On his first day in office, President Donald Trump signed an executive order directing federal agencies to “take all actions consistent with law to minimize the unwarranted economic and regulatory burdens of the [Affordable Care] Act” (“the ACA”). Congress has already begun to take steps to repeal the ACA, conducting a dramatic late-night vote in the Senate on January 11 to pass a budget resolution designed to expedite repeal of the ACA despite the lack of a replacement plan. Without a replacement plan, there is no guarantee that the more popular provisions of the ACA, such as the ban on insurance companies denying coverage for pre-existing conditions, will remain intact. Of course this vote was held in the middle of the night. When someone tries to take something important away from you, they usually do it when no one is paying attention. Giving insurers the option to deny coverage based on pre-existing conditions takes something critically important away from the most vulnerable among us – myself included.
For most of my life, I have struggled with mental illness as the result of a severely traumatic childhood. I have attempted suicide. I have been admitted to psychiatric hospitalization as an adolescent. I have struggled with depression, anxiety, recurring nightmares, obsessive feelings of guilt, obsessive suicidal ideation, insomnia, and self-harm. Yet somehow, I managed to graduate as Salutatorian of my high school class, graduate with honors from college, graduate with honors from law school, pass the Massachusetts Bar Exam, carve out a career for myself as a consultant in the tech industry, and find a wonderful woman to marry.
If insurers may once again deny coverage for pre-existing conditions, then I am potentially one gap in employment away from losing access to the medical care that has saved my life. I will lose access to the therapy that helps me to recognize and shut down self-destructive thought patterns, the medicine that keeps a flood of obsessive suicidal thoughts at bay, and the care for the other conditions that only exacerbate these problems. I will lose access to the very things that allow me the dignity to live as a normal person, despite all I have done to earn that right. I shouldn’t have to earn the right to live with dignity, but it seems that we would rather pay our Senators to gather together under cover of darkness and kick the disadvantaged while they are down than pay to give them a helping hand. We would rather pay our new President – who is already a billionaire – to reflexively ease the “regulatory burdens” of the ACA on insurance companies than to spare a thought on the burdens doing so will place upon those among us who suffer.
I have been told that my story is “exceptional.” If this is true, then we must also acknowledge that the root of that word is “exception.” We cannot all be exceptions; and we should not use the exceptions to set the rules. There are many blessings in my life that have allowed me to become an exception: race, gender, citizenship, and the presence of people who let me lean on them when I needed help. For each person like me, how many are less fortunate? Ten? A hundred? A thousand? We may never know, because while the stigma of mental illness keeps people like me from coming forward (despite the fact that one in five of us will suffer from a diagnosable mental illness in a given year), it keeps people who suffer without care from having the strength and courage to advocate for themselves. Those of us who can must speak out on behalf of everyone who suffers because their own mind robs them of the means or ability to tell their own stories.
At this point, repealing the ACA passes cruelty and enters into atrocity. To offer insurance to millions of vulnerable people who could not otherwise afford it, only to take it away just when they are beginning to realize its benefits, speaks loudly to the fact that our government cares more about the health of insurance companies than the health of its citizens. But it is particularly atrocious to allow people with chronic mental health problems a chance to live with dignity, only to remove it from us. Living with mental illness is bewildering and terrifying. To give people like us a moment of clarity, during which we can form the hope of a better tomorrow, only to take it away? It serves as a reminder why Hope was the last of the evils contained in Pandora’s Box.
We have suffered long enough. We have lived long enough without hope. Overwhelmingly, we just want to lead normal lives, free from the fear that our world could come crashing down upon us at any moment. If we, as a society, believe that protecting an insurance company’s bottom line is more important than relieving human suffering, then I have to ask: am I really the one who is mentally ill?
-Kevin Carboni, Watertown, MA