"My health care is a joke to you?"

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Amber Gustafson, a writer and nonprofit fundraiser in Ankeny, Iowa, doesn’t qualify for Affordable Care Act subsidies. But she’s still bracing for impact if lawmakers let them expire at the end of the year.

“I want them to continue to subsidize the plans of other people,” Gustafson said, “because the more people that are part of the ACA, the more cost effective it is for everybody.”

Before the Affordable Care Act was passed, Gustafson struggled to access care her family needed under private health insurance. The ACA changed that, and it also changed how she voted. A lifelong Republican up to the 2008 presidential election, Gustafson changed her party affiliation and watched with frustration as GOP lawmakers opposed passing the ACA.

Gustafson is a degree removed from lawmakers’ current fight over extending tax credits for people on Marketplace plans—she doesn’t qualify for the credits, and she faces a smaller monthly premium increase next year than many other marketplace enrollees. Still, she says Republicans’ constant threats to her marketplace coverage cause stress. And after watching her family enter poverty during the 1980s farm crisis, she knows how quickly stability can give way to financial uncertainty.

“You want these robust safety net systems in order to protect you,” she said.

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