As a lung doctor, I spend a lot of time hearing about what it’s like when you can’t breathe. If you can’t breathe, you can’t work. If your kids can’t breathe, they can’t go to school, and someone has to miss work to stay home. That’s dollars out of the family budget.

My patients from rural Oregon suffer a great deal from respiratory diseases, whether from high pollen counts and wildfires outdoors to woodstoves or tobacco smoke indoors. Unfortunately, all of these illnesses are treated with avoidance (which can be hard) as well as inhalers. Ask anyone you know who needs an inhaler, and he or she will tell you that there aren’t any generics, and the co-pays can be very high. They are almost impossible for the average family to buy out-of- pocket. If you end up in the ER or hospital, things can be even more expensive.

People die from diseases like lung cancer more in rural areas, stage for stage, likely due to difficulties accessing care. These problems are similar for almost every medical problem, from heart disease to diabetes. The Affordable Care Act helped provide more access to medications and care across our state, especially in rural Oregon. The benefits were biggest for many of our rural hospitals, which had been providing a great deal of uncompensated care prior to the expansion of Oregon Medicaid and the individual insurance market. Hospitals were stabilized and Oregon added over 20,000 healthcare jobs after the ACA. It has also allowed for innovation in healthcare, trying to expand telemedicine services further into rural areas to help chip away at those differences in health outcomes based on location.

Where you live shouldn’t determine the quality of your family’s healthcare, and it is impossible to have a healthy economy without healthy people. The recent House and Senate bills, as well as any repeal of the ACA without a viable replacement, would be devastating to rural Oregon. It would cause the loss of medication and health coverage for many as well as the loss of healthcare jobs. Rural hospitals and clinics may be closed or scaled back.

The Affordable Care Act was not perfect, but it was a good starting point. It needs to be built upon and strengthened, potentially by increasing subsidies, adding an affordable public option or expanding Medicaid or Medicare eligibility, not by destroying all the progress that has been made.

I am a member of the Oregon Thoracic Society, a group of lung doctors, respiratory therapists, thoracic surgeons and other health professionals who meet in Central Oregon every year, and this year, we have been very concerned about how politics may affect the lung health of Oregonians. We work with the American Lung Association of Oregon, and join with them in opposition to repealing the Affordable Care Act without a replacement that guarantees essential and affordable healthcare for all Oregonians. It is vital that we put patients over politics.

Erika Maria Moseson, M.D., M.A.


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