Las Vegas Sun

July 19, 2019

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Guest column:

Trump is out to get me, and I’m terrified

I have a mental illness. I live with bipolar disorder — mood swings come and go and I struggle to control them. It is a medical condition formerly known as “manic depression.” It’s hereditary. My father had it too.

Even though I’ve come a long way in managing my moods over the years, they won’t go away even if I stay in bed and drink lots of fluids. Being bipolar has its roots in my brain, and it’s not something that can be cured, only tempered by learning coping skills, becoming informed and taking well-known medicines like lithium and quetiapine that help stabilize my moods and slow down my brain when I’m manic. Then there’s lamotrigine, which I take to keep depression away, so I don’t end up lying in bed for days, unable to work or even cook a meal.

In other words, I need ongoing, long-term medical attention through no fault of my own — a regimen that would bust my bank account if it weren’t for Health Plan of Nevada, an Obamacare-based medical insurance plan I’m on now that covers much of the cost of my medications, doctors and therapists. I have an individual policy. Because I am a freelance writer, and not employed full-time by any one company, I have to purchase insurance through the Affordable Care Act’s market exchanges.

President Donald Trump thinks I should have to pay for this care 100 percent out of my pocket — and because of this pre-existing condition, I should have to pay all my other medical expenses as well, whether I get pneumonia or the flu, or fall on ice and break an arm, or need a round of blood tests before my next doctor’s visit. Without insurance, a visit to my orthopedic surgeon, which I need from time to time for a permanent leg injury — costs upwards of $300 per appointment.

Granted, I could luck out and land a full-time writing job that offers health insurance benefits and where the insurance company doesn’t care about pre-existing conditions. But not only would that be a rare find, it can be difficult for me — and for many others who have mental illnesses — to work 40 hours a week in a stressful, pressure-filled office environment. Oh, how I wish I could, but my brain revolts under stress, and that does no favors for me or anyone in my proximity. Besides, sometimes I get nightmares while I sleep, and I’m forced to take sleeping medications to calm my overactive brain so I can get some proper rest. When that happens, I can sometimes be too groggy in the mornings to focus on work. I don’t just have to live with the cost of medications, but I live with their side effects too.

Since I became covered under the ACA in 2012, I’ve gotten the medical care I need. And anyone who comes in contact with me should be grateful for that. I’ve been treating my bipolar disorder in some way or another for nearly 30 years. Without proper medication or medical care, I can’t function. I can’t concentrate, focus, interact kindly and predictably with others, and my life is a bunch of miserable highs and lows.

Prior to the passage of Obamacare, I feared drowning in medical bills and being forced to declare medical bankruptcy, destroying my credit for years to come. That would mean I wouldn’t be able to rent an apartment, take out any kind of loan or get approved for credit cards. So I avoided doctors and emergency rooms, fighting illnesses without the benefit of antibiotics. I went to a free, government mental health clinic for indigents to get my psychiatric medications; I was allowed one 30- minute visit with the doctor every three months. Spending two hours a year with a psychiatrist did not parlay into terrific care.

To the relief of struggling Nevadans, then-Gov. Brian Sandoval, a Republican, expanded Medicaid in Nevada, bringing coverage to some 700,000 people who previously were uninsured. Had I lived here at the time, I would have been one of them.

Signing up for Obamacare can be complicated at best. Fortunately, I met a young, cheery woman named Sonia Allegria who works for Community Health Alliance, a nonprofit medical clinic in Reno. Her sole full-time job is to sign people up for the ACA. Even with her help, it was complicated. It took multiple visits to her office, letters sent back and forth to the government, and a lot of discussions about which plan I qualified for and how much I could afford.

But Trump wants to put Americans like myself, living with pre-existing conditions, in harm’s way. Just this past week, the Department of Justice said in a legal filing that it agrees with a Texas district’s court ruling that the ACA should be declared unconstitutional.

I pray that Gov. Steve Sisolak and the members of our congressional delegation do all they can to block the destruction of the ACA. Wrecking Obamacare would be a life-changer for me and 20 million other Americans living with pre-existing conditions.

Kim Palchikoff can be reached at [email protected]