating state of constancy, because unlike when other upsetting things happened in my life (when my dad died, when Trump won), I couldn’t fake myself into a half-hour of peace. I couldn’t just turn on the TV, zone out for a few minutes in front of good old High Fidelity, and not think about the situation at hand. Nope: This time, my body wouldn’t allow it. The nausea was inescapable, excruciating, and on top of that, it was a constant reminder that I wasn’t feeding myself — or my son.
I was diagnosed with hyperemesis gravidarum when my ob/gyn confirmed that I’d lost 10% of my body weight in the first four months of being pregnant — 14 pounds out of 140. By six months, I was down 16 pounds and weighed what I did at age 12. People complimented me; I vomited and then cried. I got back decidedly un-applause-worthy blood test results: My body was severely depleted of potassium and other electrolytes, not to mention dangerously dehydrated. My doctor sent me straight to the ER, where I cried some more, out of guilt, because I felt I was somehow taking away from the valuable time these medical professionals could be spending on “real” emergencies. Didn’t they have puncture wounds to tend to? I was just a useless pregnant woman slowly wasting away and wishing for a peaceful death — they didn’t have to bother with me!
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The ER staff pumped me with a five-pound bag of fluids and shot me up with the same antiemetics they give chemo patients. They also gave me a prescription to take home with me. I’m not a big fan of medication, but that night, because of the drugs, I was able to eat vegetable curry and a milkshake. I slept 14 hours, woke up, and had a goddamn cappuccino. I felt like I’d just been scooped up from the abyss.
Photo via @Apedelman.
"I've never posted a naked photo before, but these are two bodies that survived hyperemesis gravidarum thanks to affordable healthcare," the author wrote on Instagram.
Today my son is 1 and fat and healthy; I’ve gained my weight back and then some. But what if I hadn’t had insurance? What if I couldn’t get insurance because of the “pre-existing condition” of my pregnancy? What if this had all happened at some point — any point — during those five years of zero health coverage and a $33K salary? I couldn’t have paid thousands of dollars over and over again for ER visits and IV fluids. I couldn’t have paid for prescription medication. I couldn’t have paid for the permanent PICC line that so many women with hyperemesis need in order to get nutrients. What then? Well, I probably would have done what I did best in those months: just stay home, alternately crying and vomiting, all within a safe radius of the toilet.
Hyperemesis can be life-threatening and definitely “feels like you’re dying,” but hey, I was healthy to begin with — so I’ll give my body the benefit of the doubt and guess that I wouldn’t have died without treatment. But I know I would have given up.
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Without treatment, I would have had neither the emotional nor the caloric reserve to go on. I would have holed up, quit my job, iced out my partner even more, slept 20 hours a day, lost touch with myself and everyone I love. If I knew from the beginning of pregnancy that I would not have access to that caring doctor, that expert hospital team, and that life-changing medication every step of the way, all paid for by insurance that I could afford, I would have given up hard. Eight-weeks-pregnant me would have probably called Planned Parenthood (one of the few medical resources we’ve all been able to count on, at least for now), dropped the one-time $300 to $800 for a medication abortion, and quit while I was ahead.
But I didn’t. I made it through, and so did my amazing son. Because it was 2015, and we both had insurance. In fact, the great thing about the ACA is that it has allowed me, my family, and so many others to afford healthcare coverage through years of emergencies and job layoffs and moves and upheavals and, yes, “preexisting conditions.”
Today, the accessibility of that life-saving insurance coverage is uncertain at best, and our basic right to healthcare is on the line. I’m terrified, and I — a 32-year-old able-bodied and generally healthy cisgender female who happened to survive nine months of living hell known as hyperemesis gravidarum — have had it fucking easy.
But the GOP isn’t scared of me. Instead, they’re tossing any remnant of compassion out the window because they’re scared of trans folks and disabled folks and kids with cancer and all the other valuable human beings whom they’ve decided are “too expensive” or “a burden.” But here’s the thing: Humans are not burdens, and healthcare is a human right. And here’s the other thing: Life is full of surprises. You never know when a diagnosis or a layoff or an accident or an expense or a friendly case of hyperemesis is going to show up and completely blindside your supposedly healthy ass.
If you’re someone who thinks you “don’t need the ACA” — because you have a job and money and maybe you’re the healthiest person in your family, just like I am — you’re right. You don’t actually need affordable healthcare — until you really, really do.
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