The most difficult challenge over the years was paying for the escalating costs of health insurance before the Affordable Care Act (ACA) went into effect. Health insurance is essential because without insurance there is no health care. My 51-year-old brother went to the emergency room in 2010 with a health crisis due to an undiagnosed condition that ultimately took his life a year later. He worked full time but could not afford insurance therefore he had no access to preventative care, testing, diagnostics, or any medical interventions.