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8 People Who Owe Their Lives to Obamacare

Mother Jones

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President Donald Trump has vowed to dismantle the Affordable Care Act (ACA)â&#128;&#138;—â&#128;&#138;a move that could leave some 30 million Americans without health insurance. ACA literally sustains millions of livesâ&#128;&#138;. Without the health insurance it provides, many people wouldn’t have access to medicine and procedures that they need to survive. When we asked people on Twitter and through healthcare advocacy organizations to share their stories of how ACA keeps them alive, we were overwhelmed with responses. We heard from people waiting for organ transplants, from cancer survivors, from people with debilitating mental illness, and more. They told us about the toll that disease has taken on their lives: Before the ACA, some were forced to skip treatments because of the price; others couldn’t get insurance at all because they were already sick. Here are a few of their stories.

Claudette Williams

Claudette Williams, 58, Orlando, Florida: I lost my job in 2005. After that I decided to purchase a policy. I found them online. They had a gentleman come to my house, and we talked about my blood pressure medications. The insurance was almost twice what they had quoted me because of the medication, and also because of my condition. I eventually couldn’t afford it any more. I was uninsured, except for one year when I qualified for Medicaid. I ended up in the emergency room on a few occasions for heart trouble. I also developed diabetes. I couldn’t afford to have regular mammograms. In 2014 I signed up for Obamacare. I was diagnosed with breast cancer in September of last year. The lumpectomy alone was billed at $40,000. I have four more chemo sessions to go, and after that, I have to do radiation. Luckily my cancer is only a stage one, so my prognosis is pretty good. But it is really scary thinking about my insurance being taken away. This is a fight for my life.

Charis Hill

Charis Hill, 30, California: When I was 25, in 2012, I had a series of unexplained and undiagnosable respiratory challenges that felt like the flu or bronchitis or pneumonia. Doctors just couldn’t figure out what was wrong with me. My condition got worse and worse. I visited urgent care a few times. I thought I was having a heart attack once. They tried to blame it on anxiety.

Eventually reached out to my dad, who was estranged from me. I knew that he had a severe health condition. The first words out of his mouth were, it sounds like you have what I have, which is ankylosing spondylitis (AS). I knew that I would need health insurance to be treated. But if I were to get a diagnosis before getting health insurance, I would have the preexisting condition working against me. So I got the cheapest plan that existed. I wasn’t getting all the tests done or getting all the treatments. Then, ten months later, the ACA was implemented, and because of my income, I was eligible for a subsidy to purchase health insurance on the exchange in California. I got a better plan for less than I was paying before, which meant that I could access more treatment and not skip medication.

I have infusions of a drug every eight weeks. I have to go to an infusion center for 2.5 hours. There’s no generic. There’s no way to get those treatments unless I have insurance. They slow down the progression of my disease. I also take anti-inflammatory medications orally. AS is a severe inflammatory condition. It primarily affects the spine. It causes a lot of pain and fatigue from the body trying to fight that inflammation. I’m permanently disabled. I was a college athlete, and now I’m not even able to run. I use a wheelchair sometimes. As hard as I fight to be healthy, I’m never going to be healthy, and I’m always going to have to rely on the medical system to keep me alive.

John Weiler, 27, Oakland, California: I got HIV when I was 19. When I was in college, I was on my parents health insurance, so when I started meds when I was 21, I took it for granted that I was going to have insurance that would cover it, because it was so easy. When I went to grad school, I naively accepted a position without asking any questions about how the insurance was structured. When you do a science PhD, it’s typical for the school to pay your tuition, pay your health insurance premium, and give you a stipend. In my program, the stipend is about $30,000 a year. So when I enrolled and started to look at my insurance situation, I realized the policy offered to students provided up to $10,000 worth of prescription coverage per academic year, and that was it. But in 2013, the student government got together and petitioned the university to change across the UC system. The students basically said, ‘We don’t care if our insurance premiums are higher, we don’t want these things that the ACA offers to not be part of the insurance plan for the school.’

I was on a med cocktail called Complera, and that one was $22,000 a year. HIV meds are super expensive. I switched to a different medication since then, called Stribild, and I don’t know exactly what it is this year, but if I remember correctly, that one was closer to $27,000 a year.

I’m about to graduate and find a job, and, let’s say worst case scenario, first Congressional session they manage to totally gut the ACA and revert to how things were before. If that were to happen and I were to get a job, it would be totally legal for an employer to be like, ‘Hey, yeah, we’re not covering this.’ I’d be looking at close to $35,000 a year in medical expenses just for maintenance, let alone if I got sick.

Ruth Linehan

Ruth Linehan, 26, Portland, Oregon: I graduated college in May 2012. I was 22. About a month later, I started an internship as a software developer at a Portland startup. Thanks to ACA I was on my parents’ insurance. After four months I was offered a full time job, but the insurance didn’t start until 6 weeks after my first day as an employee. On my first day I was diagnosed with Burkitt’s Lymphoma. I looked like I was 7 months pregnant. I started chemo the day after I was hospitalized. This is an incredibly fast-growing cancer. I was in the hospital for seven weeks. I received about four rounds of chemo. After four months I was declared in remission. I continue to be in remission. The hospital bills were about half a million dollars. I only had to pay about $10,000 because I was on my parents’ insurance.

If I lose my job and the cancer comes back, what am I going to do? I worry about illness down the road. I’ve had cancer at a very young age and a lot of very harsh chemo. I worry that I won’t be able to get affordable insurance, or get insurance at all.

Larry Sterlingshires, 35, Tennessee: I have a condition called hidradenitis surruptiva—look it up, do not look at pictures, because it’s not a good time—it’s a chronic skin condition that’s ultimately debilitating. As it progresses, it causes tissue degradation on the skin layer that doesn’t heal, like normal wounds do. Sometimes it creates lesions that don’t heal for a year and half. It’s debilitating because it’s painful—the tissue underneath is exposed without that protective layer, so it bleeds regularly. You have to keep everything patched and bandaged, and it easily gets infected. But because of the ACA, I can have medication that can’t completely undo the symptoms, but it seems to have halted its progression, and even promoted some healing. Complications related to the tissue damage and infections can be fatal.

The medications I’m on right now, in addition to just my normal medications for diabetes and hypertension, will help me survive longer. This lets me afford something called Claravis, and another medication called Humira. Humira runs approximately $7300 a month, and the Claravis is about $4000 a month. Those basically keep me functional without being completely disabled. That’s no exaggeration. If you check the disability schedule, it’s so painful and considered debilitating enough that you can qualify for full disability with it. The Affordable Care Act covers all of that medication in full. I come from poverty, I’m just now getting used to having insurance for the first time in my adult life, and now that seems like it might evaporate.

Debbie Lynn Smith, 59, Las Vegas, Nevada: I was a TV writer and producer. In 2000 I was diagnosed with bronchiolitis obliterans. It’s also called popcorn lung. I got it from buttered popcorn. When you work in TV, you work 15 hour days. They provide snacks and things. Microwave popcorn is one of the things they give you. I ate a lot of it. It just so happened that I was susceptible to this disease.

I was in remission for 16 years, but I was living with 50 percent of my lung capacity. I couldn’t do TV anymore, couldn’t put in those long hours. I really had a hard time working and being reliable because I would get sick. So I couldn’t get insurance through work. I had insurance through the high-risk California program and I was paying $2,000 a month for that. My husband was on it, too, he had prostate cancer. We moved to Nevada. When the ACA came around we were ecstatic. We were both out of work at the time, so we went on ACA.

This year, in April, my disease came out of remission. I am now down to 30 percent of my lung capacity and waiting for a lung transplant. So you can imagine the fear I have—being so close to getting a transplantthat they might repeal the ACA right away, and I will no longer have access to insurance, and I won’t be able to get my transplant. I am extremely stressed. I was so stressed before the election that I could not take anything else. I was working for Hillary and I ended up in the hospital.

Michele Munro

Michele Munro, 64, Southern California: I was first diagnosed with breast cancer in 1997. I was 44. I was a single mom with two boys. I had Kaiser insurance. It wasn’t a bad cancer, and we caught it early. Then seven years later I was diagnosed with a different type of breast cancer. That was 2004. I also had a hip replacement. The Kaiser premium doubled, so I went without insurance for the first time in years. I was working as a freelancer, and insurers told me I was uninsurable. In 2011, ACA started to kick in. It was not allowing insurance companies to consider preexisting conditions. I applied and was accepted into Aetna. The first thing I did was go for a mammogram, and, sure enough, I had a triplenegative tumor. Very aggressive. It was small and early, so we caught it just in time. I had a double mastectomy and chemotherapy and breast reconstruction, all covered through ACA. I went into the hospital seven times total for infections. The billing was $900,000. Aetna settled and paid out $180,000.

I’m feeling really good right now because December was the fifth anniversary of being cancer-free. I exercise a lot. I’m doing everything I can on my end. But there is only so much you can do. I’m scared for myself, and also for my children. My parents had to claim bankruptcy for health insurance reasons. They were not covered for a medical emergency.

Suzanna Moore, 29, Fairfield, Iowa: When I was a baby, I had a stroke. I recovered well, but I would always have issues afterward. Throughout my childhood, it always a concern if I would have proper health care. I grew up in a pretty poor family in New England. With Obamacare, I went to an orthopedist for the first time in forever and got a prescription for orthotics to alleviate chronic pain in my knees and ankles on one side, because my right side was affected more from the stroke than my left side. The pain built up for a while, but basically throughout my twenties, I was never able to get it addressed, because I was living on my own in Tennessee and was unable to focus any money toward my personal health care.

I also had a meniscus tear during that time. Had I had surgery on that on my own, it would have been like $15,000 or more. With Obamacare, we still had to prioritize, but we didn’t go in debt over it.

My husband has a rare condition called achalasia, which means the muscles in his throat stopped working the way they were supposed to, so he had trouble swallowing and eating. He had to force food down his esophagus with air and water. After a while, it got so painful that he was eating less and he was losing weight rapidly. It was hindering his quality of life, and, left untreated, it could contribute to throat cancer. So he had to have surgery about eight months after I had my knee surgery. We were able to afford all of it. We wouldn’t have been able to do that without Obamacare.

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8 People Who Owe Their Lives to Obamacare

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Obamacare Approval Really Has Gone Up, Especially Among Democrats and Independents

Mother Jones

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A month ago I took a look at Obamacare approval levels and wasn’t too impressed at the spike since Trump’s election. The increase was pretty small, and it was hard to tell if it was sustainable. So let’s take another look:

I don’t usually look at the “Less Smoothing” version of Pollster’s charts, but I’m doing it this time to try and get a sense of what’s been happening recently. This time, it really does look like there’s been a genuine change since Election Day, somewhere in the range of 5-6 points. Both Kaiser and Pew, which have conducted high-quality tracking polls for a long time, show the same thing. Pew breaks down the results by party, and it turns out the increase is due almost entirely to Democrats and Democratic-leaning independents:

In the past year, approval levels have increased 7 points among Democrats and 14 points among independents. Breaking this down further, approval has spiked a whopping 20 points among Democratic-leaning independents. By contrast Republican-leaning independents are up only slightly and Republicans haven’t budged even a single point.

In other words, now that Obamacare is under serious attacks, more lefties are finally deciding it’s worth defending after all. Finally.

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Obamacare Approval Really Has Gone Up, Especially Among Democrats and Independents

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Gutting Obamacare Would Leave 3 Million Americans Without Drug Treatment

Mother Jones

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There’s no denying that America is experiencing the largest drug epidemic in its history: Around 2.5 million Americans are addicted to opioids like heroin and prescription painkillers. Last week, Alaska became the latest state to declare the opioid epidemic a public health disaster.

President Donald Trump has particularly strong support in areas that have been hit hard by the crisis. Yet if Obamacare is repealed, as Trump has repeatedly promised, thousands of Americans would lose access to their daily or weekly treatment for opioid addiction.

Here’s what gutting Obamacare would mean for the people who depend on it to fight America’s opioid epidemic:

What’s the connection between the opioid epidemic and Trump?

Shannon Monnat, Penn State

Kathleen Frydl, a historian and the author of The Drug Wars in America, recently found that in nearly every Ohio and Pennsylvania county with high drug overdose rates, Trump’s share of the 2016 vote was 10 points higher than Romney’s in 2012, Clinton’s share was 10 points lower than Obama’s in 2012, or both. While the link between the drug epidemic and Trump’s popularity is circumstantial, “When you’re dealing with counties that have overflowing hospital parking lots, the message that America is already great doesn’t resonate with people,” Frydl says.

It’s not just overdoses: Trump overperformed in counties with high rates of “deaths of despair,” or deaths from alcohol, drugs, and suicide, according to research by Penn State sociologist Shannon Monnat. Counties with high despair death rates and high Trump turnout weren’t necessarily the poorest, but they were, generally speaking, financially worse off than they were a generation ago. “They’re places that have been experiencing economic downturn for at least the last three decades,” Monnat says. “There’s been a heavy loss in manufacturing jobs, natural resource extraction jobs—there’s a sense in these places that there’s been a dismantling of the American dream.”

Where are people most reliant on Obamacare for addiction treatment?

What has health advocates particularly worried is that the states with the highest overdose rates also rely the most on Obamacare. West Virginia, New Hampshire, Kentucky, and Massachusetts, have the first, second, third, and seventh highest overdose rates in the country, respectively, according to the Centers for Disease Control and Prevention. The rate of uninsured residents in those four states would roughly triple if the ACA were repealed.

U.S. Department of Health and Human Services

These maps from the Department of Health and Human Services show this overlap. In the first map, red states have the highest overdose rates; in the second, red states have the most residents per capita who would lose their insurance if Obamacare is repealed.

What would repealing Obamacare mean for addiction treatment?

If Obamacare disappears, nearly 3 million Americans with addiction disorders would lose some or all of their health insurance coverage, according to recent research by Richard Frank and Sherry Glied, professors of health economics at Harvard and public service at New York University, respectively. Of those, about 222,000 would lose opioid addiction treatment.

Last December, in a rare moment of bipartisanship, Congress enacted the 21st Century Cures Act, which will allocate $1 billion over the next two years to expand access to opioid addiction treatment. But Frank and Glied estimate that repealing the ACA provisions that address substance abuse and mental disorders would take away at least $5.5 billion annually from the treatment of low-income Americans with mental health and addiction disorders. A one-time $1-billion increase in spending would “not even serve as much of a bandage,” they write.

Why is Obamacare a big deal for opioid treatment?

The ACA has been particularly important for those seeking addiction treatment, says Keith Humphreys, a Stanford University psychiatry professor who advised the Obama administration on drug policy. “It was designed to be very broad, but at the same time we knew that if there was anything that this would help a lot for, it’s addiction,” he says.

Before the ACA went into effect, a third of individual market insurance policies didn’t cover substance abuse treatment, including medications like buprenorphine that have proven critical to keeping former opioid users off of drugs. The ACA deemed substance abuse and mental health treatment to be essential health benefits, and now insurance plans are required to cover them. In states that expanded Medicaid, 20 percent of hospital admissions for substance abuse and mental health disorders were uninsured in 2013, before the bulk of the expansion provisions kicked in. By the middle of 2015, the uninsured rate had fallen to five percent.

In addition, Obamacare covers Americans who are are most at risk of becoming addicted to opioids: People with incomes below 200 percent of the poverty line have a 50 percent higher risk of having an opioid problem than people with higher incomes. Humphreys adds that most users start using heroin or pain-killers when they’re young. Since the ACA lets children stay on their parents’ health insurance until they’re 26, it’s easier for young users to access treatment.

Without the ACA, says Humphreys, “We’re back where we were before: bad access, low quality of care, and a lot of patients being turned away.”

What could Obamacare do better?

The ACA hasn’t fixed everything. While it’s increased the number of people with coverage, there’s still not nearly enough treatment capacity, leading to big gap between the number of people who have treatment and those who need it. About 420,000 people who suffer from opioid addiction don’t have access treatment. Frank and Glied estimate that repealing the ACA would widen this treatment gap by 50 percent, bringing the number Americans who can’t get opioid treatment to 640,000.

Apart from the ACA, there’s the more general issue that federal funding for addiction treatment and services has flatlined over the past decade, says Andrew Kessler, founder of health policy consulting firm Slingshot Solutions. Overall, states get about two thirds of their funding for addiction prevention from Department of Health and Human Services block grants—and given the rate of inflation, those grants have lost about a quarter of their purchasing power. Under Mick Mulvaney, the former representative from South Carolina who was confirmed as Trump’s budget director last week, “we’re bracing for a very austere budget,” says Kessler.

What will come after Obamacare?

Congressional Republicans have long promised to repeal Obamacare. Many proposals that Republicans have put forward, including Speaker of the House Paul Ryan’s “A Better Way,” would eliminate the requirement for insurance policies to cover essential benefits, including substance abuse and mental health treatment.

This has some GOP leaders worried. Ohio Gov. John Kasich, whose state has been hit particularly hard by the opioid epidemic, warned fellow Republicans in January about the implications of Obamacare repeal. “What happens to drug treatment, what happens to mental health counseling?” he asked. As Humphreys puts it, Republicans “ought to realize that they will really harm their own constituents pretty substantially if they took this away.”

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Gutting Obamacare Would Leave 3 Million Americans Without Drug Treatment

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Uninsured Population Holding Steady at About 10%

Mother Jones

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The latest CDC numbers on the uninsured population are out, and as of September 2016 the number of uninsured in the US had dropped from about 17 percent before Obamacare to 10.3 percent. That continues to be below the original CBO estimate of 11 percent for the full year.

For all of Obamacare’s faults, this is a tremendous achievement at a surprisingly modest cost. It’s beyond belief that Republicans want to destroy it instead of making it better.

NOTE: As always, I’m using the CDC’s figures for the nonelderly population. This is because (a) this is what CBO used for its estimates, so I need to use comparable numbers, and (b) it’s the number we actually care about. The overall figure for all ages is currently 8.8 percent.

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Uninsured Population Holding Steady at About 10%

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Slavitt: Obamacare Should Be Profitable This Year if Republicans Don’t Blow It Up

Mother Jones

Andy Slavitt ran the Centers for Medicare and Medicaid Services under President Obama, which included responsibility for Obamacare. Here’s a tweetstorm he posted today:

I talked today/last night to 5 health plan CEOs. Won’t use names but: 1 Blues, 1 integrated w hospital, 2 non-profit, 1 VC backed. All 5 health plan CEOs believe they priced 2017 #ACA business & should at least breakeven. Several of the plans beat their ACA membership projections.

Of the 5 plans, w/ current uncertainty none can yet commit 2 participate in 2018. All seemed aware that new #ACA stability reg is coming. One plan said with all the work to be profitable in the #ACA (they hadn’t been), ironic to question participation now.

….They didn’t say, but I will: if there is ambiguity, they will raise prices if they participate. One CEO who has an actuarial background said he would be at single digit rate increases but for all the uncertainty. It sounds like the plans will submit #ACA rates for 2018 high to hold place in line. Big increases all from repeal & mandate uncertainty.

It is a shame. Not sure if representative, but single digit if we would wipe uncertainty off table. Still can. But needs to be fast….I think people are so weary of the unpredictability of politics. It zaps energy from their real jobs.

We don’t yet have final enrollment figures for 2017, but it appears that even with double-digit rate increases, uncertainty over Republican repeal plans, and deliberate sabotage from the new Trump administration, signups will be only 2-3 percent lower than last year. That’s a pretty stable market, and probably a profitable—or at least breakeven—one. Fairly modest changes could fix a lot of Obamacare’s existing problems, and higher funding could fix the rest of them.

Instead, we have massive uncertainty in an industry that felt like things had finally settled down after years of work. Slavitt is right: it’s a shame. We can only hope that Republicans will wake up and decide that repairing Obamacare and then taking credit for its success is a better path than blowing up the entire individual health insurance market.

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Slavitt: Obamacare Should Be Profitable This Year if Republicans Don’t Blow It Up

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