Life was so different before the election. I consistently have patients ask me about the cost of the health care services. Before the election, I felt confident in encouraging patients to apply for Medicaid or an Affordable Care Act (ACA) plan, because then they wouldn’t have to pay extra for birth control, screening for sexually transmitted infections, or cancer screenings. I could also encourage transgender patients to apply for health insurance, because the ACA requires coverage for gender affirming medical and surgical services, which are lifesaving for many individuals. Now, I still encourage patients to apply, but they are so crestfallen when I do because we both know that their insurance could be taken away from them at any time in the next few years.

A young patient with whom I’ve been working closely to find the right combination of medications to manage severe depression and fibromyalgia pain said that they are looking for jobs in another country because they would die without the ACA. While I assured them that we would find ways to make sure they continue to have the same access to health care, the truth is that yes, the ACA is lifesaving, and repealing the ACA is a death sentence for many.