In 2013 my wife and I launched a small consulting business. We threw everything we had into it: all of our funds, our house, my reputation, her time, my time. All of our family finances now rested on BAC’s success or failure. It was a huge, huge gamble and a major life decision.
So far it’s worked. The business is sustainable, and maintains a family of four (including two, and soon to be three with student loan debt).
I don’t think we could have done it without the Affordable Care Act. At best it would have been much, much harder to survive, much less to succeed. That’s because of our family health situation and how American health care economics works.
Each member of our family (two adults, and in 2013 two teenagers) had health care needs, including preexisting conditions ranging from celiac to Lyme disease to awful gut disorders. Starting our new business meant starting up new health care insurance, which tend to hate paying for preexisting anything.
On top of this, we lived in Vermont, which had very little health care insurance competition, keeping prices high and service low. For bonus points we had to COBRA insurance for a year while the business started up. If you haven’t done this, you’re lucky, as it means seriously high prices.
All of this together meant health care would have been *the* leading cost for our firm, especially with co-pays and out of pocket expenses. I seriously considered not being on insurance for myself and just risking it, what my brother calls “the oldest American health care plan: don’t get sick. Or hurt.”
During the first year of BAC (2013-2014) we worked like demons. I always put in 70-hour weeks and traveled all over, soliciting and meeting clients, building up services and products, doing work.
Ceredwyn spent weeks researching health care and how to pay for it, which meant entering a Kafkaesque maze of bureaucracy and confusion.
And we pulled it off. ACA kicked in soon after our first half-year. Vermont launched its health care insurance exchange, and while it was a disaster and for years after an ongoing mess, we were able to buy policies and gain subsidies. We were able to throttle down those medical costs. Our business balance sheet turned from red to black.
But if ACA hadn’t been there, our costs would have skyrocketed. Several of our family members have had injuries or illnesses that required expensive treatment, from new medications to major tests to surgery. I don’t know if our business could have survived the financial hit.
Looking to the future, I still work 70-hour weeks. Ceredwyn labors mightily to handle our finances. We make it work. If the ACA gets cut back or eliminated… I don’t know how we’ll survive. Owain, our youngest, is starting college this fall, so we have that major financial hit coming up. Neither Ceredwyn nor I are getting younger, and statistically we are likely to need more medical care over the next few years, rather than less.
Would ending the ACA also end our business? It might. What would happen to the four of us? That‘s the threat staring us in our faces right now.
To my wife, who struggles mightily to make health care work.