Health Reform Leaves Disabled Disappointed in 2010
May 13th, 2011 Archie Mathys
Because of budget constraints, health reform may not have enough budget to support aid for disabled workers.
Unable to afford medical insurance and disabled by chronic back pain, Lea Walker hoped health care reform would close a 2-year coverage gap that has left her and millions of other workers to fend for themselves.
Bad news. It won't.
What's Wrong?
Although improvements will be made, legislation that's moving to final passage in Congress isn't cut and dried on disabled coverage and some of the neediest could find themselves still in limbo.
For Walker, in 2007, the government declared Walker, a home health nurse, too sick to work. She started receiving monthly disability checks from Social Security, but found she would face a long arduous 24-month wait for Medicare. Insurance from her husband was astronomical at $800.
An estimated 1.8 million disabled workers wallow in the Medicare coverage gap, a cost measure instituted around 40 years ago. Many became uninsured. Lawmakers had wanted to close the gap as part of health care reform, but concluded it would be too costly.
"I'm very disappointed," said Walker, 61, who has difficulty even walking to her front door.
Although her own wait will be over in April 2010, she's been unable to pursue surgery that could help her, and had to rely on a sympathetic doctor for free medication samples.
Budget Constraints
This failure to rescind the Medicare waiting period shows the difficulties faced by Democratic lawmakers to keep the costs of the legislation from exploding. If the bill passes Congress and is signed by Obama, an estimated 18 million eligible Americans would still remain uninsured, many still unable to afford coverage, even when it's fully in place in 2019.
"I think everyone needs to realize this is going to be a first, very major step toward health care reform and then there will be a need to come back in the next several years and make midcourse adjustments," said Sen. Jeff Bingaman, D-N.M., who pushed unsuccessfully to phase out the waiting period.
"I think what we are hopefully going to be able to do with this bill is fix an awful lot of the problem," Bingaman added.
Legislation would provide two alternatives to tide over disabled workers in the Medicare waiting period. But it's not clear how well that would work.
Stopgap Measures
Starting 2010, people who can't get affordable private insurance because of medical problems could buy a policy through a new high-risk insurance pool.
But there's a catch. The Senate bill would require patients to be uninsured for six months. The House bill would allow people to be covered immediately in cases of medical necessity. Right now lawmakers will have to work out the difference.
By 2014 at most, disabled workers would be able to buy coverage in new health insurance markets called exchanges. Open to individuals and small businesses, the markets would take over the role of the high-risk pools.
New consumer protections would take effect, prohibiting insurers from turning down people with health problems, or charging them higher premiums. Government subsidies would start to flow to consumers in the exchanges. Medicaid would be expanded to pick up adults near the poverty line.
Yet potential problems already have appeared.
Drying Up
The $5 billion that the Obama administration and Congress earmarked to finance the insurance pool may fall short of the need, according to a report by economic analysts at Medicare. They project the funding would run out in 2011 or 2012, and this will affect an estimated 375,000 frail individuals.
It's not yet clear how comprehensive the coverage would be once the bill is fully phased in.
"If you look at the bill in terms of perfection, there are many shortcomings," said Stephen Finan, policy director for the American Cancer Society Cancer Action Network. "But if you look at it relative to the status quo, it represents a very significant improvement for people with serious medical conditions."
Walker, the North Carolina nurse, doesn't see it that way. Workers pay Medicare taxes throughout their careers, and should be able to get coverage if they become disabled.
"It's atrocious that in America we would have people with medical problems bad enough that they can't work, and they're not be able to afford to seek medical help," she said. "I just can't believe they didn't cut out the two-year wait."
About the Author:
Archie Mathys is a research writer on current events affecting American life. From his home in Reston, he writes interesting but true slices of American life. Currently, he works on reading Kiyosaki, personal finance & the Wall St. news updates. He has a fascination for futurism and enjoys figuring out how things will work out in the future. Life Insurance Quotes Directory - The Life Insurance Quotes For Consumers Blog
Article Marketing3 people like this article
