House sets stage to gut health law; bigger hurdle of replacing it looms
Woman credits ACA for granting her life-saving heart transplant
Anne Bunting’s heart failed a week before Barack Obama was elected president in 2008.
Eight years later, she wrote him a letter:
“Dear Mr. President,” it began. “Thank you for saving my life.”
Bunting isn’t an insurance expert and doesn’t know if the Affordable Care Act was the best way to reform health care coverage.
She only knew it came along at the right time for her.
On the night Obama gave his first victory speech a little more than eight years ago at Grant Park in Chicago, Bunting was at home in Houston, getting used to life with a pacemaker.
A temporary fix, her doctors had said.
The 58-year-old voted for Obama but had never considered herself very political. She hadn’t paid much attention to his campaign promises to overhaul the health care system. She was self-employed and had always been able to afford decent insurance.
Her view of the industry changed four years later when, after weeks of feeling short of breath, she sat with a cardiologist at Baylor St. Luke’s Medical
Center in Houston. “Ms. Bunting, you can’t go home,” the doctor said. “You need a heart transplant.”
Dr. Stephanie Coulter and her colleagues began the work of adding Bunting to the national transplant waiting list. The next day, the physicians got an upsetting message from Bunting’s insurance company, Blue Cross Blue Shield: The company wouldn’t be paying for a heart transplant, a representative said, because the patient’s heart failure was considered a pre-existing condition.
“They told me, ‘You can’t give her a heart transplant,’ which is what she needed,” said Coulter, the head of women’s health at Texas Heart Institute. “They said we could give her this other device instead, a pump that’s implanted in the left ventricle to help the heart continue beating. The insurance company was literally telling us, the physicians, how to proceed with her treatment. It was crazy.”
And, for the time being, it was legal.
Bunting barely survived the operation.
Just as Coulter had feared, the battery-powered pump implanted in her left ventricle put an immediate strain on the right side of her heart. To save her, doctors had no choice but to add a second pump to that ventricle.
Coulter felt terrible, she said. No patient of hers had ever survived with a dual pump. Bunting was different. “She was the most amazing fighter woman,” Coulter said. “She recovered, which is a miracle, and then she actually left the hospital. She was walking around with two pumps.”
By then, Obama was a few months into his second term. He’d survived a campaign in which his opponent vowed to undo his signature policy achievement, the Affordable Care Act, with most of its biggest changes set to go into effect at the start of 2014.
Critics and supporters alike had taken to calling it “Obamacare,” an acknowledgment that the divisive law wouldn’t have happened without the president who championed it.
For better or worse, he was uniquely responsible for its consequences.
By that spring, doctors were worried her heart wouldn’t work much longer, even with the mechanical pumps.
An insurance agent helped Bunting find a new Blue Cross Blue Shield plan on the marketplace exchange created by Obamacare. This time, under the new law, the insurer was barred from denying payment for specific treatments based on preexisting conditions.
Bunting’s new plan went into effect on April 1, 2014. The next day, her doctors added her to the waiting list for a new heart. Ten days later, she had a lifesaving transplant.
Members of her care team, amazed by all that she’d endured, clapped and cheered in the operating room as her new heart began to beat inside her chest.
“Suddenly, after that, it was like I was back to normal,” Bunting recalled. “Finally I could breathe. I could go hiking and work out and travel. I was alive again.”
She had the thought then, but didn’t voice it:
She got the idea to write to him in the fall, in the midst of a bitter presidential campaign that seemed as much about his legacy as anything.
Hillary Clinton promised to build on Obamacare, despite premium spikes, the rise of high-deductible plans and a growing chorus of critics who’d said the law had been a failure. Donald Trump promised to kill it and replace it with something different.
A few days after Trump’s victory, she sat at her computer and typed a note. Four paragraphs, 286 words:
“My name is Anne Record Bunting … I was told I needed a heart transplant … in 2014, the Affordable Care Act came into being … 10 days later, I received the gift of life … thank you.”
She didn’t expect to get a response. It came a few weeks later, printed on White House stationery:
“Dear Anne … Thank you for your kind words … I am glad that the Affordable Care Act helped you … It is why I worked so hard … Michelle and I send our love.”
Bunting read and reread the letter, tracing her finger over the looping letters of his signature. Then she put it in a frame.
On Friday, as members of the U.S. House voted to begin the process of repealing the health care law — exactly a week before Trump’s inauguration — Bunting carried her letter from the president to Texas Heart Institute and showed it to some of the physicians who’d helped save her, wiping away tears as they recalled together how close she’d been to death.
“This woman is one of the bravest people I have ever met,” said Dr. Leo Simpson, one of her cardiologists, before pulling her into a hug.
A few weeks ago, an Obama aide had asked if the president could share her story with reporters to highlight ways the law has been successful, a lastditch effort to sway the public as Congress begins to craft a replacement plan.
If people want to use her letter for political means, that’s fine, she said. But it’s not why she wrote it.
She just wanted the president to know that he’d had a major impact on her life.
“When someone does that,” Bunting said, “I think you should tell them.”
Dr. Leo Simpson hugs a tearful Anne Bunting on Friday at the Texas Heart Institute. Bunting received a heart transplant in 2014, soon after the ACA went into effect.
Anne Bunting received a personal reply from President Obama: “I am glad that the Affordable Care Act helped you . ... It is why I worked so hard.”