Get your IUD before Planned Parenthood closes? Stock up on your meds? Well, when your med is radiation, that’s not exactly an option. Alaina Leary points out that the Affordable Care Act repeal, if/when it comes, is going to come down hard on those with chronic illnesses above all else:

With all the recent public discussion about the Affordable Care Act and women’s access to health care, I’ve seen a lot of posts urging people to “seek healthcare now, while you still can.” They suggest that readers stockpile their medications, schedule all their annual visits, and look into long-term birth control like IUDs. These tips are meant to help, and will help many. But they almost always leave people with disabilities and chronic health conditions out of the conversation — and we’re arguably one of the most vulnerable groups that can be affected by universal healthcare laws.

While some medications can certainly be stockpiled (my dad has been stockpiling his acid reflux and allergy medications for over two years now in case he ever loses coverage again), many cannot, including chemotherapy, insulin injections, birth control, many medications for mental health conditions, and any controlled substance. Stocking up on meds is a good idea for the basically healthy and able-bodied, but it’s not feasible for many of the people who are in the most danger from losing their prescription coverage.

“Get an IUD now before birth control stops being covered” is also fantastic advice — except for all the people it leaves out. I’m on a daily hormonal birth control entirely for serious medical reasons; I’d be physically devastated if the Pill became prohibitively expensive, whether I got an IUD or not. There are also plenty of people who can’t choose IUDs because their bodies will reject them, or they won’t be able to physically get it implanted to begin with. By treating IUDs as an imperative, we risk not only ignoring these people but making them feel alienated and hopeless.

Here’s another vile fact to file under “reasons Republican voters should be disenfranchised”–estimates of the number of people dying without healthcare if the ACA is repealed and the individual mandate is not replaced come in between 36,000/year to 64,000/year, the majority of which would be folks with chronic illness. “Negligent manslaughter” is an understatement.

-Shiv