Rural Realities of Repealing the ACA

My husband woke me on election morning, flipping on the hallway light and walking into the living room where I’d been sleeping.

“What time it is?” He didn’t answer as I fumbled for my glasses.

Later, I’d find out it was 2 o’clock. Our alarm goes off just after 4 am.

He sat down next to me, cradling one hand with the other. “I think I may have fucked us over with good intentions.”

It was not a white male premonition for how the election would end twenty-four hours later. He’d gone outside around 9 o’clock to transfer that day’s yogurt making from incubation to refrigeration and passed the barn’s wide-open garage door on his way back to our trailer. I have a moderate case of Raynaud’s Disease, which causes the blood supply to my fingers to decrease, particularly on chilly, drafty mornings. He’d decided to close the garage door, keeping some of the heat from our fifty-cow herd in the barn to make my morning milking better. He’d done so in the dark, not able to see that his hand was placed in the track. He’d crushed three of his fingers beneath the wheel.

We examined his swollen, purple fingers in the lamp light. Two were numb. One was too swollen to bend. He’d fallen asleep, but woke up after midnight in excruciating pain.

“Want me to take you to the ER?”

He flexed his hand, winced. “I don’t think they’re broken.”

“Want to put ice on it?”

“I already put frozen corn on it before I fell asleep.”

“Advil? Aspirin for the swelling?”

“I think it’s in the car. Don’t bother getting it.”

“Toast? Do you want toast?”

That finally made him pause. “Yeah, I’ll take some toast with jam and butter.”

I made me coffee and him toast. Eventually, he fell asleep and I went out to the barn early to start morning chores to compensate for him being down one hand. I fed cows hay and molasses, filled the feed cart, scraped and bedded the barn before starting to milk at 5:30am.

Despite me joking that he couldn’t vote with a finger injury, we drove to our polling station after milking and cast our ballots.

It wasn’t a pleasant morning, but it wasn’t terrible, either. Despite working on a small dairy farm, we have health insurance through the Affordable Care Act. Had his hand gotten worse through the day, I’d have scheduled a sixty-dollar office visit with our GP or gone to one of the urgent care facilities in town, which are more expensive, but address issues more quickly.

It’s now two days since Donald J. Trump was elected to be the next president of The United States with both the Senate and the House of Representatives remaining in Republican control. I know the peace of mind given by the ACA will soon be gone and not just in regard to crushed fingers.

My husband and I work for a small business in the agricultural sector with less than ten employees. It was formed in 2008 and is still a growing, struggling operation. We’re paid a living wage plus housing for our sixty to seventy hour work weeks, but the owner is unable to offer health insurance. It is the ACA that allows us to both work for a small business and have affordable healthcare.

We work with cows every day, animals I trust and love. Gentle giants can still be dangerous. Over the past eight years, I’ve been knocked down by a steer trying to mount me, carried through the barn then dropped beneath the hooves of a stampeding dozen, and, most recently, thrown down on a cement pad, skidding on my elbows and the bare skin of my back after standing behind a fight between Jelly Bean and Mica.

Danger comes with the work, as it does for all farmers. In addition to animals hazards, we are surrounded by large equipment, noxious fumes, chemicals, all manner of weather conditions, and long, grueling days. I’ve also been shocked by lightning through an electric fence and smashed in the shin with a sledge hammer. These incidents have proven to me how invaluable the Out-of-Pocket maximums are to people who work in high-risk environments. We can go about our work bravely, unafraid that one slip up will ruin our family’s finances.

As the saying goes, farmers are land rich and money poor. Wealth is tied up in their land and operations, leaving little liquid for themselves and their family. My parents ran a dairy operation for twenty years. The only expense they talked more about than property taxes was health insurance to cover our family of four. They managed our small household budget tightly, making sure we were well cared for, despite second hand clothes, discount glasses, and no vacations.

We were luckier than our neighbor who wasted away from stomach cancer without health insurance to aid him. Even now, I see a healthcare void in the agricultural community. A visit to the weekday hay auction shows you farmers with teeth rotting out of their mouths, pronounced limps, maimed fingers, asthmatic wheezing from a life of inhaling hay and dust. These are fiercely independent individuals, old men who want the government out of their lives until milk prices drop or the corn suffers from drought. They bitch and whine all the way to The Farm Service Agency where they sign up for crop insurance and government-sponsored loans. I have no reason to see why their opinion on the ACA will be any different, loathed until it is no longer available.

I worry for my community, but I also worry for myself. We were college graduates in the mid-aughts, young people driven to get an education in fields we loved with the promise of gainful employment for our student loan investments. The reality of the economic landscape was in stark contrast to the hopes we had.

For us, and for so many older Millennials, we’ve had to carve our careers from the margins. Classmates and friends of mine have gone on to start CSAs, carve and paint historic bows, compose scores for video games, teach violin lessons, do contract web-design, perform in multiple orchestras. Many have gone on to find normal careers, many have not. For those of us who haven’t, the ACA was a life-changing bill. We were able to take struggling careers and legitimize them, stabilize our lives and plan our futures. When politicians speak about about supporting small businesses, they focus on decreasing tax rates and low-interest loans, forgetting that small businesses are started by people who first need to ensure the safety of their families and lives.

My husband and I now face this reality as we plan for a future without the ACA. For years, we’ve been planning on starting our own small agricultural business, renting land farmed by my family for three generations. We’ve been saving money, writing business plans, raising a herd of our own. Without affordable health insurance, this is something we’ll be unable to do together. One of us will have to reenter the workforce, seeking full-time employment with sound benefits. We’ve had insufficient health insurance plans in the past. During one of our lowest financial points, we spent almost $20,000 for three years of coverage. During that time, we went to the doctor twice and had charges of over $75 both times. We rarely used our benefits because, despite insurance, the cost was too great for our tight budget. I often wondered if we’d have been better off putting that money towards our student loans, yet know from experience that not having health insurance can be devastating.

We’ve been using our health insurance more frequently in the past year and a half, catching up on dentist appointments, monitoring my husband’s genetic disposition to high blood pressure, having my first pelvic exam in six years. The reason for this has been twofold. First, we’re finally getting to a financial place where we have the luxury of spending money on preventative healthcare. Second, we were talking about having a child. For most of our marriage, we’ve viewed parenthood as a financial impossibility, joking that we are economically infertile. It’s only been in the three years since I’ve turned thirty that we’re becoming secure enough to contemplate having a baby. Though I’d like more years during which to plan, I’ve been facing down the biological reality that I only have so much time. Before the election, we were reviewing plans on the healthcare exchange with this future in mind, comparing prenatal coverage and delivery fees. We’re now thrust back to square one, deciding whether or not we can afford to have a child and provide it with the financial security a family needs.

The planned repeal of the ACA has placed us in a world of uncertainty for our financial future, our agricultural future, and our family’s future. Despite this, in spite of this perhaps, I know I am privileged. My husband and I have college educations. We have solid work histories. One of us will be able to find a full-time job before the end of 2017. We may have to abandon plans we had for our future, but we will continue to survive. I mourn the loss of possibility, of promise, of our pursuit of happiness. For us and for the 22 million other citizens who will lose their health insurance upon the repeal of the ACA, this doesn’t feel like the American dream.