From the archives: How the Affordable Care Act will help people with disabilities

President Obama signs the Affordable Care Act. Photo is in the public domain.
President Obama signs the Affordable Care Act. Photo is in the public domain.

Now that congressional Republicans are shamefully dismantling the Affordable Care Act, I thought I would reprise this 2010 piece that I wrote for The Guardian shortly after President Obama signed the bill into law. (I have left the Britishisms intact.) The death of Obamacare is going to have a huge, negative effect on millions, including people with disabilities.

Previously published by The Guardian.

It was some years ago that my wife and I learned a crucial fact about living in America with a disability.

Our daughter, Rebecca, now 17, had been diagnosed at birth with achondroplasia, a genetic condition that is the most common form of dwarfism. At five months she ran into dwarfism-related breathing complications that required a tracheostomy, oxygen and home nurses for a good part of the day and night. It was a harrowing time in our lives — not to mention hers. But by the time she was three years old she was fully recovered.

One day when Becky was still a baby we found ourselves at a gathering of Little People of America, an organisation akin to Britain’s Restricted Growth Association. We were looking down — way, way down — at our soon-to-be-friend Ruth, the local LPA director. Ruth told us that Becky should focus on a career at either a large corporation or the federal government. That way, she said, Becky would never have to worry about having health insurance.

We were appalled. It’s not that working for a big company or a government agency is such a terrible fate. Ruth herself is a federal bureaucrat, and a good one. So, for that matter, was my father. But the idea that our daughter should shy away from launching a business or joining a small start-up company lest she lose her health coverage was offensive to us.

Those days are now behind us — and her. After Sunday night’s historic vote in the House of Representatives, we count Becky among the tens of millions of Americans who have been liberated. It’s long overdue.

Much of the attention over the past few days has rightly focused on the 32 million uninsured Americans who will be covered, and on new regulations that will prohibit insurance companies from denying benefits to people with pre-existing conditions.

What hasn’t been emphasised enough is that many of those folks with pre-existing conditions, like Ruth, have good jobs and great coverage — but that some of them might like to do something else with their lives. Maybe an accountant who’s recovered from cancer wants to try his hand at consulting. Maybe a mother with an autistic child has a killer idea for a restaurant. Maybe a wheelchair-using lawyer at a large firm would like to hang out her own shingle. Now there’s nothing to stop them.

It is the release of this pent-up entrepreneurialism that is among the most exciting aspects of healthcare reform. When Barack Obama has spoken about healthcare in the context of the economy, he has stressed the high cost of insuring employees. For instance, in the president’s address to a joint session of Congress last September, he described cost as the reason that “so many aspiring entrepreneurs cannot afford to open a business in the first place”. Obama was right, but he overlooked what happens when entrepreneurs themselves have medical conditions that prevent them from taking risks that could benefit society as a whole.

There are other reasons, of course, to get excited about healthcare reform, even if you’re a middle-class family with good coverage and no health issues. For many families, the ability to insure your adult children under your own plan until they are 26 is a change of enormous importance. Sticking with the personal theme of this commentary, our 19-year-old son, Tim, plans to spend the next several years establishing himself as a commercial photographer. Now he – and we – have one less thing to worry about.

We are hardly unusual. Across the country, in red states and blue, in households that voted for Obama and those who think he’s a “socialist”, folks are going to discover their lives have been made better in measurable ways. The idea that Republicans will repeal the healthcare law is laughable. Instead, as Republican strategist David Frum, a speechwriter for the second president Bush, wrote on Sunday, the GOP’s just-say-no strategy has led to a “disaster” for the party’s prospects.

What happened on Sunday restored some faith that our political leaders can work on behalf of the people who elected them. It was a great moment for Obama and House speaker Nancy Pelosi, who overcame odds that seemed insurmountable following Republican Scott Brown’s surprise election to the US Senate in January.

It was also a great moment for all of us.

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