Health law clock is ticking for sickest patients

In this Tuesday, Nov. 5, 2013 photo, Jill Morin, right, poses for photos with her son Kyle at their home in Raleigh, N.C. Morin suffers from a serious heart condition and suffered a cardiac arrest in 2009. Morin and hundreds of thousands of other people with preexisting chronic conditions who are covered through high risk insurance pools will see their coverage dissolve by year’s end. (AP Photo/Gerry Broome)

In this Tuesday, Nov. 5, 2013 photo, Jill Morin, right, poses for photos with her son Kyle at their home in Raleigh, N.C. Morin suffers from a serious heart condition and suffered a cardiac arrest in 2009. Morin and hundreds of thousands of other people with preexisting chronic conditions who are covered through high risk insurance pools will see their coverage dissolve by year’s end. (AP Photo/Gerry Broome)

— With federal and state online health care marketplaces experiencing glitches a month into implementation, concern is mounting for a vulnerable group of people who were supposed to be among the health law's earliest beneficiaries.

Hundreds of thousands of people across the country with pre-existing chronic conditions such as cancer, heart failure or kidney disease who are covered through high risk-insurance pools will see their coverage dissolve by year's end.

They are supposed to gain regular coverage under the Affordable Care Act, which requires insurers to cover those with severe medical problems. But many of them have had trouble signing up for health insurance through the exchanges and could find themselves without coverage in January if they don't meet a Dec. 15 deadline to enroll.

Administration officials say the federal exchange, which covers more than half the states, won't be working probably until the end of November, leaving people just two weeks to sign up if they want coverage by Jan. 1.

"These individuals can't be without coverage for even a month," said Tanya Case, the chairwoman of the National Association of State Comprehensive Health Insurance Plans, which represents the nation's high-risk pools. "It's a matter of life or death."

High-risk pools were created by state legislatures to provide a safety net for people who have been denied or priced out of coverage. While the Affordable Care Act will forbid insurers from turning away people in poor health, those who qualify for a subsidy must enroll through the state or federal marketplace.

More than a dozen of the 35 states that run insurance pools for people with serious medical issues will permanently close their pools within a month and half. Other states will keep their pools running for a few more months.

The federal pool covers about 100,000 people and was created in 2010 by the Affordable Care Act as a temporary bridge until the law fully kicks in. It will cease to exist at the end of December.

"I'm scared. I'm in the middle of my cancer treatment, and if my insurance ends, I'm going to have to cancel the rest of my treatment," said Kelly Bachi, an Oklahoma boat repair business owner who has breast cancer and is covered through a pool.

Cancer treatment without insurance would cost her about $500,000, she said.

Bachi has not been able to enroll via the healthcare.gov federal website, although not for lack of trying. She attempted to sign up half a dozen times, was eventually able to create an account, but was later blocked from accessing the account.

Others — including Jill Morin of Raleigh, N.C., who has a severe heart condition and is covered by her state's pool — have not attempted to enroll.

"It's the unknown, the uncertainty that gets to me," Morin, 42, said. "I don't know what my cost will be at the end of the day. I don't know if my two cardiologists and my procedures are going to be covered under the plan. There just isn't enough information on that website."

But, she said, she has no choice. She must pick a plan soon because she can't afford to go without. She plans to go to an insurance broker for advice, then contact the federal call center to bypass the online marketplace altogether.

State officials throughout the nation have been scrambling to figure out how to help people like Bachi and Morin.

Last week, the board of the Oregon Medical Insurance Pool — which covers about 11,000 people — ordered the state to create a contingency plan for its members because the state's online exchange still has not enrolled a single person.

For now, the only way to enroll for coverage in Oregon is to fill out a 19-page paper application. The state has so far received just 7,300 such applications from all Oregonians, not just those in the pool, but it has not yet processed any of them. The process takes up to several weeks, so no one has completed it and successfully enrolled, Cover Oregon spokesman Michael Cox said.

Oregon pool administrator Don Myron said he hopes to speed up enrollment for its members by mailing them a paper application and following up to make sure they filled it out.

In Indiana, the Department of Insurance extended the high-risk pool coverage until at least Jan. 31 because of difficulties with the federal health insurance exchange. Its pool covers about 6,800 people.

The move was crucial, officials said, because people in the pool were not able to schedule treatments without proof of health coverage for the coming year. Indiana will spend $6.3 million to extend the coverage.

In Wisconsin, the Health Insurance Risk-Sharing Plan that covers 24,500 people is rolling out an outreach effort to make sure their members are signed up by the deadline, chief executive Amie Goldman said.

The state created a worksheet and directories of carriers to help people prepare for enrollment, has sent postcard reminders and is answering questions through its Facebook page and weekly newsletters.

Many of those in high-risk pools across the nation will be shopping for insurance for the first time in years.

"Even if the technology was really perfect, it would still be hard to sign up because many people who are really sick don't respond well to change," said Linda Nilsen Solares, executive director of Portland-based Project Access NOW, which connects uninsured people with care. "Many of them are just trying to get through the day."

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Comments » 11

August8 writes:

They need to strike a match to the entire thing and return to the private sector for a fix. Garbage in garbage out, never a better case !!

1Paradiselost writes:

Florida does not have a "state online health care marketplace"

Governor Scott & the state legislature decided Florida would not open a state marketplace even thought it was funded by the federal government.

Twenty-three percent of Floridians have no health coverage at all.

Florida is one of 27 states refusing to set up their own health insurance marketplace.

Gov. Rick Scott, has asked the Legislature to take the federal funding to expand Medicaid, but lawmakers have declined to follow his lead. Some state lawmakers have said they will try again in the 2014 legislative session.

I have a summer property up north. When I returned, I was informed by my current insurance carrier my policy would be cancelled by years end.

Obamacare being the law, I called the number for the federal exchange. As a Florida resident my monthly bill went from $263.00 per month to $328.00.

Instead of getting angry, I wondered how much insurance would cost where my summer house was located. It's in a state where they set up their own exchange, so I made the call.

I was told my premiums would be $84.90 a month for the same coverage I was quoted in Florida....

Question.. Are all Floridians over paying for insurance due to the governor and the state legislature in Florida?

This is just my experience now that I'm required by law to purchase insurance thru the federal exchange.

Has governor Scott kept competition out of our state?

Has anyone else experienced the same results as I did?

panola60 writes:

PolitiFact Says Obama's Lie About Lying is a Lie

Monday evening, President Obama gave a speech to campaign organization, Organizing for Action. During his speech, he suggested the media had misreporting the "you can keep your insurance, period" pledge he had made. Two days later, PolitiFact reviewed the President's statement, giving it their worst possible "pants on fire" rating.

Doodles writes:

One of the reasons Florida opted out of establishing their own exchanges using the federal funds is the fact that the federal funds are NOT guaranteed to the states after the first several years (I am not certain on the timeframe but somewhere in this ball park of 2-4 years?). In several years the States that opted into the program will be on their own to come up with the funding to continue managing these exchanges.

The reason there are price differentials in the premiums in various states and localities are due to the costs of care differing geographically and based on administrative costs of the insurance carrier.

Just like a car - the premiums change based on the zip code.

1Paradiselost I wish you luck in finding a policy that fits your needs. Be very careful and make sure you note the out of area benefits that the coverages provide since you travel to a second residence.

Captian_Cataracts writes:

WoW! What a load of garbage.

no one is going to go without insurance. The web site isn't fast but it does work if you'll just stop clicking buttons randomly when it's slow.

Does anyone really think that between now & Dec 15th they won't be able to logon & fill in a couple of forms? If so, you don't deserve insurance.

how about stopping the complaining about 'Obama Care' & consider the benefits to US all.

I'd rather spend my tax dollars on healthcare insurance then on more B-1 bombers & WMD.

August8 writes:

in response to Captian_Cataracts:

WoW! What a load of garbage.

no one is going to go without insurance. The web site isn't fast but it does work if you'll just stop clicking buttons randomly when it's slow.

Does anyone really think that between now & Dec 15th they won't be able to logon & fill in a couple of forms? If so, you don't deserve insurance.

how about stopping the complaining about 'Obama Care' & consider the benefits to US all.

I'd rather spend my tax dollars on healthcare insurance then on more B-1 bombers & WMD.

What part of New York City did you live in ?

Konfuzius writes:

in response to 1Paradiselost:

Florida does not have a "state online health care marketplace"

Governor Scott & the state legislature decided Florida would not open a state marketplace even thought it was funded by the federal government.

Twenty-three percent of Floridians have no health coverage at all.

Florida is one of 27 states refusing to set up their own health insurance marketplace.

Gov. Rick Scott, has asked the Legislature to take the federal funding to expand Medicaid, but lawmakers have declined to follow his lead. Some state lawmakers have said they will try again in the 2014 legislative session.

I have a summer property up north. When I returned, I was informed by my current insurance carrier my policy would be cancelled by years end.

Obamacare being the law, I called the number for the federal exchange. As a Florida resident my monthly bill went from $263.00 per month to $328.00.

Instead of getting angry, I wondered how much insurance would cost where my summer house was located. It's in a state where they set up their own exchange, so I made the call.

I was told my premiums would be $84.90 a month for the same coverage I was quoted in Florida....

Question.. Are all Floridians over paying for insurance due to the governor and the state legislature in Florida?

This is just my experience now that I'm required by law to purchase insurance thru the federal exchange.

Has governor Scott kept competition out of our state?

Has anyone else experienced the same results as I did?

"Everyone, as a member of society, has the right to social security and is entitled to realization, through national action and international cooperation, taking into account the organization and resources of each State, of the for his dignity and the free development of his personality essential economic, social and cultural rights."

(Article 22 of the Universal Declaration of Human Rights, 1948)

The German social system has the current conditions in the change of time successfully adapted - in terms of the European Union. The German social insurance system as a core element of social security system is based on principles underlying the general need for social security the necessary framework conditions. One of the most important principles is the principle of solidarity: the risks to be insured are in principle taken jointly by all insured persons.

Sometimes it is better to do bench marketing even in political sector. The present American Social Security System stinks. You can not expect that a century reform works overnight. But 80 000 000 uninsured Americans are 80 000 000 uninsured Americans to much. Paradise your example shows, that the American federal system is not en vogue anymore. Time over. I guess great President Barack Obama will be historically the first President of America who started the change. For a better America.
Be a modern American and go ahead. Maybe you are part of the begin of another American revolution.
Understand your patriotic responsibility.

August8 writes:

in response to Konfuzius:

"Everyone, as a member of society, has the right to social security and is entitled to realization, through national action and international cooperation, taking into account the organization and resources of each State, of the for his dignity and the free development of his personality essential economic, social and cultural rights."

(Article 22 of the Universal Declaration of Human Rights, 1948)

The German social system has the current conditions in the change of time successfully adapted - in terms of the European Union. The German social insurance system as a core element of social security system is based on principles underlying the general need for social security the necessary framework conditions. One of the most important principles is the principle of solidarity: the risks to be insured are in principle taken jointly by all insured persons.

Sometimes it is better to do bench marketing even in political sector. The present American Social Security System stinks. You can not expect that a century reform works overnight. But 80 000 000 uninsured Americans are 80 000 000 uninsured Americans to much. Paradise your example shows, that the American federal system is not en vogue anymore. Time over. I guess great President Barack Obama will be historically the first President of America who started the change. For a better America.
Be a modern American and go ahead. Maybe you are part of the begin of another American revolution.
Understand your patriotic responsibility.

If you want to write a book why don't you contact a publishing company I believe they are always looking for excellent fiction junk ?

Konfuzius writes:

in response to August8:

If you want to write a book why don't you contact a publishing company I believe they are always looking for excellent fiction junk ?

A difficult to comprehend kit is for you already an intellectual excellence.

August8 writes:

in response to Konfuzius:

A difficult to comprehend kit is for you already an intellectual excellence.

Perhaps, but should you be sober to participate ??

Fustrated_Consumer writes:

in response to Captian_Cataracts:

WoW! What a load of garbage.

no one is going to go without insurance. The web site isn't fast but it does work if you'll just stop clicking buttons randomly when it's slow.

Does anyone really think that between now & Dec 15th they won't be able to logon & fill in a couple of forms? If so, you don't deserve insurance.

how about stopping the complaining about 'Obama Care' & consider the benefits to US all.

I'd rather spend my tax dollars on healthcare insurance then on more B-1 bombers & WMD.

This comment was garbage! I am all for a working health care plan. The issue here is that we are being held hostage by our insurance companies who know the site is not working. We have individual healthcare and live in FL and we just received our letter from CIGNA informing us that our rate will go up a couple of hundreds of dollars if we do not choose to move to the market place. Yesterday I started and made it though the questions and got to the end electronically signed it and got a error that they were having problems check back in 24 hours. So I did just that, it did not save any of my information (which was about 30 minutes of input and I am not ignorant when it comes to the computer) and then errored out again. So I called the phone number and then it errored out on there computer. Then she said sorry try again online in 30 minutes and once again it did not save any of my and my families information. I do not want my children to go without insurance but will have to find an alternative because I cannot pay what CIGNA wants us to in order to keep there plan. SO your comment was on November 8, I have had no success on the 11th and 12th of November. I do really think that we will continue to have a hard time logging on until the 15th of December and I and my family do deserve insurance. I get your agenda you just approached it wrong. I am all for a working system and this is not that and is now and issue with my families finances and health concerns.

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