In 2013, only a few months after first coming to Congress, I was told I would need major heart surgery due to an underlying health condition. I was 40 years old, in good health, and had no way to know this was coming or to prepare for it beforehand.
Thankfully, my family and I were able to weather the unexpected impacts and cost of the surgery, physical therapy and my appointments before and after the procedure. But that’s not the case for most Americans. In fact, a recent study by the Federal Reserve found that 40% of Americans don’t have $400 in the bank for emergencies — let alone the high out-of-pocket costs often associated with unexpected surgeries, hospitalizations or treatments for chronic conditions.
The Affordable Care Act exists to protect the American people against the rising price of health care — costs that I’ve witnessed both personally and through the tragic stories of my constituents. Repeal of the ACA would not only mean that 371,000 of our fellow Nevadans would lose coverage this year, but also that Nevadans with private health coverage would lose guaranteed access to free preventive care such as immunizations and cancer screenings.
Some people in Congress would happily see these life-saving measures denied to millions of Americans. I am not one of those people.
But affordable health care is not simply limited to surgeries and appointments. Since my heart surgery, I’ve had to take several pills a day and probably will have to do so for the rest of my life. I’ve heard from many Nevadans about the struggle of keeping up with prescription drug costs. That’s why I introduced the SPIKE Act, bipartisan legislation to stop pharmaceutical industry price gouging by requiring them to justify their large price hikes.
But before the SPIKE Act, on my first day in this Congress, I took a stand for Americans whose health care is at stake. For the past two years, the Trump administration has been trying to take necessary coverage away from 100 million Americans. The administration tried and failed to pass legislation that would have repealed the ACA and raised health care costs across the board. Now, the White House is trying to use the court system to take away people’s health care.
This month, the U.S. Court of Appeals began hearing arguments in Texas V. United States, the latest attempt by Republicans to undermine the law. Immediately after being sworn into office, I voted to allow the House of Representatives to intervene in that case — to defend the Affordable Care Act, including Nevada’s Medicaid expansion and protections for Nevadans with pre-existing conditions.
Without the Affordable Care Act, the 1.2 million Nevadans who are living with a pre-existing condition — myself included — could be discriminated against by insurance companies. Under the Affordable Care Act and Medicaid expansion in Nevada, our state’s uninsured rate has been cut in half.
I refuse to let our state go backward. That’s why I voted to pass the Protecting Americans With Pre-Existing Conditions Act — legislation I co-sponsored to stop the Trump administration from allowing insurance companies to discriminate against sick Nevadans. I also co-sponsored legislation overturning the administration’s rule allowing short-term “junk” health plans that permit insurance companies to discriminate against Nevadans with pre-existing conditions, and refuse to provide essential health services.
I recognize that the ACA isn’t perfect — there is room to grow. For instance, I support the repeal of the so-called “Cadillac Tax,” a 40% tax on high-premium employer-sponsored health care. Plans deemed a part of the “Cadillac Tax” disproportionately affect women employees, workers with dependent children, older workers and employees at smaller businesses. I will do everything in my power to correct this.
In addition to my personal experience living with a pre-existing condition, I’ve also seen the ways the ACA has lessened the burden of health care costs for those in our community. About half of Nevadans — 51% — live with a pre-existing condition. One of those Nevadans is Joe Merlino, who lives in North Las Vegas.
In 2011, Joe was diagnosed with a rare form of cancer called chondrosarcoma of the larynx. In September 2013, Joe underwent a 12-hour surgery to remove much of the tumor. He awoke with a tracheotomy. Joe’s tracheotomy hole — his stoma — never healed, and he experienced a complication called a tracheal stenosis, which affected his ability to breathe.
These complications kept him from going to work. In February 2014, he was notified by his employer that his employer-sponsored health care would end, and he could not afford a COBRA plan on his disability payment. Luckily, he was able to get coverage under Nevada’s expanded Medicaid program. In 2016, with the help of the Medicaid expansion and the ACA health plan, he was finally able to get back to work and continue living a fulfilling life.
Joe is not alone in his fight for health care — there are thousands of stories like his across our state. And while there are those who would gladly see Joe lose his insurance for a political win, I will continue to stand up for the millions of Nevadans who need affordable health care and who deserve to have that access.
The Affordable Care Act is not perfect, but it has delivered for millions of Americans. Now is the time to decide which side you’re on: the side of protecting the health of our people, or the side that would deny Americans care.
Rep. Steven Horsford, D-Nev., was re-elected in 2018 to the state’s 4th Congressional District seat, which he had held from 2013 to 2015.