Can ANYONE Explain PCIP and/or Obama's Affordable Care Act?

Medigal:

I know this won't be helpful right now but there was an editorial in the St. Louis Post Dispatch, reprinted by the Kansas City paper (the Star?) this week that showed up on Google News and it says that "single payer" is what America needs not only to cover everyone but to get the deficit under control - as for the details of the mess that is U.S. Healthcare good luck with getting anyone to respond to your written requests - try calling their offices instead.

Medigal, here's a web page with further info and a number to call to get additional specifics. 

I only partly agree with Fearless_One. The law won't be "dismantled," per se, because that would be political suicide for either party. But it's possible the funding sources for many aspects of the Affordable Care Act will be eliminated.

I'm not sure whether there's any governmental cost associated with requiring companies to accept people with pre-existing conditions. If there's no cost to it, it will almost certainly happen.  

Medigal, one thing to remember is that part of the job of your member of Congress is to help you with governmental issues. Each member has a Constituent Services group that performs this function.

That being said, some members have excellent Constituent Services and some are more like Constituent Service Prevention departments, so your ability to get help will depend on how good your member's staff is and how much they want to help their constituents.

You might want to call your Congress member and ask to speak to someone who works in Constituent Services. Call the local, district office -- not the Washington DC office.

If you don't know how to locate a phone number for your Member of Congress, send me a PM and I'll help. 

Thank God we can kiss this health care reform goodbye, it's not worth a rats *ss.

The requirement that companies cover those of us with pre-existing conditions will cost insurers much money.  The mandatory coverage for all is what made up for that cost.   Bigger group would spread the costs out.

Unfortunately if the mandatory coverage is done away with I fully expect that the folks with pre-existing conditions who do not have employer sponsored group coverage will be thrown back under the bus.  They will be back where they are now ... unable to get coverage at all or only available at a cost that is wildly unaffordable, i.e., up the creek without a paddle.

Medigal ... I think you are unable to find acceptable solutions right now simply because there are none.  It sucks.   

To answer Medigal's question: If the person on whose behalf you are asking is not a dependent (26 or under, and under a parent's insurance plan), there is a high risk pool that provides coverage for those with pre-existing conditions. It is a subsidy and the coverage may not be that great, but it is there, al least by law, under the Affordable Care Act. For more information, and to check what there is in your state, go to: http://www.healthcare.gov/law/provisions/preexisting/index.html

Mountains1day: in what way do you think the Affordable Care Act is bad? Is it simply because the provisions that will help you haven't been implemented yet?

Mountains1day -- some points. 

1. The fact that something is a certain way in a transitional plan doesn't mean it will be that way in the final implementation.

2. Shortcomings in pciplan or the eventual implementation of the Affordable Care Act shouldn't mean that the Act is worthless. Would it be preferable for those with pre-existing condtions to have no healh insurance whatsoever? I don't believe it would.

3. I'm no expert in the Affordable Care Act, but my impression is that it's not intended to be all things to all people. The low cost insurance plans that should become available under the Act will not be "Cadillac" plans, and one of the things you miss out on in a non-Cadillac insurance plan is coverage for the newest and most expensive drugs.

4. Health costs have reached a crisis in America. Insurance prices and drug prices have skyrocketed and the compensation of executives at insurance and drug companies have also skyrocketed. (Hmm, do you think there could be a connection? I wonder!)

People have become homeless due to medical expenses. Sixty-two percent of personal bankruptcies are due to medical expenses. Businesses are struggling to provide medical insurance coverage for their employees. The Affordable Care Act was designed by human beings, and like any human enterprise it is by definition imperfect.

But Americans are finding the alternative to be untenable.

I'm very sorry that your cancer care drugs are not covered under a transitional plan. But IMO to say that the lack of coverage for certain drugs means that the entire Act is worthless is not appropriate. 

cycle path - good points

The idea of offering coverage to those with pre-existing conditions who otherwise would not be able to attain, is better than nothing.  However, this pcip plan so far, and is indicative of what will come (if not booted by 2014) may not help the average cancer patient if the basic drugs needed are denied and/or not covered. 

I am curious to know if anyone has signed up for this plan at www.pcip.com yet and how it's working out as a cancer patient?

FYI,

  Florida( HRP) high risk pool has been closed to enrollment for years!

  Yes, they must offer you coverage BUT...for example, they offered me a plan for around 950.00 a month...but I have no job so although they offered it...I cant afford it (and yes I checked with many insurers after COBRA ran out. So much for afforable health care...sigh..

Best,

M

Soccermom, did you check if you qualify for Medicaid? At my previous employer I worked with a young women who could not afford the premium for the employer provided health insurance. She was paid $30,000 a year, and had 1 dependent (8 years old). She got approved for Medicaid. Somehow we have to muddle through until Jan 2014 when hopefully the pre-existing clause no longer applies. 

Hugs, Helmie

I checked out the PCIP and the NC high risk pool. NC's pool has a 1 million dollar lifetime benefit cap. Once the new legislation required insurers to remove the lifetime caps, I called to ask why the cap wasn't removed from the NC plan. The rep said they were "grandfathered" and weren't required to follow the legislation. I was really angry....if you intend to live with cancer for years, a million dollars won't go very far. Moreover, I wonder how many people enroll without realizing or thinking what will happen when/if that cap is met.



The PCIP is a catch-22 for people who really need to be in the pool. The

Huffington reporter's explanation doesn't make any sense to me. Why in the world would private insurers want to retain high risk customers?