Kim Palchikoff: Mental illness – a pre-existing condition

President Trump is out to get me, and I’m scared to death.

I have a mental illness. I live with bipolar disorder — mood swings that come and go as I struggle to control them. It’s a medical condition formerly known as “manic depression.” It’s hereditary. My father had it too.

Even though I’ve come a long way in managing my moods over the years, they won’t go away even if I stay in bed and drink lots of fluids. Being bipolar has its roots in my brain, and it’s not something that can be cured, but only tempered by learning coping skills, becoming informed and taking well-known medicines like lithium and quetiapine that help stabilize my moods and slow down my brain when I’m manic. Then there’s lamotrigine which I take to keep depression away, so I don’t end up lying in bed for days, unable to work or even cook a meal. In other words, I need ongoing, long-term medical attention through no fault of my own — a regimen that would bust my bank account if it weren’t for Health Plan of Nevada, an Affordable Care Act-based medical insurance plan I’m now on that covers much of the cost of my medications, doctors and therapists. I have an individual policy. Because I’m a freelance writer, not employed full-time by any one company, and not earning large amounts of money, I have to purchase insurance through the ACA’s marketplace.

Trump thinks I should have to pay for this care 100 percent out of my pocket — and because of this pre-existing condition I should have to pay all my other medical expenses as well, whether I get pneumonia or the flu, or fall on ice and break an arm, or need a round of blood tests before my next doctor’s visit. Without insurance, a visit to my orthopedic surgeon, which I need from time to time for a permanent leg injury — costs upward of $300 per appointment.

Granted, I could luck out and land a full-time writing job that offers health insurance benefits and where the insurance company doesn’t care about pre-existing conditions. But not only would that be a rare find, it can be difficult for me — and for many others who have mental illnesses — to work 40 hours a week in a stressful, pressure-filled office environment. Oh how I wish I could, but my brain revolts under stress and that does no favors for me or anyone in my proximity. Besides, sometimes I get nightmares while I sleep, and I’m forced to take sleeping medications to calm my over-active brain so I can get some proper rest. When that happens I can be too groggy in the mornings to focus on work. I don’t just have to live with the cost of medications, but I live with their side effects too.

Since becoming covered under Obamacare in 2012, I’m getting the medical care I absolutely need. And anyone who comes in contact with me should be grateful for that. I’ve been treating my bipolar disorder in some way or another for nearly 30 years. Without proper medication or medical care, I can’t function. I can’t concentrate, focus, interact kindly and predictably with others, and my life is a bunch of miserable highs and lows.

Prior to the passage of the ACA by Congress in 2012, I feared drowning in medical bills and being forced to declare medical bankruptcy and destroying my credit for years to come. That would mean I wouldn’t be able to rent an apartment, take out any kind of loan or get approved for credit cards. So I avoided doctors and emergency rooms and fought illnesses without the benefit of antibiotics, waiting for them to subside on their own. I went to a free, government mental health clinic for indigents to get my psychiatric medications; I was allowed one 30-minute visit with the doctor every three months. Spending two hours a year with a psychiatrist didn’t parlay into terrific care.

To the relief of struggling Nevadans, then-Gov. Brian Sandoval, a Republican who was a staunch supporter of Obamacare, expanded Medicaid in Nevada in 2012, bringing coverage to some 700,000 low income Nevadans who previously were uninsured. If I had been living here at the time, I would have been one of them. I get insurance through Obamacare’s Marketplace, which is based on my income. I make too much money to get Medicaid coverage, which is free for those who qualify, but I can purchase insurance at a discounted price and no pre-existing condition will get in the way.

But Trump wants to destroy all vestiges of the ACA, including what I’m receiving, even if it means trying to get the courts to declare it unconstitutional, as a judge in Texas has done. Trump is intent on putting Americans like myself, living with pre-existing conditions, in harm’s way. We already know that, despite all his bluster, Trump doesn’t care about the little people. He doesn’t relate to people like me, because his heart is as hard as the golf ball he drives down his fairways.

I pray Gov. Steve Sisolak and our congressional delegation do all they can to block the destruction of the ACA. Wrecking Obamacare would be a life-changer for me and 20 million other Americans living with pre-existing conditions.


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