Affordable Care Act under seige

Right now, across the United States, there are tens of thousands of Americans who’ve been sick with COVID-19 for months. Not days. Not weeks. Months

These individuals, collectively called “long haulers,” have experienced an array of symptoms, ranging from fatigue and shortness of breath to more serious issues affecting the heart, lungs, and brain. 

Hannah Davis, a 32-year-old computer programmer, experienced extreme fatigue, a racing heart rate, and difficulty breathing. She also felt like she had developed a brain injury.

“I have a hard time remembering who I was,” Davis told BuzzFeed News. “It was hard to remember I had to feed myself a couple times a day.”

The plights of people like Davis have perplexed doctors and public health professionals. They’ve also reinforced just how little we still know about the novel coronavirus and the disease it causes, COVID-19.

“We have a disease that may cause problems that we don’t even know the magnitude of yet,” Dr. Dori Russ, a Florida-based physician, told COURIER.

One thing that has become increasingly clear, however, is that many Americans will likely suffer long-term consequences from COVID-19 and potentially develop chronic, lifelong medical conditions as a result. 

“There are people who are getting COVID who are not dying of it,” said Dr. Ian Gilson, a Wisconsin physician. “They’re surviving. But they’re surviving probably with long-term [conditions].”

These conditions could include neurological issues, lung damage, and myocarditis—or inflammation of the heart muscle—which makes access to health insurance essential, according to Dr. Gilson.

The landmark Affordable Care Act (ACA), which went into effect in 2014, guaranteed protections for the tens of millions of Americans living with pre-existing conditions, and would protect those who suffer long-term complications as a result of COVID-19. 

But that could all change.

A coalition of 18 Republican-led states—with the backing of President Donald Trump—are suing to repeal the ACA. The case is set to be heard before the U.S. Supreme Court this November. If the ACA is repealed, more than 20 million people will lose health insurance, and tens of millions could once again find themselves denied coverage due to diabetes, cancer, heart disease, and—yes—COVID-19 complications.

Howard Koh knows better than most how difficult it was for people with pre-existing conditions to get health coverage before the ACA. The former assistant secretary for health for the U.S. Department of Health and Human Services under President Barack Obama, Koh was intimately involved with rolling out the healthcare law.

“If you had a pre-existing condition before the ACA, depending on where you lived and whom your carrier was, you could be denied coverage or be deemed uninsurable,” Koh said. “And given the burden of chronic disease in our country, that involved millions of people.”

In 2010, the year the law was passed, an estimated 50 million Americans were uninsured, according to the U.S. Census Bureau. Many of these people were uninsured because they had pre-existing conditions.

While the ACA has been far from perfect, the law made it illegal for insurance companies to discriminate against people with pre-existing medical conditions, allowing millions of Americans to obtain coverage. Without it, those who survive the coronavirus with long-term complications would suffer.

“They’re really going to be in trouble. They’re not going to be able to get good care,” said Dr. Gilson. “They’re going to get these junk policies that you can get that exclude anything you need. That’s the way it used to be.”

The number of people that develop long-term conditions as the result of COVID-19 is impossible to predict yet. However, based on initial research, this population could number in the hundreds of thousands in the United States alone.

study in Italy found that 87% of hospitalized patients were still exhibiting symptoms after two months, while German researchers observed in a cohort of 100 patients, including some who recovered at home, that 78% had heart abnormalities after two or three months. Another study of 60 COVID-19 patients published in the medical journal Lancet found that 55% of them were still displaying neurological symptoms during follow-up visits three months later. 

Perhaps more worrying, one informal survey of 640 long-haulers found that they reported experiencing 62 different symptoms. These have included everything from lung damage and fibromyalgia-like breathing problems to extreme fatigue and abnormally heavy menstrual cycles (or none at all).

In some cases, people experience a half-dozen or more severe symptoms. Lauren Nichols, who first fell sick with C?OVID-19 on March 10, was still experiencing symptoms in August, when she spoke to The Atlantic.

During that five-month span, she had experienced bouts of hand tremors; fever; night sweats; gastrointestinal problems; morning nausea; extreme fatigue; bulging veins; excessive bruising; an erratic heartbeat; short-term memory loss; gynecological problems; sensitivity to light and sounds; and brain fog.

And it’s not just the elderly or those with previous medical conditions that are being affected. Plenty of young, healthy, fit people are developing serious conditions in the wake of COVID-19.

More than a dozen college athletes at Power Five conference schools have been identified as having serious inflammation of the heart muscle following coronavirus infections, according to ESPN.

In Major League Baseball, one of the best Boston Red Sox pitchers, Eduardo Rodriguez, told reporters he felt “100 years old” after he developed the same condition following his bout with COVID-19. 

The Mayo Clinic has warned that COVID-19 can cause organ damage, strokes, seizures, and Guillain-Barre syndrome, a condition that causes temporary paralysis. COVID-19 may also increase the risk of developing Parkinson’s disease and Alzheimer’s disease, the clinic states on its website.

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