Tags: Healthcare Reform | coverage | gap | obamacare | canceled

Gap in Coverage From Failed Rollout Panics Chronically Ill

By    |   Thursday, 12 Dec 2013 11:29 AM

HealthCare.gov's technical failures coupled with individual policy cancellations could have grave repercussions for Americans battling serious or chronic illnesses: bankruptcy or even death, according to The Washington Post.

"For some of the high-risk members, it's a matter of life or death," says Tanya Case, executive director of the National Association of State High Risk Pools. "We have many members who are on specialty medications that they have no way of affording on their own."

Editor's Note: ObamaCare Is Here. Are You Prepared?

Though Obamacare fixes are being addressed since the program's failed Oct. 1 rollout, they are not being rectified quickly enough for the 15 million people who purchase individual coverage, millions of whom will have their coverage canceled at the end of the year because their policies do not meet Obamacare standards.

The Post interviewed the father of a 45-year-old Utah man with a rare degenerative disorder who said the family would fall into bankruptcy if there is any gap in coverage. Try as he might, John Gisler has been unable to purchase coverage through the healthcare marketplace.

"We've had three separate applications that failed to make it through," Gisler says. "I have a notebook with all the calls I've made, maybe 50 or 100. It just goes on and on."

Too worried about the gap in coverage, Gisler ultimately gave up, foregoing his son's $3,000 tax credit and instead buying coverage from a local insurance broker.

"We have a son who is critically ill," he told The Post. "We cannot take any chances. Not having insurance would, in no short order, lead our family to bankruptcy."

Even with Obamacare coverage, the health of chronically ill patients may still be in peril. Many of the health exchange plans do not cover certain drugs or they require co-pays up to 50 percent, resulting in the same problem: bankruptcy or no treatment.

Out-of-pocket costs for a patient taking $15,000 worth of medication would fall between $1,000 and $6,000 for the first month Obamacare insurance is used, according to healthcare consulting company Avalere Health.

Five percent of Americans suffer chronic and complex conditions. But the cost of treating those patients accounts for nearly half of all U.S healthcare spending, according to the National Institute for Health Care Management.

In the first two months of enrollment, nearly 365,000 people signed up for coverage, according to CNN, but that figure is well below what's needed to reach the 7 million target by March 31, the date the IRS is expected to begin penalizing Americans who don't have coverage. The administration also has a goal of enrolling 9 million people for Medicaid by that date.

Editor's Note: ObamaCare Is Here. Are You Prepared?

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HealthCare.gov's technical failures, coupled with individual policy cancellations, could have grave repercussions for Americans battling serious or chronic illnesses: bankruptcy or even death, according to The Washington Post.
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Thursday, 12 Dec 2013 11:29 AM
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