With healthcare on the chopping block ...

Four hours out of surgery, Chris Terwilliger was grateful for his Obamacare and deeply concerned it won’t be around next year.

“If I hadn’t had it, I wouldn’t have gotten this done,” Terwillinger, head brewer at Lookout Brewing Co. in Black Mountain, said of his hernia surgery. “I would have ended up in the emergency room.”

Like many Swannanoa Valley residents who got health insurance through the Affordable Care Act, Terwilliger was grateful to have signed up by Jan. 31, the last day the ACA marketplace was open. Like thousands of North Carolinians, he was able to get health insurance he could afford through the marketplace.

He, like them, is worried about President Trump and the Republican-dominated Congress’ plan to repeal the Affordable Care Act and replace it with something else. Terwilliger scheduled his hernia surgery in part to get it done before Congress could act. The surgery cost about $6,500; under his plan, Terwilliger paid about $1,400 of it. most of it raised by friends. “It’s still expensive," he said, "but I definitely wanted the surgery stepped up."

When it comes to the ACA, there are two sets of people, said Michael Murphy, president and CEO of the Plantinum Group, a provider of payroll and accounting solutions in Asheville. Those who have subsidies and low deductibles are generally very happy with the ACA, and those who don’t qualify for subsidies and have seen their premiums increase over the past few years generally dislike it, he said.

“Even the insurance carriers are concerned,” he said. Insurance companies have to file their rates for the  healthcare marketplace in the next several months, and “they have to know what the (ACA) plan looks like to file those,” he said. “There’s not consensus in Congress that I’ve seen exactly as to what this is going to look like. The Nov. 1 (beginning of) open enrollment may seem like a long way off, but it’s not.”

Terwillinger, 35, hadn’t had health insurance in 17 years when he signed up for Obamacare in December. At work, he routinely picks up 60-pound sacks of malt and slings around 84-pound kegs of beer. “I’m always lifting or pulling or pushing something,” he said.

Up to now, he’s been mostly OK, except for the time he burned himself badly on boiling wort. But he’s getting older, and he’s expecting his bones to get more brittle as he ages. “With my doing physical labor, a lot of things can happen,” he said.

If Trump and congressional Republicans repeal Obamacare and don’t have a substitute for it, Terwilliger will just go without insurance, he said. “I’ll be screwed,” he said. “For me to get insurance outright (a private policy), it’s close to $400 a month. And let’s say I go a whole year without using it, that’s $4,800 just thrown away.

“If you’re a working person and you pay taxes, you should have insurance.”

Judy Hamby is scared when she thinks that might happen to her Obamacare in 2018.

The Black Mountain resident doubts it will be around then.  She’s heard a lot about the repeal part, but not much about replacing it with anything.

“I’m thinking something will happen this year, but I have no idea what,” said Hamby, who works with people with special needs. With the help of Pisgah Legal Service volunteers at Black Mountain Library in November, she got ACA coverage through the healthcare marketplace for this year. She works part-time (she took an early retirement from her previous job) and qualified for a subsidy that brings the cost of her prescriptions down to $4-$10 and her medical co-pays down to about $20, she thinks (she hasn’t been to the doctor since she got the policy).

“Obamacare has worked out fine for me,” Hamby, who voted for Hilary Clinton, said. If it weren’t around or if the subsidies disappeared, she might not be able to afford health insurance, she said. “One hospital bill could wipe you out,” she said. “It just scares me to think about going to the hospital. I’m not getting any younger.”

“We’re getting lots of calls from people concerned" about what they've been hearing about the repeal of Obamacare, said Shannon Cornelius, ACA program director at Pisgah Legal Services in Asheville. “We keep telling them that the ACA has not been replaced, that it’s still in effect for 2017. This isn’t about political opinion, this is about the need for people to get affordable health insurance.”

Because of Obamacare, Aaryn Joyner recently got her first physical in four years. Next she’s getting her teeth cleaned. “I’m so thankful that it’s so affordable,” the Black Mountain resident said.

A mountain biker who loves extreme sports, she’s relieved to be covered after going for four years without it. “I ride a little bit stronger,” she said of having coverage.

But Joyner, who works at Urban Farm Girl Flowers, is afraid it won’t be around in 2018. “The fear of getting hurt and not being able to pay for my health care is a huge concern,” she said.

“I know there’s still a lot of improvement to be made (in national healthcare), but I’m hoping they won’t tear all the progress down," she said. "Right now it doesn’t seem like they (Trump and Congress) have a plan. If they take (her plan) away, I just won’t have health care. I’ll be back to where I had been three, four years ago, which is just hoping that I won’t get ill.”