focused on understanding several bills that attempted to change the ACA. The material should also help you

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focused on understanding several bills that attempted to change the ACA. The material should also help you form your own opinion on how further healthcare reforms could be designed.

For the Current Issues Journal of Chapter 12, read three true individual experiences that detail how an individual fared during a health episode prior to the implementation of the ACA. These individual experiences are included below; select one of the three to discuss. In the writing, describe how the individual benefits under the ACA. Then, choose one repeal-and-replace option and describe what changes would occur for that individual as compared to the ACA. Make sure you articulate under which situation (the ACA or a repeal-and-replace option) you think your individual will fare better and explain why. Also, some details about the individuals are intentionally left vague. If needed to support your answers, you may make educated assumptions about the individual's situation. Make sure that you explain the assumptions you made in your journal.

Individual Experience 1: Pat is an administrative assistant for a lighting firm in San Antonio, Texas. It has been six years since he held a job that provided health insurance coverage. While looking for a job that includes health insurance benefits, he has been faithfully paying a premium to Assurant Health, buying a series of six-month medical policies. Assurant Health advertised that the insurance he was buying would protect him against "unexpected" illnesses and accidents that can happen every day. Pat renewed his policies on time for the last six years. Because his premiums are very low for his coverage, it also means he faces a very high deductible. The high deductible meant that Pat had to cover all of his basic and preventative healthcare costs from his modest wages. Therefore, due to cost, Pat put off going to the doctor until he was very ill. When tests confirmed that Pat was suffering from kidney failure, Assurant found a term in their policy contract that defined his new illness as a pre-existing condition, even though he was diagnosed well after having paid for years of insurance coverage. Since his illness was deemed as pre-existing, Assurant refused to pay any of Pat's medical bills and discontinued his insurance coverage. In addition, as Pat continued treatment, hospitals charged him their highest rates because he was not covered by a large group insurance plan or a government plan that can bargain for lower healthcare reimbursement rates. Pat also had trouble finding any public insurance program because Texas is a state that has one of the least generous Medicaid programs. Pat continues his treatment with financial help from his family and is seeking to enroll in a county program to help with his future medical bills. However, stress from accumulated unpaid medical debt gives him anxiety and sleepless nights. (Jacobs & Skocpol, 2016).

Individual Experience 2: Ryan is a 25-year-old teacher in Boston. His job pays pretty well considering that he is a new teacher, but it does not include any health insurance coverage. On a rainy evening, Ryan's bicycle commute home from work ended with a costly fall and an injured knee. Ryan was able to walk without the problem at first, but an hour after the accident he could barely get around. After a week, there was still no improvement in the condition of his leg, and continued to suffer from swelling and pain. However, lacking health insurance, Ryan kept hoping that it would get better with time. Finally, at his father's urging, he decided to go to the emergency room. Ryan was told at the hospital that since he lacked insurance and qualified based on income for the hospital's charity care program, his ER visit and subsequent referral to an orthopedist were covered. Two months later, Ryan saw the orthopedist, but the doctor said that he could not do much for Ryan without an MRI that was not covered by the charity care program. Unable to pay for the MRI, Ryan left the office without a diagnosis or appropriate treatment options. Ryan did the best he could on his own to try to manage the pain with over-the-counter anti-inflammatory medication and a self-designed physical therapy regime. In the meantime, Ryan realized that he would most likely have to seek a job with health insurance coverage to get the appropriate care for his knee. Although Ryan has little interest in office work, he accepted a full-time office job at less pay than what he received for teaching, but the new job includes health insurance benefits. Ryan will have to work for six more months before qualifying for the health benefits associated with the job.

Individual Experience 3: Lenny worked 30 years at a silver mine that was recently forced to close permanently. At 51, Lenny found himself unemployed and without health insurance. After a long job search, Lenny finally found work installing telephone lines. The new job offered lower pay than in the mine but it did provide health insurance. Workers for the company were required to work for 60 days before becoming eligible for health insurance. Only 30 days after starting the job, Lenny fell from a telephone pole from cardiac arrest. Paramedics flew him to Spokane, Washington, where doctors were able to save his life. His recovery was far better than expected, but he was saddled with $140,000 in medical bills. Currently, his sole income is a pension paying $400 a month that he receives from the mining company. Lenny would like to go back to work, but in the wake of his fall, he suffers from headaches and dizziness that would make working on telephone poles unsafe. His doctor has provided written certification of Lenny's inability to work and he has applied for Social Security Disability coverage. However, his application has experienced processing delays. Unemployed and with a pending disability application, Lenny is still without health insurance coverage.