See more of the story

As the owners of a toy shop for over 20 years in Minnesota, we enjoy a good puzzle. But instead of showing off cool games to our customers, we have been trying to sort out the puzzle of health care. With the latest confusion over the Texas v. U.S. lawsuit attacking the Affordable Care Act, the Trump administration’s motives are clear — attack our health care and leave us picking up the pieces.

Before the Affordable Care Act, our family was paying an extraordinary amount for health care. Due to Millie’s juvenile diabetes, a pre-existing condition, private insurers refused to cover her. We paid more than $25,000 a year with insurance premiums and high deductibles stacked up. Instead of being able to invest in our business, we were barely afloat. Over 130 million people were in this same situation — and their care is at stake.

Health insurance costs were the No. 1 drag on our business. The costs kept us from investing or expanding.

After the ACA passed, we were able to purchase private insurance through the new exchanges. Later, when our business changed and our income decreased, we qualified for our state’s expanded Medicaid program (MinnesotaCare). Now, like 14 million other Americans, our Medicaid coverage is at risk if the ACA is invalidated. It was a huge relief to be able to go to the doctor when we needed to and not put off preventive care due to cost. But it is still precarious. Because we own a retail store, our income fluctuates, making it very difficult to predict which program we’ll qualify for.

The puzzle of will we or won’t we qualify is so frustrating. Add to that the risk of the Republican district attorneys prevailing in invalidating the ACA, with the support of President Donald Trump’s Department of Justice, makes it that much harder to predict our expenses and therefore directly affects our business. As small-business owners, we understand that uncertainty is part of the deal, but it should be uncertainty and risk from our industry, not our health care.

For Millie, the increasing costs of insulin and drug prices mean there is absolutely no Plan B if the ACA is invalidated. The cost of insulin has skyrocketed from about $60 a month to $600 to $1,000 for the same medicine. The increasing drug prices are just another example of how the private health care market has continued to fail our family and our business.

We know what it was like before the ACA — completely untenable. And with all this back-and-forth and legal gymnastics (the Fifth Circuit just sent the lawsuit back to the district court last week), it’s clear we need more than a quick fix. What’s at stake is more than our health; it’s our business and our children’s futures. We can’t go back to before, but the current situation brings new anxiety with every new headline. Let’s move forward to universal health care, protecting those with pre-existing conditions and preserving the gains of the Affordable Care Act. The predictability and access alone would be huge for supporting small businesses and our communities.

Millie Adelsheim and Dan Marshall are co-owners of Mischief Toy Store in St. Paul and members of the Main Street Alliance.