Days before two federal courts issued dueling interpretations of the Affordable Care Act, I came across a 1958 photo of my paternal grandmother and felt the familiar onslaught of what-ifs.
What if she'd gone to the doctor earlier?
What if she'd been diagnosed sooner?
What if money hadn't been a concern?
In the picture, she is smiling as she holds me in her lap, her fingers laced around my outstretched arms. Soft curls have escaped their bobby pins to frame her face, which is radiant without a touch of makeup.
Through family stories, I know several things about my grandmother in this snapshot in time: More than a decade has passed since she buried her eldest son, who was killed in a Navy airplane crash. She is the mother of 11 other children, all grown, who had made her a grandmother many times before I showed up. She is 54 years old. Two years later, she was gone, dead from what my parents called "female cancer." Ovarian or uterine, no one ever said. What I did know, from a young age, was that my grandparents had little money to spare, and she waited too long to get to a doctor. She was 56 years old when she died.
As of this week, I have lived longer than my grandmother. In that dark way common to those who lose family members too young, I am dwelling on this milestone. My life is different from hers in many ways. I eat more healthful foods because we know more about nutrition. Medical advances keep my asthma under control. I never worked the land to feed my family, never made a living through physical labor.
Also unlike my grandmother, I have access to affordable health care. If I were facing cancer, I would be as scared as my grandmother surely was, but I would not fear an outcome tied to income.
I can't shake the certainty that had she seen a doctor sooner, she would have been diagnosed earlier and lived longer. Limited resources limited her options. With affordable coverage come greater odds of survival. That was true in 1958, and it is true today, which is why the Affordable Care Act is so significant.
Tuesday was a ricochet day for Obamacare and the Americans who now depend on it.
First, a three-person panel of the U.S. Court of Appeals for the District of Columbia Circuit struck down an Internal Revenue Service regulation that authorizes federal subsidies, which makes health insurance affordable for 4.5 million people in more than 30 states that failed to set up their own exchanges.
Less than two hours later, the 4th U.S. Circuit Court of Appeals upheld the subsidies as a "permissible exercise of the agency's discretion."
The D.C. circuit's full 11-judge panel will likely uphold the subsidies. Good news for those already benefiting from Obamacare, but this will do nothing to move us in the direction of making a good law better.
In April, President Barack Obama announced that 7.1 million Americans had signed up for health plans through the Affordable Care Act.
That is a real number of real people benefiting from health care reform. Nevertheless, a new CNN poll shows that a whopping 72 percent of Republicans -- and 64 percent of conservatives -- say the law has helped no one.
Not one person.
Connie Schultz is a Pulitzer Prize-winning columnist and an essayist for Parade magazine.