Jayne O'Donnell, USA TODAY
Published 5:00 a.m. ET July 27, 2017 | Updated 8:09 a.m.
ET July 27, 2017
Jayne O'Donnell of USA Today speaks with
Dennis Hobb of the McClendon Center about his concerns over the possible repeal
of Obamacare. USA TODAY
They have injured spines, costly cancers and
risky conditions including epilepsy and diabetes. But what many people with
chronic health conditions are focused on this week is taking place in
Washington.
As they watch the Senate's fast-changing
health care debate, they’re worried about whether they will still be covered
and whether their premiums will go up or down.
"The debate scares the hell out of
me," says Doug Hoffman, a retired Minnesota police officer who says his
health premium is his biggest cost.
Senators rejected a measure Wednesday
that would have repealed major parts of the ACA, but that was scant relief to
some of those with health issues. Senators can still amend a more basic
bill in ways that pose particular risks to premium costs and coverage
if they have preexisting conditions.
The plan still under consideration would
eliminate the requirement that people have insurance or that employers provide
it. That would increase premiums by reducing the incentive for healthy
people to sign up for insurance and make it harder for insurers to offset
the cost of covering sicker ones.
If people aren't required to buy insurance,
any replacement legislation needs to have "strong incentives for people to
obtain health insurance and keep it year-round," the Blue Cross Blue
Shield Association said in a statement Wednesday.
Without that, it would be impossible "to
avoid steep premium increases and diminished choices that would make coverage
unaffordable and inaccessible," BCBSA said.
That doesn't mean the current system is
working either, ACA critics say.
"The individual mandate was supposed to
force back into the market the young and healthy people that Obamacare has
overcharged," says Avik Roy, a free market health care expert who has
advised presidential candidates and other politicians. "But that hasn’t
happened; those young and healthy individuals have in large part stayed out of
the market."
But for those with current health issues, the
whole debate is worrisome.
Hoffman, 55, is a Republican who is
worried that if both parties don't work together, his premiums could go even
higher. He retired due to a knee injury, isn't eligible for premium assistance
and finds health insurance is his biggest cost.
"Partisan politics will not work,"
says Hoffman, who works only part time. "If the Democrats think by not
participating they will win, they are wrong. If the Republicans force feed a
plan, they are being just as shortsighted as the Democrats in the opposite
direction."
Other concerns:
• Medicaid coverage. The fate of
the expansion of Medicaid under the ACA, as well as overall funding for the
program remains uncertain. Conservative Republicans favor eliminating the
expansion that gave coverage to most people earning below poverty in states
that opted into it. More moderate Republicans oppose deep cuts and support
a more gradual phase-out of the expansion.
Todd Gregory, 50, who has debilitating
headaches from three brain surgeries, already finds it hard to pay the
out-of-pocket costs for some of the 13 medications he has to take.
"Should I pay for the medication or not
have any food for two weeks?” asks Gregory, of Georgetown, Ky.
Now he's worried about what will happen to his
Medicaid coverage if any of Congress' ominous cuts to the program make it into
law.
"I don’t wish a brain injury on anyone,
but i almost wish someone in their family might need (Medicaid) when they
decide how to spend the money," says Gregory, a member at the
patient networking and research site PatientsLikeMe.
• Pre-existing conditions. Senators
will have a chance to add amendments to any bill being considered, which
could put guaranteed coverage for those with health problems in jeopardy.
In South Carolina, high premiums and
coverage for those with pre-existing conditions are the big concerns of Sally
Whitson and her daughter, Jane, who has Type 1 diabetes. Jane just turned 26
and the family was able to get a six-month extension on her insurance for $383
a month,
"If pre-existing conditions are not
covered and rates skyrocket we might not be able to keep her covered,"
says Sally Whitson. "We are not rich. $383 a month is an expense we bear
because the alternative is that she would die."
Before the ACA, Jane Whitson had coverage
through South Carolina's high-risk pool.
"It was a terrible experience," says
Sally Whitson. "Returning to the high risk pool is high risk for people
with chronic heath issues."
Roy, co-founder and president of Foundation
for Research on Equal Opportunity, thinks health reform could lower premiums
if repealing the mandate is coupled with other improvements to the law.
But he blames Democrats for "doing their best to block regulatory
reform using parliamentary maneuvers."
"Why can’t we begin to see the human side
of this?" asks Sally Okun, a vice president at PatientsLikeMe. "What
worries me the most are attempts to parcel out the kinds of supports people
rely on for their health and well being."
Whitson has been watching the health care
debate closely, as she worries about her daughter and the many
hearing-impaired children on Medicaid she treats as an audiologist.
"Health care is not a deficit reduction
issue and it needs to be bipartisan," says Whitson. "Maybe my
daughter could have the same health plan as our Congress people and their
families. "
Laura Porter of Sherburne, N.Y., is disabled
with a spine injury, epilepsy and diabetes, and she worries what will happen to
her Medicaid coverage if she has to go back to a nursing home. But she also
worries about high ACA premiums if her grown children have to pay for their own
insurance instead of getting it through their employers.
"The health insurance business is just
crazy," says Porter, also a PatientsLikeMe member. "You can’t
afford to pay for it, but you can’t afford to not have it."
https://www.usatoday.com/story/news/politics/2017/07/27/senate-health-care-debate-adds-stress-chronically-ill-patients/512193001/?utm_campaign=KHN%3A%20First%20Edition&utm_source=hs_email&utm_medium=email&utm_content=54689669&_hsenc=p2ANqtz-8Woe6_OEZEzeWXp1rMx-bcUY4kwwGhEk8FZqw8Ss2MZ5TX_Sss_eU2H5akLbdZ9XPWt5YoNa332RrIMM0Jov18udeXDA&_hsmi=54689669
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