Jessica Karabian is afraid that Donald Trump's promise to promptly "repeal and replace" the Affordable Care Act will hasten her death.
Karabian, a 32-year-old wife and mother of a 3-year-old, was diagnosed two years ago with incurable breast cancer that had spread to her bones. She's had a double mastectomy, ovary removal surgery, radiation, and continuous cycles of chemotherapy at the University of Pennsylvania. Her care is mostly covered by Medicare because she is considered disabled at this point, but she also relies on a supplementary policy through the ACA, better known as Obamacare.
"My greatest concern is that [health insurance] will go back to what it was before Obamacare, and that Trump will unravel all the progress," the Bucks County resident said on Wednesday. "If my supplement is dropped, I can't afford treatment and I die. I'm afraid this will give me even less time than I already have."
The ACA has two provisions that are crucial to cancer patients: a guarantee that coverage can't be denied to people with pre-existing conditions, and that the lifetime dollar amount of that coverage can't be limited. These rules apply not only to individual policies, but also to employer-sponsored plans.
"There is much fear in the cancer patient population that as Obamacare is repealed, the most essential provisions -- from cancer patients' point of view -- may be repealed," said Tom Marsilje of San Diego, Calif., a 44-year-old metastatic colon cancer patient who blogs for Diagnosis:Cancer.
On Trump's campaign website, the document "Healthcare Reform to Make America Great Again" makes no mention of protecting patients from coverage caps or exclusions for pre-existing conditions.
At Living Beyond Breast Cancer, a patient advocacy and support organization based in Bala Cynwyd, CEO Jean Sachs said patients were posting on social media Wednesday about their fears.
"Women living with metastatic cancer are frantic and scared," Sachs said. "So many of them couldn't get insurance if they didn't have the ACA. Trump had a lot of rhetoric, but now, what does that mean?"
Karabian's husband Michael, a construction worker, also has health insurance through the ACA.
If the law is repealed, "he would be one of those millions who would lose insurance," Karabian said. "I beg them to think of us."