For so many Americans, Obamacare offered career freedom. A repeal could take that away.

“I’m facing the possibility of quitting my job.”

Health insurance and career opportunity are impossible to separate for Erin Hoover.

Hoover is a 37-year-old Florida State University student who will graduate with a doctorate in English literature this spring. She is also eight months pregnant.

Until recently, Hoover had a clear plan. She would have her baby in March, graduate in May, and begin adjunct work to build up her resume. She felt like she was on a good path; one of her poems was recently selected for the Best American Poetry anthology of 2016.

Adjunct positions typically don’t offer health insurance, but that seemed fine. Hoover expected she and her baby would continue to get coverage through the Affordable Care Act, which she has relied on since 2014.

But the presidential election changed all that. Republicans have promised to repeal the health law, but haven’t yet shown what their replacement plan looks like. Hoover doesn’t know if the programs she relies on now will be available. And she thinks that might reshape her impending job search. She is now considering going back to a career in public relations because it would offer benefits.

She is not thrilled at the idea.

“I just spent five years getting this degree,” she says. “I was hoping to utilize it in a new job rather than the old job that I used to work in years ago.”

I spend a lot of time talking to Obamacare enrollees like Hoover: people who struck out on their own — left a job, started a business, went back to school — after Obamacare. They felt empowered to do this because in the reformed individual market, insurers had to offer everyone coverage — and couldn’t charge sick people more.

And now, many of them are already beginning to rearrange their lives around the law’s uncertain future.

There were 1.4 million self-employed people who relied on the marketplaces for coverage in 2014, recent research from the Treasury Department shows. That works out to one-fifth of all marketplace enrollees being people who work for themselves.

Vox has spoken to about a dozen of them, mostly members of a Facebook group we run for Obamacare enrollees. For them, the Affordable Care Act was an opening of opportunity: the possibility to try a new career path knowing that they didn’t have to worry about where they’d get coverage. The possibility of repeal, they say, feels like a narrowing of choice.

Here, they describe the choices they were able to make because of Obamacare — and how they are changing their lives now that the law’s future is in jeopardy.

“Without the Affordable Care Act, I wouldn’t be here today”

Erin Hoover, graduate student, Florida

As an older mom who had to make a decision about whether to have a child now or forgo having a family, I was less worried about becoming pregnant in graduate school even with uncertain immediate job prospects. Even if I had to piece together work from multiple adjunct teaching jobs, I believed that I would at least have health insurance for me and my baby.

Liam Mulshine, actor, Pennsylvania

Looking back at how many hundreds of dollars I was paying monthly for individual health insurance before the ACA was implemented, if things had stayed that way I very well might have quit pursuing my dreams and looked primarily for less-fulfilling employment that offered health insurance or more compensation so I wasn’t spending more on coverage than I was making in a given month.”

JP Perry, small-business owner, Oregon

My wife and I have worked in the film industry for a decade. Two years ago, we decided to leave our desk jobs and start our own small business: a video production company. We couldn’t have done that without the health care law. Before, my wife was denied coverage by every insurer in the state. She has a preexisting condition, a thyroid condition. And getting insurance was difficult for the rest of our family, too: I have two fused vertebrae, and we recently had a baby boy who spent some time in the NICU.

Will Knapton, freelance translator, Maryland

I became a freelance translator in 2000, when I was 27. Every year my wife and I had more and more riders attached to our policies. Mental health wasn’t covered because we both had sought counseling at various points in the past. Sports-related injuries weren’t covered because I had seen a doctor for knee pain. I almost never went to the doctor because I didn’t want more to be added to my history. The ACA made it possible for me to obtain an affordable policy with decent coverage and continue to be self-employed. If the ACA is repealed, I would likely be more motivated to look for a different job that provided health benefits.

Mehran Azimi, former teacher, Washington, DC

Without the Affordable Care Act, I wouldn’t be here today. In September 2015, I wasn’t sure if I had internal bleeding in my stomach. I called the nurse and they told me to go to the hospital. There was bleeding going on and they had to do a procedure to operate to stop the bleeding. If I didn’t have insurance, I would not have gone to the hospital and bled to death.

The fact that I had insurance saved my life. I really don’t know what to do if they repeal ACA. I had some investments, and after working for 28 years, so I have a little money. I don’t use government assistance or disability yet, but I might have to eventually.

“If Obamacare is repealed, I’m really not sure what would happen to us or our family”

Marissa Garrett, small-business owner, Texas

I own a small web-publishing business with my fiancé. We have four staff members. I’m facing the possibility of quitting my job to be able to get a policy through a larger employer. Standard working conditions impact my illness (bipolar disorder) in negative ways due to stress. My depression was the worst it has ever been when forced into an 8-to-5, Monday to Friday job.

Joan Griffin, retiree, Virginia

Fortunately, our finances are such that we can afford to pay the full cost of insurance without subsidy, so the issue for us will be whether we will be excluded from coverage because of our preexisting conditions. If we are excluded from adequate coverage, one or both of us will have to return to work. Since we retired, we have been active doing volunteer work for nonprofits in our community. We will not be able to continue doing volunteer work if we have to return to work to obtain health insurance.

Alex Ajeto, medical student, Washington

I have considered additional investigation into my GI symptoms, but the risk of finding something like a more serious irritable bowel disease such as Crohn’s or ulcerative colitis has me hesitant. I don’t know what the right time to diagnose a new possible ‘preexisting condition’ would be.

Angela Eilers, stay-at-home mother, California

My husband opened his own business as a research analyst, and he employs four people right now. Leaving corporate America has significantly affected our family in a good way. He’s home and has a flexible schedule to coach Little League, take my daughter to tumbling, and be engaged with them.

I’m worried because my 7-year-old daughter has a serious preexisting condition, a congenital heart defect. Before she was 1, we had just under $500,000 in medical costs for my daughter. If Obamacare is repealed, I’m really not sure what would happen to us or our family. My husband would maybe need to go back to working for corporate America and give up his small business.

Michael Hall, independent contractor, Washington, DC

I don’t work for a company that provides for any type of health care. I’m a self-employed, independent contractor and don’t work regularly. I don’t smoke, because I was able to get Chantix. Without my basic insurance, Chantix would be $300 for a one-month supply. I’m a nonsmoker as a direct result of that. With the potential repeal, I’ve made more appointments. I’m going to be 50 in four months. I have a lot of stuff I want to put off. But they may pull back my coverage, so I need to figure it out and check where I am.

Some of the people we spoke with said they’d like to figure out a way to continue their careers, despite the uncertainty repeal brings. They’re hoping that a Republican replacement plan might offer certain features they like about the Affordable Care Act, such as the requirement to cover everyone regardless of preexisting conditions.

But most, like Erin Hoover, were just worried.

“I may have felt comfortable going without insurance myself, but I won’t let my daughter go without care,” she says. “I am now being forced to choose between taking care of my family and following my professional ambition.”

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