Empty Chairs at the Cancer Center: The Threat of ACA Repeal

I spend a lot of time in the place no one wants to be — the cancer center. Every two weeks I’m there with my husband. He is the patient; I am the partner. Sadly, it is always crowded. The chairs are filled and it is hard to find a place to sit, but eventually you do and then you wait.

You wait to be called for blood tests, you wait again to see the physician or nurse practitioner so you can discuss your current conditions and test findings, you wait again to be called and take your seat in the chemo room, and then you wait for the chemicals to finish dripping into your body. After that, you wait for the nurse to hook the pump into your port so that you can go home and have the chemicals continue to infuse your body for the next forty-six hours. That is the routine on the fourth floor, where the patients with GI cancer get their care. Perhaps it is slightly or even very different on the floor below, which is largely devoted to breast cancer.

The people in the waiting room are there for three reasons: they have cancer, they want to live, and they have health insurance. Now, for some of them, that insurance may disappear and their visits may end. My husband’s oncologist once said to us that she doesn’t know which of her patients gets insurance through the ACA, and she is grateful for that.

In the future, she may learn who has the resources to be treated. What happens when the ACA is repealed, or repealed and replaced? Who will lose insurance coverage under Medicaid? Who will not be able to afford the insurance co-pays because money has to be spent on other things — someone else’s acute illness, paying a child’s college expenses that aren’t covered by scholarships and loans, a car that breaks down and needs to be fixed so you can get to work? Who will have to stop treatment because the only affordable insurance has co-pays so high they cannot be met? Who will be left out of the high-risk pool if people with pre-existing conditions are pushed out of the standard insurance market and forced to wait for entry to a state fund for those with expensive pre-existing conditions?

The debates about health care taking place in Washington D.C. seem very far away from the cancer center waiting room. I know the politicians in Congress and the White House are talking about cost controls, insurance company profits and losses, federal state partnerships, and punishing people who don’t keep up with their insurance payments.

I’m sure these elected officials cannot imagine walking through the waiting area of the cancer center and ordering people to leave, but that is what they are planning on doing. I am afraid of what cancer is doing to my husband and our lives and for our future. I am afraid of what Congress and the President might do to some of the people who sit with us in the cancer center, week after week. I dread the day we arrive to find empty chairs in the waiting room.

Janet Golden

Janet Golden is a historian and author of Babies Made Us Modern: How Infants Brought America into the Twentieth Century (Cambridge University Press, 2018) and Message in a Bottle: The Making of Fetal Alcohol Syndrome (Harvard University Press, 2006). She coedits the blog, The Public’s Health. You can also find her work on her website.

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