Rehearsing her protest speech in the parking lot of a Doral office building on Tuesday, Karla de Anda looked down at her handwritten notes and thought back to her life before 2014 — the year the Affordable Care Act’s major coverage expansions took effect.
De Anda, 41, said she would sometimes go days feeling emotionally drained and physically ill from a mental health condition and gastrointestinal disorder she was diagnosed with in 2014. The episodes would pass, and de Anda said she was able to hide her pain and continue to work as a live-in nanny.
“It’s invisible. But it exists,” de Anda said of the pain.
According to the U.S. Department of Health and Human Services, an estimated 20 million Americans have gained health insurance under the Affordable Care Act’s coverage expansions.
Like nearly 1.5 million people in Florida, de Anda has an ACA plan that she bought on the insurance exchange at healthcare.gov — coverage that includes psychiatric counseling, prescription drugs and hospitalization if she ever needs it.
But now, worried that she might lose the coverage under President-elect Donald Trump, de Anda joined a protest outside the offices of U.S. Sen. Marco Rubio of Florida, a Republican and frequent critic of the health law commonly known as Obamacare.
De Anda and about two dozen people gathered on the sidewalk along busy Doral Boulevard carrying picket signs and chanting slogans like “healthcare is our right” to protest plans by Republican leaders in Congress and Trump to repeal the ACA.
And they had a message for Rubio: “What he needs to think about when he makes his decision is who he represents,” said Marcia Olivo, executive director of the nonprofit Miami Workers Center, which advocates for labor and social issues. “In Florida ... people will lose coverage without the Affordable Care Act.”
Matt Wolking, Rubio’s press secretary, issued a written statement emphasizing that the senator remains strongly opposed to the health law.
“Obamacare has led to skyrocketing premiums and patients losing access to their doctors, and it’s been such a failure that health insurance companies are demanding billions of taxpayer dollars to bail them out,” Wolking said. “Senator Rubio looks forward to repealing Obamacare and replacing it with a system that puts patients first and provides more choices and better care at lower costs.”
Senator Rubio looks forward to repealing ObamaCare and replacing it with a system that puts patients first and provides more choices and better care at lower costs.
Matt Wolking, press secretary for U.S. Sen. Marco Rubio
For de Anda, a naturalized U.S. citizen who immigrated from Guadalajara, Mexico, in 2000, Obamacare is working, she said. She got coverage for the first time in her life in 2014, and pays about $3,000 a year in premiums and out-of-pocket costs. She also receives the most generous financial aid available.
“I can talk to my doctor whenever I need to,” she said. “I won’t feel unprotected if I have a crisis. I won’t be left without medication. Not being able to afford medication is like a death sentence.”
De Anda’s experience reflects the findings of a study released Wednesday by The Commonwealth Fund, a nonprofit that advocates for coverage expansion, which reported that the ACA has dramatically reduced the uninsured rate among children and adults across the country.
In 2013, the year before the ACA’s major coverage expansions, 17 percent of Americans younger than 65, or about 45 million people, were uninsured, according to the Commonwealth Fund report, which relied on data from the U.S. Census Bureau and the Centers for Disease Control and Prevention.
By the end of 2015, the Commonwealth Fund study found, the uninsured rate had dropped to 11 percent in the same group.
In Florida, one of 19 states that has refused to expand Medicaid coverage to more adults as part of Obamacare, the rate of uninsured people younger than 65 fell from 24 percent in 2013 to 16 percent by the end of 2015, according to the report.
Not being able to afford medication is like a death sentence.
Karla de Anda of Miami, an Obamacare consumer
The Commonwealth Fund report also found that fewer Americans had skipped needed healthcare because of the cost, from about 16 percent of working-age adults in 2013 to about 13 percent by the end of 2015.
In Florida, the proportion of adults who went without care because of the cost fell from 21 percent in 2013 to 176 percent by the end of 2015, according to the report.
David Blumenthal, a physician and president of the Commonwealth Fund, said the report was designed to illustrate the impact that the ACA has on healthcare access and to give lawmakers a reference for future changes.
“It’s important to hold on to these gains and continue to make progress in ensuring people can get and afford the healthcare they need,” Blumenthal said at a teleconference to discuss the report. “Whatever policy changes are undertaken, they should continue to move in the direction of increased coverage, better access to care and improved affordability.”