Xavier Carrigan is a Democratic candidate in Iowa’s third Congressional district. He delivered these remarks at the Iowa Insurance Division’s August 19 public hearing on proposed increases in health insurance premiums for policies sold on Iowa’s Affordable Care Act exchange. Although he is not directly impacted by these potential price increases, he felt that sharing his own experience from recent years was important to add to the context of the unaffordability of health care in the U.S., as part of his fight for Medicare for All.

My name is Xavier Carrigan, and while I am running for the U.S. House, I am here today as a citizen who has been forced to navigate the ACA marketplace when I had no other insurance options.

I know what it’s like to lose your insurance and be thrown into a system where every choice is a bad choice. When you’re uninsured and dealing with a chronic condition, the marketplace becomes a cruel joke disguised as help.

I have asthma. Without insurance, my Breo Ellipta costs nearly $500 a month, and my Albuterol about $75. That’s almost $600 a month just so I can breathe. When I lost insurance, I had to ration a three-month supply of Breo and stretch it over fifteen months. Imagine cutting your oxygen by four-fifths and praying you do not collapse before you can afford your next prescription.

I also ended up in the ER with a leg infection while uninsured. Two and a half days in the hospital, and the bill was over $30,000. Every doctor who poked their head into my room billed me as if I had begged for their time. They were billing my sickness like a mechanic charging for parts I never asked for and never received.

That experience taught me something important: when you have no choice but the ACA marketplace, you’re not choosing health care. You’re choosing how you want to go broke.

And today, you’re being asked to make those choices even more impossible.

Medica is asking for rate increases averaging 26.76 percent, with some plans jumping as high as 47.73 percent. Iowa Total Care wants 10.26 percent increases. UnitedHealthcare is demanding 15.6 percent more. Wellmark Health Plan wants 12.6 percent increases on ACA plans. Oscar is asking for increases averaging 6.6 percent, with some plans up to 30 percent.

The federal growth rate standard is 5.6 percent. Every percentage point above that is not medical necessity. It’s corporate greed.

Let me tell you what these numbers mean for real people. When someone like me – someone with a chronic condition who lost their employer insurance – has to choose between marketplace plans, we’re already choosing between rent and medication. Between groceries and prescriptions. Between keeping the lights on and keeping our lungs working
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These rate increases don’t just affect premiums. They affect whether people like me can afford to be sick at all.

Meanwhile, UnitedHealth raked in $14.4 billion in profit last year. Elevance Health made $6 billion. Cigna cleared $3.4 billion. These companies are not struggling. They are not operating on thin margins. They are extracting maximum profit from people who have no choice but to pay.

When I was in that ER, uninsured and facing a $30,000 bill, UnitedHealth executives were getting bonuses. When I was rationing my breathing medication, insurance company shareholders were getting dividends.

Here’s what I demand on behalf of everyone who has been forced into the marketplace with no alternatives:
• Do not approve rate increases that exceed the federal growth standard unless these companies can prove, down to the last cent, that every dollar is going to actual patient care.
• Impose complete transparency so the public can see exactly how much money goes to medical care versus executive compensation and shareholder profits.
• Remember that people forced into this marketplace don’t have other options. When you approve these increases, you’re not just affecting numbers on a spreadsheet. You’re deciding whether people can afford to stay alive.

We are not walking ATMs. We are not profit centers. We are people who got sick and lost our insurance, and we deserve a system that treats our health as more important than corporate quarterly earnings.

Deny these excessive increases. Stand with the people who have no choice, not the companies who created that lack of choice.

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Editor’s note from Laura Belin: You can watch the video of the public hearing here. The proposed increases in individual health insurance premiums are available on the Iowa Insurance Division’s website.