Obamacare Women Standing Their Ground

by valerie morales

photos: emily muncie, darrell carr

Four days after Donald Trump fired the acting attorney general for disagreeing with his executive order, another woman was fired. She too faced off with her privileged boss as a matter of moral grounds. But the second woman wasn’t a lawyer. She didn’t hold degrees from Georgia. She didn’t earn a professional’s salary. She wasn’t someone who could afford boldness in the workplace.

Paloma Lara didn’t work inside the Beltway. She was a full time nanny which supported her full time studies as a medical student in Boise, Idaho which supported her Obamacare, which allowed for her rent to be paid. There was the baby and the two year old she cared for while their parents worked, children she loved to death. But on a Tuesday in February her doorbell rang while she was dropping wings in the fryer. Her boss on her porch stood there grim but a little pleased with himself the way men sometimes are when they are about to issue a stern judgment.

Her boss said she was fired though he didn’t used the word “fired”. He prettied it up a little bit as men like to do as a matter of anachronistic pretense. We don’t need you any longer. As of today. When Paloma asked why, her boss said it was because of what Paloma said to him the day before.

What Paloma said to him the day before was that the country that Donald Trump is now ruling with an iron fist is invested in and proud of its inequality so someone like Paloma, who quit her retail job to study to be a doctor, struggles to get ahead, while at the same time, someone who is entitled and born into family privilege does not know the pain of neglect. It isn’t fair, she said. Dismissively, her boss said that he didn’t want to pay for welfare or Obamacare or anything else to assist poor people. Let them handle their own problems. They have nothing to do with me. “I have something to do with you”, she said, “I take care of your children.”

Paloma had heard this argument so many times before and she had shut up then but she couldn’t shut up now even as she held his baby in her arms, even as her boss was getting wound up like a Christmas toy, now railing against Black Lives Matter and the taxes he had to pay and the problems with poor people and their laziness.

A year ago, Paloma would have stood there, silent, saying nothing, regretting her own submissiveness, fearful. But something happened to her at the Women’s March in D.C. The unspoken quest to be affirmed and acknowledged ran like parallel blood in her veins, saturating every tissue. It wasn’t strength she felt in that one moment but depth. She was awake in a way she had never been before. With the baby cradled at her neck, she said “no” to her boss. She said that he was wrong. Dead wrong. His privilege was blinding. Women like her were invisible and were suffering, condemned to a tragic fate. The next day he fired her.


Donald Trump didn’t create male fragility in the presence of female power and assertiveness. But he is normalizing it as acceptable behavior. Threat translates into aggression that punishes women for insisting on fairness. With Trump as their example and hero, flawed men are suddenly helping themselves to an ambush narrative. Their victims of choice are women who refuse to submit to patriarchal logic. It is the intoxication of being male that creates a shut up, sit down, you have been warned culture. Assertive women are not the problem.

Because her boss wanted to teach her a lesson about his own power in the face of her dependency, Paloma juggles finances now. She believes there will be another job, upper income families always need help with their children. There is an irony here though. She left her job in retail with full benefits, wanting to be a doctor, absorbing all the stories about how you do better by being better. You create the life you want to lead. But two years later, it has come to this. Catastrophizing. “I lived a really tough life and other people have lived harder lives and now he is going to make their lives even harder”

He. Donald Trump. Drunk on executive order mixed cocktails.

Far away from Trump’s conflicted early presidency, Paloma’s job is a receding problem now, one that will get fixed. But her Obamacare coverage fills up her nights with worry. When (if) her Obamacare insurance is taken from her like her job was taken from her, either because she can no longer afford the premium or it is stolen by narcissistic and heartless Republicans similar to her boss, Paloma knows she will lose the ability to manage her sickness and her health. She will lose her freedom. But, in a peculiar way there is something very familiar about it.

“My mom struggled a lot. She was an alcoholic and she couldn’t keep a job and she tried to get an education and it was too hard. My dad didn’t pay a ton of child support so she was on her own and surviving and she lived in a car for awhile. Because her mom was an alcoholic, I have seen the generations of it. We, those of us on the reservation, get treated like we are nothing. We live up on these dirt road reservations where we practice our religion and that is all we are getting, this small piece of land. I always got teased. I got called Pocahontas my entire life. I have been called Geronimo. I always knew it was going to be a struggle because I watched my mom suffer and she could never find a way to dig herself out of a hole and I think a lot of it was we wanted to help her and there was no opportunity for her to get help. It was cruel.”


Paloma doesn’t call herself poor even though she grew up on the reservation. Unlike many sympathizers and critics, she intimately knows what poor is. She knows poverty’s rot; the air is scented with unbearable despair. She knows rolling up your sleeves, at the end of the day, only makes you tired. She knows blinding soulless hunger and bleary desperation. She knows the escape mechanisms magnified by the art: cutting, drinking, weeping, drinking, sex. She knows one box with all your possessions beneath the flap. She knows you become solipsistic living like this. You appear. You disappear. She knows the geo-sociological consequence of capitalistic abandonment: poor granddaddy here, poor daddy there.

She doesn’t use any classification other than money is stressful. But the definition of poverty in America is $12,000 or less per year for an individual and she made more than that last year but only 20% more. There is a victory in the nomenclature but she is, after all, outside the norm of those who have choices.

“I am stressed out. I was very excited to go to school and do something for myself. But the idea to go to part time school and get a job so I could get health insurance, I have six years of school left, I don’t want to be 30 years old with more than 6 years of school left. It’s a little heartbreaking. I’m already working full time now. Well, I was working full time. I am doing independent contract jobs so there is more flexibility but it is stressful. It’s not like I have a whole lot of people to fall back on. To help me.”


“Obamacare is going to be repealed and replaced. We are going to have a strong country again and Obamacare has to go. We can’t afford it. It’s not good.” Republican candidate Donald Trump, Feb. 2016

The paradox is stunning. The Obamacare destroyers want to abolish the individual mandate. They call it intrusive. But it is that very mandate that makes the ACA work. The individual mandate, which brings healthy young people into the program, creates the capital for the ACA to treat and heal the sick. Erasing the mandate abandons the revenue stream the young insurers provide and increases the financial penalties on the middle aged and old who are sick. Their premiums will rise. Chaos and turbulence will follow. Mostly those over 45 years old will have to absorb the cost of the mandate being eliminated; many are white and Republican. The congressmen, then, are wrecking their own people because they hate Barack Obama that much.

Molina Health with headquarters south of Los Angeles, in Long Beach, California, is a major stakeholder in the Affordable Care Act with 600,000 insured. They too are on pins and needles, feeling this tightrope of anxiety, though they are on the other side of the equation. But still they have doubts. Molina Health has not yet committed to participating in the Affordable Care Act in 2018.

The CEO and son of the founder, J. Mario Molina told investors in October, “We have always believed that participation in the health insurance market place is directly aligned with the Molina mission to provide healthcare to people receiving government assistance.”

Their customers fall below the federal poverty line of a family of four: $60,750. One of their principles of coverage is prevention because prevention saves money and lives. Patients with chronic illnesses receive regular treatment and medicine. It helps control costs by eliminating a large group of the sick who get that way by waiting until it is late.

The Affordable Care Act’s preventable care clause allows marginalized communities the luxury of thinking about preventing disease. Routine screenings that are necessary in fighting diseases in their infancy are a staple of the ACA. For instance, black women die of cervical cancer more than white women; cervical cancer is detected through the preventive measure of pap smear screening. Black women are diagnosed in the later stages of breast cancer; no money for a mammogram. The Affordable Care Act makes sure prevention is a priority. Any reduction in the policy automatically erases prevention.

In Massachusetts and the District of Columbia, 97% of women, ages 18–64 are insured. In Minnesota and Vermont, 95% of women, ages 18–64, are insured. In West Virginia and Wisconsin, 94% of women, ages 18–64, are insured. In Ohio and Washington and Michigan, 93% of women, ages, 18–64, are covered. In Oregon, 92% of women, ages 18–64, are insured. In Colorado, Illinois and North Dakota, 91% of women, ages 18–64 are insured. In California, 90% of women, ages 18–64, have health insurance coverage. It is the feminization of Obamacare. It is its moral center.

Still. All roads lead here. For many, it is back to a choice with repeal looming overhead. Paloma Lara said with sadness, “I have to decide if I want to go to the hospital for a broken finger or pay for my books.” The ones with the most to lose are women of color.


Before he was sworn in, President-elect Trump said he had a healthcare plan that would provide insurance for everyone. One of his plans, via his spokeswoman Kellyanne Conway, is to turn Medicaid into a block grant program and let the states control it. The Center on Budget and Policy Priorities estimates that would mean a 25% cut to Medicaid and the Children’s Health Insurance Program. The estimate is that 14.5 million to 20.5 million would be dropped from the program. Added to the 14–17 million who would lose new coverage because the Medicaid expansion would be over.

It has not been a surprise that the no backbone political cohort who were banging on the Obamacare repeal for six years now are cowards. In their first town hall meetings many Republicans started out the process by ducking from their own constituents, bolting out the back door, refusing to listen. Tom Cotton (R) Arkansas greeted his female constituents with a locked door and communicated via intercom. The Cotton defense was the we are scared card. Ditto for Illinois Republican Peter Roskam. He too canceled a meeting with the very people who voted for him. Their crime? They brought too many people to the meeting and invited a reporter. The reporter was willing to leave but the meeting was still abruptly canceled.

It was not just male congressmen. In Virginia, Barbara Comstock wouldn’t meet with her female constituents either. She invited them to two grocery stores and then didn’t show. Comstock sent a staffer in her place and said the event was never intended for her to show up because of course she wouldn’t want to dialogue with the people who sent her to Washington in the first place. The arrogance was overwhelming.

Chair of the Pasco County Florida Republican Party, Bill Akins, began talking death panels at the town hall sponsored by Republican Gus Bilirakis. He was soon shouted down with the chants of “liar, liar.” It prompted Akins to call the 250 assembled “children”. Bilirakis who has hosted several town halls says it is a “choice to be uninsured”. What he means is it is our choice to take your insurance away. It is estimated that 5,000 preventable deaths will occur per year because of Obamacare repeal and up to 20 million will lose their insurance.

But the Republican tone deaf prize goes to Dave Brat (R) Virginia, who said, “Since Obamacare, the women are in my grill no matter where we go.”

At a town hall meeting in Tennessee, Jessie Bohon, aged 35, was succinct when she said, “As a Christian, my whole philosophy in life is to pull up the unfortunate. The individual mandate, that is what it does. The healthy people pull up the sick.”

Yet Republican congressman only want to pull up themselves, the privileged. Their selfish and absurd motives are evidentiary truths laying the brick and mortar for mass destruction. After their first disastrous town halls, Republicans held a strategy meeting on how to avoid the threat of too many angry women. They talked about being afraid for their children and their own lives and it was nothing more than wasted hot air in this unholy war against time. Let’s set aside the amorality of their argument, the powerful afraid of the desperate. Their timing is perverted, their prose too ridiculous to contemplate. The Hunger Games this is not. The social reality demands them to be accountable.

Perhaps they alone have not noticed the women with Obamacare begging them are frightened for what is real. An unnatural breach. Their children with leukemia. Their autistic children. Their second breast still hanging in there after the first breast was saturated with estrogen receptor cancer. The Republicans can strategize on how to fend off the rampage in grocery stores when they are shouted down by anxious Obamacare women in the produce aisle.

But the Obamacare women have no such collective revenge other than resisting in town halls and on social media and in coffee hour after Sunday worship. They are rebels with a cause. Only their voices and their aggression can stop those who care more about a letter by Coretta Scott King than about ovarian cancer survivors ability to access health for their future.


A tired Paloma Lara boarded the red-eye flight that stopped twice. She arrived in Washington early Saturday morning. Half of her plane from Chicago to Washington D.C. were seditious women like her with a native story and parallel lives: angry (I was fired), excited (my daughter needs to see me fight), furious (I have cancer, he can’t do this to me), committed (I’ll march until I die). A millennial woman, Paloma had never marched in anything before but made the decision after Donald Trump was elected. She just had to do something. After dropping her things off at a friend’s house, she met family and began sorting through the signs; the signs were made the night before.

This Pussy Grabs Back. No Illegals No Burritos. When I Grow Up I Will Tear Down Your Stinking Wall. Girls Just Want to Have Funding for Planned Parenthood. No Human is Illegal. Resist. Defy. Republicans Have NO Healthcare Plan.

Her favorite sign, This Pussy Grabs Back, was the truth. No, she wasn’t an object. She was a fighter so don’t touch me without permission.

Crowded on the subway, her large group of family and friends exited at L’Enfant Plaza, then walked, sang chanted with the growing crowd of men, women and children. Paloma’s nephews had flown in from NYC.

“I think with all Trump’s comments about women, it was just so painful and so racist. The whole time I had the feeling he was going to be winning the election and everybody was saying I don’t think that is ever going to happen and I said we have to be realistic of where our country is. I had an overwhelming feeling that I had to stand up for myself and what I believe.”

Paloma’s thoughts echoed. Energized by their solidarity with one another and against men who want to push their needs and privileges into some dark corner, women are revolutionized into a tendentious rebirth. They are in congressman’s offices, on the phone, on social media, flooding town halls. They are passing out flyers and linking protest sites and teaching their children about justice. They are stimulated because- this is the important part- they are healthy and they don’t want to be sick, or they are sick and they don’t want to get worse, or they care about poor people who have no one fighting for them, or they have children whose lives they have to protect, or they want to survive now and cry later, or they don’t want to cry at all. They want to be well.

“I felt like I needed to be there. Like this is not okay grabbing people by the pussy and putting her on her knees and putting up a wall and believing Mexicans are criminals and rapists. It’s painful to hear people talk about who you are and make it sound like I am just an object.”

And so there they were with the same howling weaponized fury, ready for the scrum, Paloma and her female patriots who all wanted the same thing- to be revered as women, to be acknowledged as mothers, daughters and wives, to be respected as important. They ended up at the White House where President Trump was ensconced in his own conceit, somewhere in that huge tax payer funded palace, tuning them out. It was the mother of all metaphors, his conspicuous absence mirroring an outline of the man himself. He begs to be looked at, refusing to shift the mirror away from his face. But his hollow indifference to others only stoked their enthusiasm, raised the stakes even higher. This was the cusp of history. By the grace of democracy and their pain, here they were.

Afterwards- there is always an afterwards- the epilogue was hardly quiet, not still, not a that was then, this is now denouement. In the still crystal moments after the march’s end, and when reflection was at its highest point, it became clear the truth is the same as it always has been though the vacuum is a little bit tighter. Women lead. Even when our beloved country has been messy but proud. Angry but organized. Defiant but specific. Anxious but determined. Women lead.

The collective cry from the Obamacare women is carried by a beautiful force of wind lingering in and out of cities, neighborhoods, malls, ranches, deep in the low rivers and ocean tides, up hills, down streams, upstate, in the low country meadows. You can hear it in the crowded town halls. The anger and power. You can’t erase me Donald Trump; it is heavy in the blowing air and in the packed rooms, this cry that is rescuing a nation. You are not powerful enough.




Writing: Race and Gender, Politics, Healthcare, Environmental Abuse, Domestic Violence

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