https://www.huffpost.com/entry/obamacare-aca-supreme-court_n_5fa441efc5b623bfac4d3f7c In 1998, I graduated college, qualified for the New York City Marathon and was starting an M.D.-Ph.D program at the University of Pennsylvania. I should have been at the top of my game, but I felt terrible. I had abdominal pain that woke me up at night and was going to the bathroom nearly every hour, sometimes urinating what looked like pure blood. I had never been sick in this way before and I was too afraid to tell anyone how I felt. During the first week of medical school, I nearly passed out while walking up a flight of stairs. Doctors at Penn acted swiftly and within weeks, I had a diagnosis: inflammatory bowel disease. I started treatment but a few months later, the medications stopped working. I also kept this to myself, determined to just get through my classes. But by winter, I was making 20-odd trips to the bathroom every day, and I could barely handle that. On Jan. 3, I woke up completely blind in my left eye. It was the start of a horrific three months. In addition to what I learned was a blood clot causing my blindness, I also had numerous severe complications of my disease throughout my body. It was abundantly clear that I was critically ill; my family was called and the faculty banded around me in the hospital. During that time, my medical school granted me a leave of absence. My parents and I were grateful for that. However, it turned out to be the start of another type of horrific experience: navigating insurance coverage before the Affordable Care Act (ACA) ― aka Obamacare. Up until that point, I had been covered under my parents’ health insurance as a student. However, the minute I took a leave of absence, the insurance company insisted that I lost my student status. My medical bills were sent to my parents — while I was in the hospital on the verge of dying. My medical school was appalled and swiftly reinstated my active-student status. However, the damage had been done: Now the insurance company insisted I had a preexisting disease and my care was suddenly substantially more expensive. Furthermore, I was told I had exceeded the maximum annual coverage for my insurance (the so-called “cap on care”). It was only February. My parents attempted to hide all of this from me as best they could, but debt collectors called me while I was sick in bed and sent medical bills directly to me. The only thing that was worse than my unrelenting pain was the guilt I felt about what I was doing to my parents. The minute I took a leave of absence, the insurance company insisted I lost my student status. My medical bills were sent to my parents — while I was in the hospital on the verge of dying. When I left the hospital, I was blind in one eye, weighed less than 100 pounds and was learning to walk again. Still, I got a job as soon possible — at first as a telemarketer (a seated job, which I needed given my lack of strength). And, as soon as I was able, I started volunteering at my hometown hospital. Why? Because I knew I needed to get back to medical school, mostly so I could save my parents from my accumulating medical debt. I still needed to be fed through an IV port in my chest, I was taking 60 pills every day, and I was getting daily lab work. This was not cheap. My plan was to sign up for student health insurance at Penn. However, as I went over the policy, I noticed caps on coverage for care and prescriptions. I was devastated. Because of my preexisting condition, this policy was not an option for me. I needed to survive. So, I made the painful decision to drop out of my Ph.D. program. This was a very personal blow ― the last time I had quit anything was the Girl Scouts when I was 7. But it was necessary; I needed good insurance and the only way I could see obtaining that was to finish my M.D. training as quickly as possible and start my medical residency, a low-paying job but one that comes with health insurance. I still had another year of medical school and I received a scholarship to go to the Harvard T.H. Chan School of Public Health. I left Pennsylvania and headed to Massachusetts. The experience was eye opening in many ways, including the discovery that I love epidemiology and public health. It was also the first I heard of an organization called Doctors for America (known as Doctors for Obama at the time), who were fiercely advocating for the ACA. As a patient, I felt grateful to see doctors fighting for my health care. As Rudolf Virchow once said, “Medicine is a social science. ... The physicians are the natural attorneys of the poor, and the social problems should be largely solved by them.” A physician’s oath extends beyond those who are lucky enough to see them in their office. Unfortunately, as I started my program in Boston, I became sick again — experiencing the “relapsing” part of my incurable relapsing-remitting disease. I soon found myself at student health services, where a wonderful primary care doctor outlined a series of referrals and tests. I sat there looking at the order slips, my brain trying to prioritize them into “urgent” versus “can wait until I find some more money.” Noting my hesitancy, the doctor asked if I had any questions. “I’m so sorry — I know there are limits on coverage and I don’t think I can afford this many tests and appointments,” I said, embarrassed. I was met with a confused look. “There are no limits, and you just have to pay the co-pay,” the doctor told me.