By Thomas Buckley

My oncologist asked: “Polycythemia Vera. Do you know what that means?”

Earlier, I lived in blissful ignorance, unaware I potentially carried a myeloproliferative neoplasm encoded within my DNA.

“Yes,” I answered, “A rare form of blood cancer, incurable, not necessarily fatal, provided it’s treated.”

At 31, I thought I had life figured out. I co-founded a growing startup, and for the first time in years, life seemed to be moving smoothly.

Walking out of Rocky Mountain Cancer Centers placed me on a different precipice.

I walked out with a second diagnosis: hereditary hemochromatosis. I was fighting iron overload, with levels five times normal, requiring weekly phlebotomy.

One fact remained: as mathematical as it was scientific — continued treatment was the only key to longevity. This was the reality I faced Sept. 30, 2025, 12 hours before the federal government shutdown. Without treatment, my condition would worsen. I was closer to planning my funeral than a midlife crisis. Fortunately, enhanced Affordable Care Act tax credits kept my Blue Cross Blue Shield plan at $30.41 per month.

The battle over the ACA credits unfolded, each vote failing, and, despite a bipartisan effort, largely along party lines. This came after H.R. 1, the Republican-led proposal, including nearly $1 trillion in Medicaid cuts that every Colorado Republican in Congress voted to pass.

News shifted from background noise into fixation: Was there an agreement? A vote? Were the credits included? Could I continue to afford to survive?

In October, there was no resolution. Nor in November. While the government was funded, health care remained unresolved for those dependent on the ACA. Health care policy is often discussed in abstract terminology: subsidies, tax credits, redeterminations, eligibility thresholds, budget negotiations, and fiscal tradeoffs. Those words sound sterile and distant until you suddenly become someone existing beneath them. Then, every stalemate and headline carries an antagonistic weight. 

My premium was set to rise to $543.81, not gradually; immediately. Nearly 1,700% for a young entrepreneur. Though I may qualify for ACA tax credits in the future, I have become seriously underemployed. Though I navigate my health conditions, Health First Colorado, Colorado’s Medicaid program, is the only coverage I can afford.

As we hit the one-year mark since Republicans in Congress passed H.R. 1, I face another health care precipice, as cuts to Medicaid and additional paperwork requirements stand to strip thousands from coverage they need — people like me who need this coverage to survive.

Though each diagnosis is unique, I am far from alone. I sit and receive treatments in the same room with friends receiving transfusions and chemotherapy. We don’t choose our medical conditions. 

We seek treatment. Not pity. Not exploitation of a system that is already difficult to navigate — to continue living. It is not ideological theatre, nor a political accessory; it’s a lived fact. Republicans in Congress have created a lose-lose dynamic: we lose our coverage, and we start down the path to losing our lives.

Colorado is staring at that reality. I am staring at that reality. Under the cuts to the ACA and Medicaid funding, roughly 80,000 Coloradans could lose private insurance coverage, while well over 100,000 are likely to lose Medicaid, as hundreds of thousands more face instability, barriers and administrative red tape.

Chronic illness already strips people of certainty, energy and control. Public policy should not compound that vulnerability by transforming health care access into a moving target or an outright cliff we stand to tumble over.

Like many, I viewed health care policy as distant and abstract until my survival became entangled within it. I never expected to become an advocate at this level, but we all deserve health care, and no one facing chronic illness should have to fear losing the treatment they need simply to live. Congress must reverse the H.R. 1 cuts and restore ACA tax credits for people like me to survive.

Thomas J. Buckley is a Colorado small business founder, co-founder (CannManage), University of Denver alumnus and health care advocate. He advocates for affordable health care access after his own experience navigating chronic illnesses and the Affordable Care Act.