nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Monday, October 4, 2010

ObamaCare's Great Benefit For Uninsurables With Pre-Existing Illness...Except Few Of Them Want It

Great idea, incompetent execution.  It's too expensive, there's a waiting period, and it doesn't cover drugs.

This is not a poison pill, really.  The concept of offering health insurance to those people who can't get coverage because they have other medical problems is a worthy one.  But, unlike the insurance companies who say they can't offer it, the government offers it... but makes it unaffordable.

The Assoc Press (Oct 3) reports on how the program is faring across the country.  California has openings for 20,000 people but fewer than 500 have applied.  Texas has received 200 applications.

Government officials estimated that about 375,000 people would seek coverage this year. Not happening...

According to the report, the problems are these:
-Premiums may be out of reach. In many states, people in their 40s and 50s face monthly premiums ranging from $400 to $600 and higher. "I think there's some sticker shock going on," said Sabrina Corlette, a Georgetown University research professor. "People who may be eligible are finding out that even if they can get the insurance, the price is too high."Pennsylvania, which set a premium of $283 for all ages, has had no problem getting applicants.
-A barrier may include requirements that people be uninsured for at least six months and that people provide documentation that they've been turned down by an insurer. "There are many people who don't meet the criteria for the federal pool, particularly the six months without coverage," said Goldman.
-In states where the federal government runs the program directly, the insurance plan doesn't provide coverage for prescription drugs until people have met a $2,500 annual deductible. "Applying this high ... deductible to the pharmacy benefit is a real barrier to consumer access to medications," Steven Browning, a Texas official, wrote HHS last week.
Government officials are now saying "it's going to take time" for people to avail themselves of this great program.  But you'd think if people were desperate for coverage due to illnesses, they would jump at it.

It's tempting to call this great benefit a pig-in-a-poke, but time will tell.

Doc D


WarmSocks said...

So, the government is telling people, in effect, to let their COBRA coverage lapse and pay their medical bills out of pocket for six months so that they'll qualify for the government plan. In those six months, my out of pocket costs for drugs, lab tests, and doctor's visits would be astronomical.

When you're not insurable on the individual plans due to the expensive medications you take, the government's $2500 drug deductible is met in one month.

Thankfully I have insurance and pay only $70-80 per month for my prescriptions. If I didn't, my last trip to the pharmacy would have cost $2542.42. Add another $180 every six weeks for labs, $250 every 2-3 months to one doctor, and $100 every six months to another. Getting sick is expensive!

Doc D said...

Will your plan meet federal standards, such that it will be allowed to continue? I just don't know how to answer yet. HCR puts tremendous power in HHS hands to define the rules. They have already missed deadlines to implement regulations on elements of the law that were front-loaded and in force already.

I have a good plan, administered by DoD, but expect higher enrollment fees, co-pays, and deductibles as the cost comes due for all the benefit authorized in the law.

Good to hear from you.

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