Dawn Wheeler: Surviving Cancer with ACA Coverage

Dawn Wheeler and her husband live in Edwardsville, Kansas, which they have called home since 1995. High school sweethearts raised in Olathe, she from Olathe South and he from Olathe North, they have been married for nearly 37 years. Together, they raised five children, two girls and three boys, and now enjoy life as grandparents to five.

For most of their marriage, Dawn and her husband were self-employed. As small business owners, health care was always a concern. “We had our own insurance some of the time through Blue Cross and Blue Shield of Kansas City,” she said. But that plan grew more expensive each year, eventually pushing them to look for alternatives. Around 2014, as the Affordable Care Act (ACA) rolled out, Dawn was one of the earliest enrollees to sign up for a Marketplace plan.

“I was really scared to do it because it was so new,” she said, citing the “horrible” rhetoric she heard about Obamacare, like possible financial consequences for not signing up. Fortunately, her concerns were assuaged by her experience. “I wasn’t sure how good it was going to be. But it’s been fantastic.”

That decision to sign up proved critical. In May 2017, Dawn received life-altering news. “My sister in Phoenix texted me and she’s like, I have horrible news. I can’t tell you to your face because I’ll cry, but I have breast cancer.” In a moment of shock, Dawn instinctively placed her hand on her chest and unbelievably, felt a lump herself. She hadn’t had a mammogram in over a year, feeling like her regular workout routine and vegetarian diet were keeping her in good health.

Her CrossFit coach took one look and warned her, albeit harshly. “If that’s cancer, you’re already dead.” Dawn scheduled a mammogram. One test led to another. “Then they called me into the conference room with my husband and the doctor. And they said, yeah, we’re 99% sure it’s breast cancer.”

What followed was a rapid and frightening medical journey. “It was almost to my chest wall. So, they were moving very, very fast. And it was very, very scary.” She had a port implanted and started chemotherapy within days. The ACA covered it all. “I’ve never had anything declined, refused. It’s been affordable.”

That care allowed Dawn to act quickly. She endured five rounds of intense chemotherapy, followed by a mastectomy. Scans revealed the cancer had already metastasized to her liver and to her sacrum. “The liver is the scary part. You need your liver to live.”

Her ACA coverage didn’t falter. “I had the choice of the best doctors, the best surgeons.” She opted for reconstruction, which included tattooing by a specialist to restore natural appearance. “All covered.”

Her medications are staggeringly expensive. One of her three chemotherapy drugs costs over $10,000 per fill—twice a month. “Who can afford that?”

She reached her out-of-pocket maximums early in the year because of high-cost treatments. “Basically, if I have a chemo in January and an MRI, I’m done for the year. And there’s just some maybe small copays here and there.”

She emphasized the magnitude of that support. “There is no way on earth I would have been able to afford the quality and quantity of care that I’ve received.”

Dawn’s insurance is through Ambetter via the ACA Marketplace. Her husband and children also use it as her husband’s employer plan would cost far more and offer less. “It was going to be almost a third to a half of the paycheck. And that’s just, we can’t do that.”

But they have no complaints of the coverage the receive from their Marketplace plan, “We’ve been really happy overall with that coverage,” she said. Even when a medication was briefly denied, Ambetter resolved it without even needing a phone call.

Not only has the ACA kept Dawn’s access to high quality care within reach, but it has also made this care affordable lowering their premiums significantly thanks to Premium Tax Credits (PTCs).

Asked whether her family could absorb a spike in premiums or loss of tax credits, Dawn was candid. “It depends on how much it would go up. Like last year, it was $194 a month, which is great. I mean, some people paid $1,200, $1,500. This year, because President Biden had lowered the premiums, it’s only $69.”

She’s aware of how quickly their support system could be taken away if Congress were to let these PTCs expire at the end of 2025 or advance efforts to dismantle the ACA. “I’m really scared…This is my life.”

Dawn has watched others around her rely on public support systems as well. Her mother-in-law needs Meals on Wheels. Her father-in-law, a veteran with ALS, lives in a VA facility. They all face uncertainty. “It’s very scary.”

She still receives chemotherapy and actively fights to stay well. “I’m trying not to let it affect me. Because a lot of treatment when you have cancer is trying to stay positive.” She channels her fear into action through protests, advocacy and staying engaged.

Dawn wants lawmakers to understand the real-life consequences of undermining the ACA. “I’m not special, but I am one of the millions of people that they would be literally sentencing to death.” She worries that lawmakers who are responsible won’t face consequences. “It’s probably going to take effect right when all those people are leaving office and won’t be accountable for it.”

She reflects on the injustice of the system. “To be the only industrialized country in the world almost that doesn’t have universal health care. I just don’t understand, we are the richest, most powerful country in the world and we can’t provide the basics for our people and are actively trying to take what they have away.”

For Dawn, the ACA is not a political issue. It’s what allows her to keep living.