The AHCA Made Me Confront My Family’s History With Breast Cancer

In terms of health care, I am incredibly privileged.

I have always had access to the health care I need. I have never had to skip a month of my medicine because I couldn’t afford it. I typically don’t have much of a copay when I go to the doctor for a general checkup. At 24, I am still on my dad’s health insurance plan.

As I prepare for the time when the ACA requires I leave the safety net of my father’s health insurance, I have been researching my company’s insurance policies to decide which one is right for me. Because I have a history of mental illness, I want to make sure I get the best health insurance that will cover my pre-existing conditions.

I began thinking about being tested for the BRCA gene mutation since I was 18. After watching my mom suffer and eventually pass away from aggressive breast cancer, the fear of succumbing to the same disease has lead me to think about my options.

Because my mother had never been tested for the BRCA gene mutation before her passing, I am completely in the dark about my chances of having it (fathers can also pass down the genetic mutation to their children, but as no one on my dad’s side of the family has been diagnosed with breast cancer, my father has never been tested). A few years ago, I spoke to my mom’s sister, who is also a breast cancer survivor that has not received genetic testing, about what I should do. She advised that I hold off on counseling until I knew exactly what I would do if the test came back positive for a genetic mutation (many women who test positive take the ‘Angelina Jolie route’ and undergo a double mastectomy and/or a hysterectomy, depending on their family history).

For the last six years, I have taken that advice. After all, I’m only 24; I have all the time in the world to decide something as serious and life-changing as removing my reproductive health organs.

Then the GOP introduced the Affordable Health Care Act, and everything changed.

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Under the AHCA, pre-existing conditions will no longer be required to be covered by insurance. The bill would leave decisions of legal requirements up to states, who could also choose to place people with pre-existing conditions in something called a “high-risk pool,” where insurance premiums are known to skyrocket. Although under a different law, genetic testing cannot be considered a pre-existing condition, any preventative measures will almost absolutely be considered one. You may not be able to get to that step, though, because procedures such as double mastectomies are typically not covered by insurance, as there are “too many risks” associated with the procedures.

Which leaves me, at 24, trying to decide if I should get genetic testing, chop off my breasts, and live in debt for years, or take my chances, possibly be diagnosed with breast cancer and force any children I may have in the future to grow up without their mother, like I did.

The Affordable Care Act didn’t solve all of this country’s health problems — not even close. But it put the country on a path that led to a more just and better health care system that served everyone, not just the wealthy or privileged. The AHCA will bring us back 20 years, and then some. It will bring us to a time when people forwent health care because they needed to pay for rent. A time when people went into thousands of dollars of debt because they broke an arm. A time when family history and preventative medicine put you in a pool where no one received health care.

The future is uncertain. We don’t know if the AHCA will be signed into law. I still haven’t even decided if I will undergo genetic testing or not. I do know, however, that the decision will have to come before I turn 25, so that, if needed, I can get the preventative surgery necessary to possibly save my life while I am still privileged enough to be on affordable health insurance.

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