6/2/11 The Obama administration announced this week that the federally run insurance plan for people with pre-existing conditions will be less expensive and easier to qualify for, beginning July 1.
The Pre-existing Condition Insurance Plan, or PCIP, provides insurance coverage to people in the private market who have been denied insurance due to conditions including rheumatoid arthritis, obesity, coronary artery disease and lupus. PCIP launched in January as part of the Patient Protection and Affordable Care Act. It serves as a bridge to 2014, when the new health exchanges open in each state, and offer insurance options for everyone, without discrimination based on health status.
Arthritis Foundation President and CEO John H. Klippel, MD, joined Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, or HHS, for the announcement on May 31. Dr. Klippel expressed strong support. “These changes will offer more Americans with pre-existing conditions an option to access the care they need without the discrimination that has occurred against those who have debilitating, expensive diseases like rheumatoid arthritis, which currently affects nearly 2 million Americans,” he said.
Making PCIP plans more affordable and lowering the application requirements may increase enrollment, which has been relatively low. About 18,000 people have joined the program, which was expected to cover approximately 350,000 participants through 2014. Some states, specifically Hawaii, Maine, North Dakota and West Virginia, have fewer than 30 people enrolled.
Sebelius said HHS will increase outreach for the program through various measures, such as working with insurers when an application is denied.
The new eligibility rules, however, may mean fewer people with pre-existing conditions will be denied by private insurers. Previously, an applicant had to a provide letter of denial from an insurance carrier to qualify for PCIP. Now, all that is required is a note from a doctor, physician’s assistant or nurse practitioner confirming a pre-existing illness.
I have tried to get help with medical care (my premiums are $274 per month, and will be going up when I hit 45 yrs old) but I would have had to be without medical insurance for 6 months (?), which is not an option for me.
I am suspecting that more people are not signing up for this ObamaCare plan because they do not have the money to pay any premiums and are just hoping that they do not get sick or injured.
As long the current system continues we will have:
1. Optimistic younger people not bothering to buy health coverage, even if they could afford it.
2. Some of these optimists getting expensive diseases and injuries that have to be treated; however they stiff the bill.
3. Cost-shifting onto those who have insurance, which usually means their employers. (Most group coverage is self-insurance which means the insurance company just shuffles papers for the employer. The insurance company incurs no underwriting risk.)
4. Accelerating off-shoring of American jobs, because ONLY IN AMERICA does access to medical ever come from one's employer.
5. Ever increasing difficulty for middle-aged people to find or keep a job with benefits, because nobody in their right mind wants to be responsible for the medical care of someone in the cancer and heart disease prone years.
You need to set your bigotry aside, spit out the tea, and recognize your real enemy!
I can not find any agent selling this new health program.
Instead of fighting one another over health care, the democrats and republicans should start working together to improve the health care system in the U.S. Many of the citizens in our country haven't been able to obtain affordable health care. One of my good friends was given a death sentence by his insurance company seven years ago, when his carrier refused to approve a kidney transplant that could have saved his life. His doctor recommended the transplant, but the insurance company refused to approve the transplant. Now, after seven years on dialysis, my friend is slowly dying and has become too sick to risk a transplant.
We should be grateful for those who are fighting to ensure that decent health care is available to everyone, not just those that can afford it.
All that aside...I suffer from O.A. in all my joints and vertabrea and I also have ITP, Immune Thrombocytopena Purpura, a rare disorder of the autoimmune and hematological systems, this causes my body to destroy the platelets in my blood causing me to spontaneously hemmorahage and capillaries to rupture and bleed into the skin causing small purple bruises and even larger ones if I'm really injured.
I am on a high risk policy w/UHC-GR at a premmium of over $830 a month w/$3500.00 copay and no RX coverage...I haven't been able to work for the past 10 years and no SSD because my medical records that could link the OA to ruptured discs has been destroyed by the doctor and hospital that first diagnosed. Seems that after 7 years doctors and hospitals do that. And, about two years after you loose your job SS disability insurance coverage stops! Didn't know either.
My husband's job was terminated because it wasn't politically correct for Mars MasterFoods, Inc. to have a corporate jet for their newly acquired pet food division. He's hasn't worked in over 3 years and the the savings, Roth and 401K are running out.
Life is (*^%$ for all of us. And, cuts have to be made. But, to throw the chronically ill and severely sick under the bus to save Medicare and SS for those under 55 and those who haven't been born, much less old enough to work and pull their own weight is insane!
And, yes. Obamacare does have a 'death panel" , it's called IPAB. Some of you clearly have been brain washed by the Left Wing fractions and main stream media.
I believe if the government wants to help, then they should cut out deductibles. Why should we pay a monthly prem and a deductible on top of that.
When I retire, there probably will be no SS and if there is, it will not be enough to
help, and by then, the Medicare prem will be too high to pay. I have a family history of heart problems.
Doomed in South Carolina.
No,the Health Care Reform Act doesn't have it 100% right. What in life is 100% right? But it's a step in the right direction. I bet a lot of you believe they were going to "pull the plug on granny." Lies from the Tea Party and Republicans. Please folks, stop drinking the Kool Aide and think for your selves.
Enough of the politics. I know folks are in pain. Physically and financially. We as a society are at the whim of pharmaceutical and health insurance corporations. We are also what we eat and drink. It's our decision to put into our mouths what we do. It's our decision to be couch potatoes. I take full credit for the RA I have had for the last three years. I had a pity party for myself for about the first 6 mos. of the onset. Then decided that I was only adding to my pain and suffering.
Anyway, I'm sure I'm upsetting the majority of you who read the above political comments. So be it. I read yours. Let's get over it. We are all Americans. We all love our country.
For those on Humira, as I, I've recently, since turning 65,have had to pay more per month since I'm now on Medicare and my employer's health care coverage, I'm retired,MANDATORY at 60 yrs., became my secondary coverage. Thankfully the Humira Protection Plan covers $500/month. A friend of mine has been on Remicade for about 5 yrs. and said she doesn't pay a thing. I looked into it and here's the scoop.
Remicade is administered at the doctor's office as an IV or intravenous infusion in your arm. Because of that, it's considered a doctor's procedure (my term) and Medicare covers 80% of the cost. I'm lucky with my secondary health insurance, that it covers 20%.
I hope the above information regarding Remicade vs Humira may help someone out there reduce their cost.
Ursolina
Every comment I see above from people that have RA, etc. say that the program has been a farce in their experience. Why don't you try to fix the problems instead of joining with the govetnment and trying to tell us how great you and HHS are?
First of all I live on a fixed tight income which our illustrious President seems to think we don't need any raises to our checks.
I guess he thinks we are all fools not to see the high gas prices and higher food prices. This doesn't count the cost of medications, and Doctor's visits. Who has the high cost for this so-called insurance?
Certainly not disabled Citizens nor Seniors who barely have an income. We do not have
the Presidents income, nor that of Senators, nor of Congressmen we live on barely next to nothing. The President couldn't make us any poorer than he has already. I ask you in good faith Where will my $470.00 for insurance in the State of Georgia come from
when I only get $770.00 per month on my Disability check....and sure I qualify for
this insurance because I have Systemic Lupus
and haven't had insurance since my divorce in over 10 years. But Who will pay this premium for me? Will you President O'bama
pay this premium for us? This would be the only way I could afford this type of Insurance. What kind of President are you?
I say the Robber of the Poor, Sick and Needy.
This is my heartfelt opinion of this matter.
Healthcare reform...and help for those with pre existing medical conditions, please. What about not having to pay such high premiums as well as high deductibles and high copays. What's the alternative for those with debilitating, life altering diseases...no dr. visits, no medical care, no prescriptions = just sit back and allow the permanent damage to one's body progress at a rapid pace, to the point of permanent and total disability. Then we apply for social security/disability benefits that are nearly impossible to get approved for(if still available)let alone live on. Politicians......all of them...need to wake up. Fix the programs where they need to be fixed!! It's about time they take care of those who are considered middle class...and yet struggling to survive.
I am 51 & my husband 59. He has all 3 & I have just the hypertension. He has lost 35 lbs. over the last year that his doctor has considered taking him off some of the medications.
Tami Keen, Tampa, FL
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