On the 16th anniversary of the Affordable Care Act (ACA), a local Arizona small business owner credits it with keeping him alive.
Robert Hess III remembers life before the Affordable Care Act (ACA).
He’d come down with illness after illness, but couldn’t do much about it because he lacked insurance. As the sole proprietor of his own consulting firm, Hess said he wasn’t eligible for group insurance plans. Hess once qualified for Medicaid, but was kicked off after he no longer met income eligibility requirements.
That’s why Hess was thrilled when the ACA was signed into law in 2010 by former President Barack Obama and signed up for coverage when it went into effect in 2014.
“I was finally happy to have coverage for the chronic conditions that I needed to continue to manage,” Hess said. “As a small business owner, I don’t have any other option. This is the only option for me.”
Hess was one of tens of millions of Americans who benefited from the ACA in some fashion.
The ACA significantly expanded health insurance coverage, lowered the national uninsured rate, expanded Medicaid to millions more Americans, banned insurance companies from discriminating against the tens of millions of Americans with preexisting conditions, and allowed young adults to stay on their parents’ insurance plans until the age of 26.
Today, more than 21 million Americans are enrolled in ACA coverage, including nearly 400,000 Arizonans.
Hess recalled how, at age 30, he was diagnosed with degenerative disc disease, a condition where the spinal discs lose hydration and elasticity. The condition soon led to “extremely painful” sciatica, Hess said.
“It completely debilitated me,” Hess said. “I could not drive, I could not sit, I could not stand, I could not lay down.”
Thanks to the ACA, he was able to get back surgery to correct the issue, which would have cost about $250,000 otherwise, he said. As a small business owner and working-class Arizonan, the costs could have bankrupted him or forced him to live in pain without surgery.
After his surgery, he decided to focus on improving his health and set his sights on running a 5k race. It was an uphill battle, as the recovery from back surgery was extensive. Hess started slowly, with physical therapy that involved walking only to the stop sign at the end of his street.
Eventually, after two years of training, he completed a 5K, a 10K, a half marathon, and triathlons. But six days after competing in a half Ironman triathlon, Hess herniated a disc in his back, and once again had to undergo surgery at age 33. Thankfully, he said, the ACA covered most of the cost, which would’ve once again totaled around $250,000 out of pocket. Instead, Hess paid about $10,000 out of pocket.
“The ACA has saved my life, not once, but multiple times, and that’s why we need the ACA,” Hess said.
Republicans have long opposed the ACA and even tried to repeal it in 2017 before Arizona’s former US Sen. John McCain, a Republican, voted to save it at the last minute. President Donald Trump has repeatedly criticized the ACA, but has failed to present an alternative.
Instead, Trump and Republicans in Congress allowed key ACA subsidies to expire at the end of 2025, causing many Arizonans to lose coverage and leading thousands, including Hess, to pay higher premium costs.
Still, he is thankful for the ACA’s existence, and worries that if it were ever successfully repealed, small business owners like him would be left in a tough position, unable to obtain private insurance any other way and likely ineligible for Medicaid. That’s why he wants Congress to understand that partisan politics shouldn’t threaten health care access.
“We shouldn’t be politicizing people’s access to life saving healthcare. It’s nonpartisan,” Hess said. “I ask folks to depoliticize this topic. Let’s just all focus on getting people healthy.”
