Ramon Castellon suffers from arthritis, and for the last couple of years also from colitis, the inflammation of the lining of the colon.

Both ailments are a pain — literally — for Castellon, 58, but the colitis pain can be excruciating if flareups are not prevented.

To manage it, the Panorama City resident needs twice-monthly injections that cost more than $1,000 — a sum impossible for him to pay without insurance.

His insurance is Covered California, the state marketplace created under President Obama’s Affordable Care Act, more commonly known as “Obamacare.”

Castellon works at a Van Nuys factory that manufactures printer cartridges and earns a little more than minimum wage. Because the company insurance was too expensive, he switched to Obamacare where, thanks to subsidies, his monthly premium comes out to $24 a month. Doctors visits are $5 and seeing an specialist, which he often has to do, costs $8.

He is one of about 1.3 million Californians who pay for health insurance under Obamacare. Another four million state residents who signed up receive Medi-Cal, the state’s version of Medicaid.

In total, 42 million people across the country now have insurance through Obamacare, and many of them are worried by a Republican plan to “repeal and replace” the health program.

A new plan — which some are calling “Trumpcare” — would reduce subsidies. It would also do away with the mandate requiring those who can’t get insurance through jobs or other means, to pay for it or face a penalty.

A nonpartisan Congressional Budget Office (CBO) analysis concluded that many older people would receive less aid under the Republican bill than under the current law, and estimates 24 million people would lose coverage over 10 years.

“The Congressional Budget Office analysis is further proof that the House GOP proposal to repeal the ACA, and [replace it with the] Trumpcare bill is bad for Californians and Americans,” blasted California Insurance Commissioner Dave Jones recently.

“Because of the ACA, today more Americans have health insurance than at any time in our nation’s history. However, under the House GOP proposal that progress will be abandoned, and reversed,” Jones said.

For his part, Covered California Executive Director Peter V. Lee noted recently that “we are deeply troubled by the CBO’s finding that the amount of support provided for consumers to buy health insurance in 2020 under proposed legislation would be only 60 percent of what is provided under current law.”

“Health insurance can be expensive, and the financial assistance provided through Covered California helps consumers save money and brings that coverage within reach of millions,” Lee said.

The House of Representatives is expected to vote on repealing Obamacare.

Castellon worries that if it’s dismantled, he would become one of those 24 million losing insurance.

“If they take away Obamacare, it would really affect me,” Calderon said. “What would I do? The medicine (I take) is too expensive. I am counting that they will not get rid of it.”

So far, what he’s heard about the Republican plan is not good news, partly because different reports show that the tax credits to help pay for insurance under the plan would shrink, and the premiums would increase because the bill allows insurers to charge more as people age and become more susceptible to health problems.

“I don’t think that’s right. The most affected will be us, the poor,” Castellon said. “The ones who benefit the most will be the rich.”

He’s not the only person feeling anxious.

Anna Diaz was laid off of her job working for a university. She thought she would be retiring from that job from being a long-time employee and a good worker.

Instead, Diaz was a casualty of her department’s cutbacks and found herself without another job to land on, and without health insurance.

“I have a college degree, but I didn’t even get calls back for an interview. It was clear that people saw me now as ‘too old,’” she said.Diaz feels caught in a void — too young to receive Medicare health benefits and too old it seemed to have someone hire her at a job that would offer health benefits.

She said she has found her range of job possibilities limited. “I can get a low wage job at a big box store, but they will keep your hours down to part-time so that they won’t have to pay for health insurance or any other benefits for you.”  

Diaz said the Affordable Care Act, was a godsend for her.  She was able to sign up and receive Kaiser health insurance for which she pays $350 each month.

Now she fears that President Trump, with a GOP majority Congress, will dismantle the program.

“I try to keep myself in good health so that I don’t have to go to the doctor much. I don’t have anyone to take care of me. What if I’m in an accident or have an  emergency? This really scares me.”

Diaz is very worried about the possible implementation of “Trumpcare.”

“Everything I’ve read about it isn’t an improvement, especially for me. His plan would penalize older people like me and I would have to pay more simply because I’m older. How does that make sense? As we get older, we have less opportunity to make more money and are on fixed incomes,” she said.

Sandy Magaña, 32, who lives in Arleta, is another person worried about losing her health insurance.

She has coverage through Obamacare because she only works part-time with special needs children, and the agency she works for doesn’t offer her health insurance.

“My parents are diabetic and I have to go twice a year to get it (my blood sugar) checked,” she said.

For the past year she’s also been managing an ankle injury from an old sports activity that has worsened.

“Six years ago I developed tendonitis. Last summer a lady stepped on my ankle. If I’m hiking, it bothers me. I’m able to work out, but sometimes it’ll hurt,” Magaña said.

She also has back problems.

“(Health insurance) is absolutely necessary. It’s much easier to have health insurance than not to,” she said.

Her premiums come to $41 a month, inexpensive and easier to pay for someone whose income fluctuates constantly.

“I think it would definitely affect a lot of people that have these services. I am worried.”

For Magaña, the fix to the health care problem is easy.

“I hope that all the companies would offer insurance for their employees,” she says.

But that’s not something either Republicans or Democrats are planning to do.