A Day Without Meds

How Trumpcare will affect millions of Americans with mental illness and other ‘pre-existing conditions.’


Hello, my name is Daniel Venegas, and I have a pre-existing condition. You can’t tell by just looking at me. There are no tubes going in to my nose. There are no aids to help me around. My illness is mental, and is kept in check with therapy and medication. I am able to afford these services because the state I live in recognizes that as a college student and part time employee, I do not make enough to afford these services without their help.

That is all set to change. The AHCA, or Trumpcare, has passed the House with a couple of changes that pleased moderate republicans who were on the fence the first go round. In this new bill is the language that would allow states to opt out of the regulations that protects patients with a pre-existing condition. This would allow insurance companies to set outrageous premiums for patients with pre-existing conditions.

Under the Affordable Care Act, or Obamacare as it was affectionately known, patients were protected from this kind of predatory practice, everyone was to be charged the same regardless of preexisting conditions. But with Trumpcare, that’s all set to go out the window.

What falls under preexisting condition, you ask? According to an article published by Business Insider , preexisting conditions would include, “AIDS/HIV, lupus, alcohol abuse/drug abuse with recent treatment, severe mental disorders such as bipolar disorder or an eating disorder, Alzheimer’s/dementia, multiple sclerosis, rheumatoid arthritis, fibromyalgia and other inflammatory joint disease, muscular dystrophy, cancer, severe obesity, cerebral palsy, organ transplant, congestive heart failure, paraplegia, coronary artery/heart disease, bypass surgery, paralysis, Crohn’s disease/ulcerative colitis, Parkinson’s disease, chronic obstructive pulmonary disease/emphysema, pending surgery or hospitalization, diabetes mellitus, pneumocystis pneumonia, epilepsy, pregnancy or expectant parent, hemophilia, sleep apnea, hepatitis C, stroke, kidney disease, renal failure, transsexualism.”

The list goes on to include other conditions that could make it more difficult to get health care. “Acne, allergies, anxiety, asthma, basal cell skin cancer (a type of skin cancer that doesn’t tend to spread), depression, ear infections, fractures, high cholesterol, hypertension, incontinence, joint injuries, kidney stones, menstrual irregularities, migraine headaches, being overweight, restless leg syndrome, tonsillitis, urinary tract infections, varicose veins, and vertigo.”

In a list that has very severe diseases, such as cancer and AIDS, it can be easy to overlook the mental health issues. But mental illness affects millions of Americans in this country.

According to National Alliance on Mental Illness, around 43.8 million adults, or 18.5% of the population experiences a mental illness in a given year. What’s worse is that 9.8 million of those people experience a mental illness that is serious enough to impede with their day-to-day life.

Lucia Gonzalez is a Licensed Psychiatric Social Worker for Kaiser Permanente. Her views do not represent Kaiser Permanente, but she had years of experience in the field and has treated many patients. She explains that patients with mental illnesses can mirror other patients with other illnesses that aren’t mental. If the patient is not receiving regular medical treatment, their symptoms can get worse and may reach a point where they require emergency care.

“Similar to someone who, for example, has medical care to treat their diabetes and can get regular checkups and this and this and that. They don’t end up going into the emergency when things get really bad. So with mental health it’s similar,” said Gonzalez.

The National Alliance on Mental Illness also found that of those millions of Americans who suffered a mental illness in 2015, only 46% of them received treatment for their disease. These are diseases, such as depression and bipolar disorder, that if left untreated can have deadly consequences. According to the Centers for Disease Control, suicide is one of the top 10 leading causes of death in the US. The importance of treatment for patients with mental illness cannot be understated.

“Being able to talk to a psychiatrist, being able to talk to a therapist and being able to make sure that their medication is working, and that the entire treatment is working, is more cost effective and it’s better than going with out treatment and then ending up coming to an ER,” said Gonzalez.

My struggles with mental disorders are well-documented. I am one of the lucky ones who has learned how to live a productive life with my anxiety disorder. This is due in no small part to the treatment affordable healthcare provided me. But my diagnosis is not curable. Anxiety and Obsessive Compulsive Disorder are things I have to live with for the rest of my life. In order to continue on with my life, it is important to have access to reasonably affordable healthcare. And I am not the only one in this boat.

Albert Serna Jr., 27 and a Mt. SAC alumni transferring to San Francisco State University, understands the importance of access to affordable healthcare. He has been dealing with anxiety and depression from a young age. In 2014, he needed to be hospitalized for two weeks due to his illness. After treatment with medication and regular visits with a therapist, he is able to continue the forward momentum his life is taking him.

Medi-Cal is a program that California offers to low income residents who can’t afford to pay for their own health insurance out of pocket. As a college student who does not live at home, Serna Jr.’s financial situation does not allow for a health plan that requires him to pay thousands a year in premiums alone.

“I’m on Medi-Cal, because I don’t make any money. I can’t afford my own health insurance, in general. Even if I did work, I couldn’t afford what I need. Medi-Cal gives me what I need as far as free hospital visits. Mostly free hospital visits, medication, therapy, those kinds of things. I am very lucky in that sense.”

Without affordable coverage, Serna Jr. would not be able to afford the necessary treatment and medications required for him to function.

“I don’t want to think about that. I can say that, even just three days without my meds, I start falling back into my mental illness,” said Serna Jr.

What is wonderful about Obamacare is that mental health care is considered an essential part of a persons health care. As such, Covered California, Medi-Cal, and other affordable health care plans allow patients like myself and Serna Jr. to afford treatment for our diseases.

Under the reforms proposed by Republicans and the Trump administration, mental illness would put people like myself in a high risk pool that would allow insures to charge me outrageous premiums due to my pre-existing condition. Sure they are not denying me or others coverage in the conventional sense, but allowing insurers to charge prohibitive prices for their premiums is the same thing. Coupled with the cuts to Medicaid, residents from states that don’t offer plans like Medi-Cal and can’t afford these premiums are in for a world of hurt.

A recent viral video features a constituent at a New Jersey town hall meeting strongly explaining the ramifications that Trumpcare would have on the public to the man who wrote the revisions that allowed the bill to pass the house, Republican Rep. Tom MacArthur. Take a look at his explanation below:

This man is not wrong about what Republicans and health insurance companies care about. Money, not the good of the people, seems to be the soul motivator of a party whose every regulation pull and passed bill makes the people who funded their campaigns even richer.

So maybe this fact will help them understand better how detrimental untreated mental illness can be for them and the economy. Pulled from the same National Alliance on Mental Illness article, severe mental illness costs America $193.2 billion in lost earnings every year. Think about the productivity employers lose from these employees in these cases.

The video above also showed a room full of constituents threatening to derail that representatives career. With the millions set to lose coverage if and or when Trumpcare takes effect, you can be sure as hell that there are plenty of other Republicans who will lose their seats when they are up for re-election in 2018. Maybe these consequences will make Republicans realize that their plans for healthcare will affect them as well.

My plans for my life continue forward thanks to the medication and treatment affordable healthcare provides me. If the AHCA passes, my future seems much less certain. For someone like me, losing health insurance could completely derail the progress I have made with my illness. Just imagine what it will do to the 23 million Americans who will lose their health insurance under the AHCA. That is a thought I can’t afford.