I came across this in Elisabeth Rosenthal’s new book “An American Sickness”. It’s an outstanding book that describes how greed has made our health care system dysfunctional.
She narrates the tragic story of Wanda Wickizer who was in good health until she had a brain aneurysm. Due to a series of circumstances, which were all too common in the pre-ACA days, she lost health insurance.
When her husband died, she continued to cover her family, including two school-age children, with an extension of his health insurance. (COBRA allows employees or their families to pay out of pocket to continue on a company policy after certain life-changing circumstances, such as firing or death.)
In 2010 her extension plan ran out and she tried to get insurance on the commercial market, but was denied by several companies, she said, because of a preexisting condition: she had once taken medicine for mild depression. (This would no longer be legal since enactment of the ACA!)
That left her in the state’s high-risk pool, where she would pay $800 per month for a policy with a $5,000 deductible and 80/20 coverage thereafter. She couldn’t afford it.
She quit her job so her kids would qualify for Medicaid. She was determined to save the retirement account for their college fees. She did her best to control her borderline high blood pressure through healthy eating and exercising because she couldn’t afford medications. In her own words, she “was doing pretty well, until a vessel in my head burst.”
Wanda survived but her hospital bill alone was $356,884.42. And this was just the beginning of a series of fights, court battles and so on; the last thing someone with a serious illness needs.
Don’t be fooled into thinking that high-risk pools are some sort of solution. There are not. Currently they are absurdly underfunded, and will provide coverage for only a small fraction of those who need it. Even if the pools are adequately funded (don’t count on it), the return of discrimination against folks with preexisting condition will bring back underwriting. This means filling out lengthy forms where you’ll have to list every visit in last seven years (or more).
And then rescission cannot be too far behind. Rescission involves retroactive denial of coverage on the grounds that the applicant did not fully disclose her history (you forgot about your history of acne when you were a teen? Too bad).
The AHCA has many more horrors: Medicaid cuts resulting in loss of coverage for millions, increased premiums for seniors, removal of Special Education funds for kids with disabilities, and loss of essential health benefits.
The 159 million with employer-provided health insurance are not safe either. The return of lifetime caps and annual limits will be a death sentence for those with cancer and other serious illnesses.
It appears that the Senate will vote soon, so let’s keep fighting.
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