The Cost of Being Sick: Affordability & ACA
I own my own business, which means I also have to own my health insurance.
Let me be honest: I can’t afford the coverage I really need. The premiums feel like a second rent payment. The deductibles are high. The copays add up. Somewhere along the way, I realized I was doing what too many people do in this country.
I was playing Russian roulette with my health: Do I pay for a plan I can barely afford and still struggle to use? Or do I go without, hope I stay healthy, and pray nothing catastrophic happens?
If that sounds familiar, this post is for you.
The Real Cost of Being Sick
When we talk about health care in America, we often talk in numbers. American healthcare costs that fall to the individual include the following:
Monthly premiums
Deductibles and copays
The price of a specialist visit or prescription
But the true cost of being sick shows up in the choices people are forced to make every single month.
Many people have to decide:
“Do I pay this utility bill this month?”
“Do I keep my home?”
“Or do I get these prescriptions my doctor says I need?”
That’s not hyperbole. That’s the math.
If you’ve ever stared at your bank account and your pill bottle at the same time, you know what I mean. This is not about people being careless with money or “not caring about their health.” It’s about bills that simply don’t fit inside a paycheck.
This Isn’t Irresponsibility. It’s Math.
We love to tell stories that put all the responsibility on individuals: “If people really cared, they’d take their medicine,” or “If people budgeted better, they could afford insurance.”
But think about Maslow’s hierarchy of needs—that little triangle many of us learned in school. At the base are the things you must have to survive: food, water, shelter, and sleep.
You know what’s not at the bottom of that triangle? Insulin. Blood pressure medication. Inhalers. Antidepressants. So when money is tight, people do what Maslow’s theory predicts: They pay the rent or mortgage, buy food, and keep the lights on if they can.
Medication and regular doctor visits become “optional,” even when everyone knows they’re not.
That’s not a moral or personal failure. That’s a *policy failure.
ACA Under Attack: Policy Choices, Not Accidents
Congress continues efforts to reduce the financial benefit to Americans in Affordable Care Act (ACA)—with no serious replacement plan.
Their actions tell us exactly who they see and who they don’t. Because the people who will be hurt the most are:
Poor and working‑class people
Black and Brown communities
Small business owners and gig workers
Anyone whose insurance premiums already feel like a second rent payment
When leaders say they want to tear down ACA protections—like coverage for pre‑existing conditions or subsidies that help people afford plans—without offering a real alternative, they are sending a clear message: “We are comfortable with some people going without care.”
The cost of being sick, then, is more than your out‑of‑pocket bill. It’s the disregard baked into the system.
Preventive Care vs. Paying More Later
As someone who cares about public health, here’s the part that frustrates me more: this isn’t just morally wrong; it’s financially backwards.
We know that when people can afford preventive care—checkups, screenings, maintenance meds—they are more likely to catch problems early and manage chronic conditions. Also, when people can’t afford care, they wait.
They wait until they’re so sick they have no choice but to go to the emergency room. And, that costs dearly:
More money for hospitals and the system
More suffering for individuals and families
More years of life lost that could have been saved
Providing affordable access up front is cheaper in the long run than constantly treating people at crisis levels. But we keep choosing the expensive, inhumane route.
Again: that’s a policy decision, not an accident.
Who Pays the Highest Price?
The burden of these decisions does not fall evenly. It lands hardest on:
Black communities and other marginalized groups already dealing with discrimination and the chronic stress of weathering, as I’ve mentioned on other blog posts here.
People working full‑time (often more than full‑time) who still can’t afford premiums + copays + deductibles.
Folks who are trying to choose the least harmful sacrifice: skip the meds and risk getting sicker, or pay for meds and risk eviction.
In other posts on this site, I’ve talked about the unfairness of the fight—how the system is often fixed against people on the margins. Health care affordability is one of the clearest arenas where that shows up. You can literally see it in life expectancy charts and zip‑code‑based health outcomes.
From Personal Pain to Civic Action
I’m not writing about this as a distant observer. I am in it. As a small business owner, I’ve had to:
Look at my income and the cost of plans.
Decide whether I can sustain coverage.
Wonder what happens if I get seriously sick at the wrong time.
Maybe you’re in the same position or have friends or family members who are. I want you to know two things:
You are not alone, and you are not failing.
This is not just a personal budgeting problem. It’s bigger than us. It is a public health and policy problem.
Which means some of the solutions are bigger than us, too.
Call to Action: Don’t Suffer in Silence—Reach Out and Reach Up
There are two levels at which we can act: practical help now and policy change over time. So I want you to Do Something with M.E.
1. Get Help Navigating Your Options (and Share It)
If you are uninsured, underinsured, or in ACA limbo, look for
Your state’s ACA marketplace or health exchange,
Local community health centers, or
Nonprofits or insurance navigators that help people find plans and subsidies.
And, use them. They exist because the system is too complex for most people to handle alone.
If you’re in a more financially stable position, make it a point to share these resources with at least one person who is uninsured, underinsured, or always talking about skipping care because of cost. Sometimes, just knowing where to start is life‑changing.
2. Tell Congress You’re Paying Attention
Because this is a policy fight, we also need to “reach up,” not just reach out.
Look up your members of Congress.
Check a trusted source that tracks major actions affecting ACA, Medicaid, and coverage. You can find both on sites such as Govtrack.us
Then contact them—phone, email, or a written letter—and tell them in your own words that you (or people you love)
Are struggling with the cost of coverage and care
Oppose efforts to strip ACA protections without real replacements
Want them to protect and expand affordable coverage, and not play games with people’s lives
And after you’ve done that, tell another person what you did, and invite them to do the same.
We should not have to play games of chance with our health.
The cost of being sick is not just the price on a bill; it is the stress of impossible choices, the years of life we lose, and the message we send about whose health matters.
Affordable care is not a luxury. It is a public health necessity. It’s time our policies—and our collective voice—reflected that.