June 13, 2017

The Honorable Richard M. Burr
United States Senator
2000 West First Street
Suite 508
Winston-Salem, NC 27104

Dear Senator Burr:

I am writing to express my opposition to the A.H.C.A. and hope that you will oppose this legislation. I support the Affordable Care Act. I also support bipartisan modifications of the ACA that would increase access to health care for all Americans.

I am a North Carolina attorney based in Durham. I represent disabled North Carolinians in their effort to obtain Social Security disability benefits and Medicaid or Medicare. The majority of my disabled clients are uninsured. Of those that have insurance, most of those have Medicaid.

I bear witness each day to physical suffering, despair and hopelessness. I have had a number of clients attempt to end their life because they can no longer endure the suffering. Some have been successful.

Many of my clients are trapped in a vicious Catch 22. Because they have no health insurance, they cannot obtain medical treatment. Without medical treatment the severity of their health problems is not adequately documented. Due to inadequate documentation, Social Security denies the claim for disability.
I would like to share the stories of four of your constituents as they struggle with serious medical conditions.

Ms. G lives in Mt. Airy, North Carolina. She is 34 years old. Last year she was diagnosed with Myelofibrosis. Myelofibrosis is a relatively rare bone marrow cancer that disrupts the body’s normal production of blood cells. The result is extensive scarring in the bone marrow, leading to severe anemia, weakness, fatigue and often an enlarged spleen. Ms. G is uninsured and cannot afford treatment for this life threatening condition, nor can she afford to purchase any medications for this condition.

Ms. G has also been diagnosed with portal vein thrombosis, a blockage or narrowing of the portal vein (the blood vessel that brings blood to the liver from the intestines). This condition can cause fluid to accumulate in the abdomen, enlarge the spleen, and cause severe bleeding in the esophagus. Ms. G cannot afford the medications that can treat this condition.

Ms. H lives in Fleetwood, North Carolina. She is 41 years old. Ms. H has degenerative disc disease of the cervical and lumbar spine, fibromyalgia, and migraine headaches. She is uninsured. She cannot afford to see an orthopaedic doctor to treat her degenerative disc disease. She cannot afford to see a rheumatologist to treat her fibromyalgia. She cannot afford to go to a pain clinic for treatment of her chronic pain. She cannot afford MRIs of her spine which I need to document the severity of her degenerative disc disease. Due to the scarcity of medical records, it will be difficult to win her disability case. If she had health insurance and obtained appropriate medical treatment, perhaps she could go back to work.

Mr. S lives in Greensboro, North Carolina. He is 49 years old. Mr. S has cardiovascular disease and hypertension. He is uninsured. Mr. S does receive local charity care which is better than nothing. However, the charity care is inadequate, and you and I would never accept it for our families. At his 1st disability hearing, I stated that Mr. S has had 3 heart attacks and I was confident would have another. The Judge denied his case and Mr. S has had 2 more heart attacks since the denial. Mr. S has now had five (5) heart attacks. I doubt he will live long enough to attend his 2nd disability hearing.

Mr. D lives in Goldston, North Carolina. He is 49 years old. Mr. D has congestive heart failure and hypertension. He is uninsured. Mr. D needs health insurance in order to obtain proper medical treatment.

Under the original ACA as passed by Congress, all these individuals would have Medicaid insurance. Unfortunately, the Supreme Court struck down this provision of the ACA. All these clients would also have Medicaid insurance if the NC Legislature had voted to expand Medicaid coverage under the ACA. The NC Legislature voted against Medicaid expansion.

I have tried to put a human face on uninsured North Carolinians. The suffering of the uninsured due to lack of access to health care is great. The A.H.C.A. will increase the number of uninsured and thereby increase human suffering in North Carolina and across America.

I hope in your wisdom and in your compassion you will defend the less fortunate among us who do not have the wherewithal to defend themselves, and work in a bipartisan effort to make access to health care a reality for all Americans.

Sincerely yours,

David R. Paletta

David R. Paletta
Attorney at Law