Associated Press – Health care will be on Rebecca Esparza's mind in the voting booth this fall.
The two-time cancer survivor from Corpus Christi, Texas, said repealing the Affordable Care Act, as Republicans have tried to do dozens of times, could make her uninsurable.
"I realize this is something that could happen," she said. "It's a terrifying thought for me not to have any insurance at all."
Efforts in Congress to gut the law — President Barack Obama's top domestic achievement — have failed to draw enough votes to override a presidential veto. But the equation changes if the GOP retains control of Congress and captures the presidency this fall.
Before the health law's protections for people with pre-existing medical conditions, patients like Esparza could get coverage through state high-risk pools. But not every state ran one, and expensive premiums kept participation down to fewer than 200,000 Americans in 2010.
Esparza, a freelance marketer, had no health insurance before her first cancer diagnosis. Insurers in the high-risk pool wouldn't cover gynecological care, since she had been treated previously for uterine fibroids, so she decided to go without.
"I thought it was totally ridiculous. Why in the world should I get insurance that wouldn't cover what I'd had in the past? So I didn't," Esparza said. "Not even four months later, I was diagnosed with ovarian cancer."
She spent her savings on a hysterectomy, then had nothing left to pay for chemotherapy.
"I felt insignificant, like I didn't matter and all that mattered was for corporations to make money. I thought I was going to die," she said. "I was 30 years old and needed chemo but had no way to get it."
She accepted charity care at a hospital. Later, she qualified for disability benefits.
In 2008, doctors diagnosed thyroid cancer. This time, she scrimped to afford insurance in the high-risk pool.
Later, "when I found out about 'Obamacare,' I was pretty thrilled about not being discriminated against anymore," she said. "That seemed like a gift from heaven to me."
She is in her third year of coverage under the law. This year, Esparza, 45, decided to buy insurance outside the government exchange — and lost a $100 monthly subsidy as a result — so she could keep her doctors at MD Anderson Cancer Center.
She's not a fan of either presidential candidate. When she casts her ballot, she said, she also will consider immigration, terrorism and the economy.
She said she suspects Hillary Clinton "cares more about my health care" than Donald Trump does, but as for how she will vote: "I don't think I will know for sure until closer to Election Day."