By Lucy NotarantonioShareNewsweek is a Trust Project memberA woman who was once driven into bankruptcy by medical bills before the Affordable Care Act (ACA) existed says the law, also known as Obamacare, later gave her a second chance at life, just as she faced a devastating cancer diagnosis.
Three years before the ACA was implemented, in 2007, Eugenia Horan's husband's appendix ruptured, and an appendectomy spiraled into a medical emergency when complications set in, leaving the uninsured couple with a $400,000 bill.
The pair from Syracuse, New York, declared bankruptcy and were no longer in the red by 2018, but the following year, Horan, now 52, was diagnosed with terminal lung cancer. She told Newsweek. "I’m alive because my cost of care was covered."
...After her husband's ordeal, he briefly obtained insurance, but couldn’t afford to keep it, leaving him uninsured for more than six years until the ACA expanded access to affordable coverage. Horan relied on Medicaid due to her anxiety and post-traumatic stress disorder (PTSD) disability, a coverage she already had before the ACA.
Then, in 2019, Horan was diagnosed with lung cancer that had spread to her small intestine.
"Without ACA, I would have had Medicaid, but I don’t think I would have survived," she told Newsweek. Horan, who spent nearly a month in the ICU, knows she would have received treatment on Medicaid, but doesn't think it would have been as comprehensive.
According to research from The American Cancer Society, people with no health insurance or with Medicaid coverage are more likely to get a cancer diagnosis at a later stage, and have a lower survival rate.
"Without that coverage, I’d be dead," Horan believes. "Now, I am celebrating being cancer-free since December 9, 2019, and off treatment—after ablation followed by solo immunotherapy, with no chemotherapy—since January 2020."
Horan added that without the protections of the ACA, she believes she would have struggled to get private health insurance too, as her cancer diagnosis would have been a pre-existing condition she could have been denied coverage for. The law prevents insurers from denying coverage, raising premiums, or excluding essential benefits, though these rules don’t apply to grandfathered or short-term plans.
...The ACA’s Impact on Care
The ACA makes health insurance affordable for millions of Americans, but at the end of the year, expanded subsidies in place since 2021 are set to expire, leading many people to face extreme hikes in the cost of their premiums, with some dropping it altogether, Prospect reported. President Trump is expected to soon unveil a proposal to address healthcare costs.
News that ACA subsidies were unlikely to be renewed led to many conversations online where people like Horan have shared their stories of how the ACA has helped them.
On November 10, Horan shared her story on Instagram Threads (@ginamancinihoran), where it quickly gained traction and has now been viewed over 430,000 times.
One user said: "Thank you for sharing this horror. Story with us! I can’t even imagine what other people have endured. It’s only gonna get worse."
Another wrote: "I worked in insurance just before and just after the ACA. People are not ready for the horrors to return…and the system is inefficient, costly, deadly and exhausted as it is now, so I am bracing myself for our futures."
"I don’t think most Americans understand what losing ACA would do to us," Horan told Newsweek. "I don’t think they understand how it will make life worse for them."
...Now, drawing on her own experience, Horan worries that others with similar diagnoses will be forced to decide whether to pursue treatment despite the risk of overwhelming medical debt for themselves and their families.
Her fears reflect a broader national anxiety. A recent West Health and Gallup survey found that nearly half of U.S. adults (47 percent) worry they won’t be able to afford the healthcare they need in the coming year—the highest level reported since tracking began in 2021.
Even so, Horan wants to send an optimistic message. “I’m an end-stage cancer advocate, and I spend much of my time teaching people that there very much is hope for ‘terminal’ cancer patients,” she told Newsweek.
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