Jefferson Keel, Lt. Governor of the Chickasaw Nation and House Speaker Nancy Pelosi of Calif. take part in a meeting with Native American leaders to discuss affordable health care, Wednesday, Nov. 4,2009, on Capitol Hill in Washington. (AP Photo/Harry Hamburg)
WASHINGTON (AP) — You're afraid your cancer is back, and a health insurance company just turned you down.
Under the health care bills in Congress, you could apply for coverage through a new high-risk pool that President Barack Obama promises would immediately start serving patients with pre-existing medical problems.
Wait a second. Read the fine print. You may have to be uninsured for six months to qualify.
"If you are a cancer patient and have cancer now, you can't wait six months to go into a plan because your condition can go from bad to death," said Stephen Finan, a policy expert with the American Cancer Society Cancer Action Network. He called the waiting period in the Senate bill "unacceptable."
Advocates for people with serious health problems, as well as some insurance experts, are raising questions about one of the most important upfront benefits in the Democratic health care legislation: a high-risk pool for the medically uninsurable.
Obama proposed the pool in his September health care speech to Congress. Intended to serve the most vulnerable as a temporary fail-safe, it would stay in place until 2013. That's when insurance companies would be banned from denying coverage because of medical problems. Government subsidies to make coverage more affordable for millions of uninsured would also start that year.
Now, concerns are being raised about the design of the high-risk pools. In addition to the six-month wait, there's a more fundamental issue — whether $5 billion set aside for the three-year program is enough. The money would be used to help people in poor health pay premiums.
Obama credits his Republican presidential rival, Sen. John McCain of Arizona, for the risk-pools idea. But when the GOP candidate proposed it in 2008, the estimated cost was $7 billion to $10 billion a year.
The six-month wait is in the health care bill the Senate Finance Committee approved last month. To qualify for the pool, patients must be turned down for coverage because of a pre-existing condition and uninsured for at least six months.
"If you are somebody with cancer or a heart condition who needs immediate coverage and immediate treatment, that's not very helpful," said Karen Pollitz, a Georgetown University health policy professor.
Senate Finance staffers say the restriction is meant to prevent people switching from more expensive coverage to take advantage of government assistance.
But the House health care bill unveiled last week by Speaker Nancy Pelosi, D-Calif., doesn't include a waiting period. Instead, it would require insurance plans who "dump" seriously ill patients to repay the federal pool. "The House provision will provide immediate relief for people with high-risk conditions who have no alternative for coverage," said Finan.
It may be easier to fix the waiting period than the financing.
Both the House and the Senate Finance bills set aside $5 billion for the pools.
"It doesn't seem like it's near enough money," said Douglas Holtz-Eakin, who was a top domestic policy adviser for McCain. The McCain campaign ultimately concluded it could take as much as $20 billion a year to properly run risk pools, he said. The White House says McCain's proposal was more elaborate and not directly comparable to Obama's.
There are 10 comments
WOW. BO proposed something that is already in existance. A high risk pool. The only difference would be a federal program instead of the state programs available in most states. Way to go BO. Taking a lesson from Queen P. Lets just rebrand and call it a new idea.
@ 6. violet
I hope things work out for you. We need national health insurance so people do not have to go through this.
Do not donate to the democratic party. Only donate to the politicians, like Grayson, who show they really are serving us.
Today in congress:
Rep. Grayson read the names of people who have died in republican districts because of no health insurance.
Keep fighting Grayson. You are one of the few really fighting for us.
about 5 years ago, i was diagnosed with serious, stage 3b malignant melanoma, at the age of 24. when i was fired because i was too sick to work during the intensive cancer treatment that followed my diagnosis, i lost my insurance and was eventually insured through washington state's high risk pool -- probably the best insurance i've ever had. when i was laid off earlier this year, though, and moved to rural california with my fiance where the cost of living was cheaper, i lost my insurance and was repeatedly denied by insurance companies. with the long waiting list on california's high risk pool, my only choice was to get limited benefit insurance from cinergy, which doesn't deny people for pre-existing conditions, but covers only 5 doctor's appointments a year (i have at least one or two a month) and provides only a "discount program" for prescriptions (often the pharmacy's cash price is cheaper than the "discount"). the good news is that when i eventually get employer or state insurance, cinergy counts as qualified creditable coverage. the downside: when, last month, it looked like my cancer might have returned, i knew that even my nearly $300 a month insurance wouldn't cover the costs of any treatment. now come to find out that i would have to give up even the meager insurance i have to qualify for this proposed high risk pool. if my cancer does return, now or in the future, 6 months of waiting for treatment could easily mean the difference between survival and death. stage 4 metastatic melanoma has only a 7% 5 year survival rate. you can probably guess the 5 year survival rate of untreated stage 4 melanoma: virtually, if not actually, zero.
a 6 month waiting period for high risk coverage is unconscionable and shows a total lack of understanding the people such a pool needs to serve.
So you have no proof and you were lying just like every other time I call you on your lies.
http://www.suntimes.com/news/politics/obama/1122691,CST-NWS-hosp 3.article
Do you have proof of your statement? Of course not, you are lying again. Sorry again about the massive election loss that you extremists suffered on Tuesday. Just shows that the alchy, the junky and Palin could not elect a dog catcher. Few people listen to them.
If I make a suggestion, why not just institute the time-honored tradition that Michele formed Chicago that drove down costs dramatically: Hospital Dumping. Then we don't have to have any pesky sick people around.
Health care for the healthy...It's a beautiful thing!
I CANNOT FIND ANY THREADS I POSTED ON YESTERDAY.
Not all internet users have ADD.
Post a Comment
You are not logged in:
Log In | Register