Reporting from Lake City, Fla. — Kathy Watson was anxious about her health coverage even before she woke up gasping for breath last month and drove herself to the emergency room with a flare-up in her heart condition.
After struggling for years without insurance, the 55-year-old former small-business owner — who has battled diabetes, high blood pressure and two cancers — credits Obamacare with saving her life.
Watson also voted for Donald Trump, believing the businessman would bring change. She dismissed his campaign pledges to scrap the Affordable Care Act as bluster.
Now, as she watches the new president push to kill the law that provided her with a critical lifeline, Watson finds herself among many Trump supporters who must reconcile their votes with worries about the future of their healthcare.
Watson, a proud, salty woman who was uninsurable a few years ago, isn’t ready to renounce Trump. But she’s increasingly frustrated by his vague promises to replace Obamacare with something better.
“I’ve been through enough,” Watson said recently, sitting on the patio outside her mobile home, down a sandy road in a rural corner of northern Florida. “I don’t want to go back.”
As one of millions of Americans who depend on the healthcare law’s protections, Watson embodies the political challenge Republicans face as they scramble to fulfill their pledge to repeal Obamacare without harming people like Watson, who helped fuel Trump’s unexpected victory.
Her story is also a cautionary tale for GOP leaders, whose promise to cut healthcare costs by scaling back insurance rules threatens to reopen the gaps that once left nearly 50 million Americans without coverage.
Watson knows those gaps better than anyone.
Like some 150 million Americans, she for years had a health plan offered by an employer, in her case, a mobile home manufacturer where her husband worked.
But in 2001, Watson’s husband had to quit after he was injured. The law office where she worked as a paralegal, like many small businesses, didn’t offer a health plan.
“That’s when my nightmare began,” she said.
For a while, the couple scraped together the money to keep his plan, an option known as COBRA coverage. After 18 months, the plan offered under the Consolidated Omnibus Budget Reconciliation Act expired.
Watson tried to buy a health plan on her own. But before Obamacare, insurers routinely screened out sick and potentially costly customers. Trump has voiced support for keeping that protection, but other Republican plans would allow insurers in some cases to charge sick patients more.
Watson had unusually high white blood cell counts and years earlier had part of her colon removed. “Nobody was going to go near me with a 10-foot pole,” she said.
Watson next tried to get a health plan by starting her own business. Insurers were sometimes willing to cover a group of employees, which are a better risk than a single person.
In 2003, Watson opened a debt-collection service for small companies. Business was good, she said, and she hired three employees. But she still couldn’t convince an insurer to sell her a plan.
By then, Watson and her husband were getting increasingly desperate. He still had high medical bills from his injury. Watson was feeling increasingly ill herself, with periodic fevers and swollen glands that made it hard to work.
A local doctor helped with basic medical care in exchange for her help collecting his bills.
But Watson couldn’t afford more extensive medical tests to find out what was making her sick until 2009, when she was diagnosed with a non-Hodgkin’s lymphoma, a form of blood cancer.
“We went through everything we had,” Watson said, including selling off her retirement accounts and mortgaging their home. Friends helped her navigate hospitals where one noted that Watson often was treated like a “second-class citizen” because she lacked insurance. Watson’s aging parents helped with many medical bills.
For a short time, Watson thought she’d found relief when an insurance company agreed to provide coverage. But when she tried to use the plan, she discovered it didn’t cover major medical costs, a trap many consumers fell into when insurers were subject to less oversight. Insurers now must cover a basic set of benefits, though GOP leaders are calling for such mandates to be scaled back.
Watson estimates she and her husband ultimately ran up more than $100,000 in medical debt.
“Kathy is a smart person, but she sure didn’t have the luck of the Irish,” said Anne Lebrecht, Watson’s 74-year-old mother.
Passage of the Affordable Care Act finally offered some relief, thanks to a small temporary program created in 2011 for people like Watson who had been denied coverage.
She was able to get on a plan that ultimately cost $363 a month and is now cancer free.
“I would have lost everything without that,” Watson said.
Before Obamacare, many states ran similar programs, known as high-risk pools. Republicans are now exploring ways to reopen them.
But many of these state plans ended up being very expensive because they covered only sick patients. Many had to cap enrollment.
The Obamacare plan that helped Watson stopped enrolling people because of costs in early 2013.
By then, Watson was well enough to get a job at a company that trained customer support staff for DirecTV. It offered a health plan for $123.50 a month.
“It was good coverage,” Watson said.
She quit the job at the end of last year after hurting herself working in her yard. This time, thanks to Obamacare, there was no gap for her to fall into.
After seeing a television ad by Florida Blue, the state’s largest insurer, Watson called the company, and in less than half an hour, she enrolled in an HMO plan, despite her long medical history.
The plan normally cost $664 a month. But because Obamacare offers subsidies to help low- and moderate-income Americans afford premiums and deductibles, Watson pays nothing.
“I still can’t believe I can get this coverage,” she said.
Today, Watson is upbeat, despite dealing with two failing valves in her heart as well as chronic arthritis and diabetes. She’s taking classes to get a real estate license so she can go back to work and get off government-subsidized insurance.
But Watson is getting irritated by what she hears from the new president. “I’ll give it a little more time,” she said. “But I’m not really sure about Trump anymore.”
She said she’s ready to go to Washington to tell lawmakers not to roll back Obamacare.
“Walk a mile in my shoes,” Watson said. “I never thought I’d have to go through all of this. I was working for an attorney. I was making good money. … I’m not here to get something for nothing. I just want to be healthy, pay my bills and go about my life.”
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