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So Obama was gonna save us all?

Help for 'uninsurables' mired in political battle


WASHINGTON (AP) — Republicans are offering to bail out a financially strapped program in the federal health overhaul, one that's a lifeline for uninsured people with medical problems. Truce in the health care wars? Not!

The GOP bill, headed for a vote Wednesday in the House, would divert billions from another program under President Barack Obama's signature law, a transfer Democrats say would undermine broader goals. The White House is threatening a veto of the measure.

Caught in the middle are the so-called uninsurables, people like Susan Zurface, a small-town lawyer from Ohio with a recent diagnosis of leukemia, no health insurance and medical bills piling up. The Pre-Existing Condition Insurance Plan was designed to offer them a path to private coverage.

"For people like me who can't afford the insurance, it doesn't matter where the Republicans want the money to come from or where the Democrats want the money to come from — it has to come from somewhere," said Zurface, who lives in the rural southwestern Ohio community of Hillsboro. She has a slow-growing form of the blood cancer and wants to start tackling it now when she is in her 40s and otherwise in good health.

"I'm starting to feel that sense of panic because I have no idea where the money is going to come from to pay for this," added Zurface, a solo practitioner who focuses on representing children caught in family breakups.

Obama's Affordable Care Act was supposed to banish such fears forever by requiring health insurance companies to cover people with pre-existing medical problems. But those consumer protections don't take effect until Jan. 1, along with a mandate that virtually every American must get coverage, expanding the insurance pool to try to keep costs in check.

Until then, the pre-existing conditions plan — known as PCIP — was supposed to help. It guarantees private coverage at average rates to people who had problems getting insurance because of a medical condition and were uninsured for at least six months. It would disappear in 2014.

But Congress allocated a limited amount of money. And in February, the Obama administration said it would stop taking new applications to ensure enough money would be left to cover more than 100,000 people already enrolled.

Zurface said her completed application was sitting on a table at home, ready to go out, when she got the news. She had no inkling the program was in financial trouble.

PCIP patients have turned out to be sicker and costlier than anticipated. But in his budget, Obama did not ask Congress for emergency funding to keep the program going.

House Republicans say they want to help Zurface and others like her by providing up to $3.6 billion to not only keep the doors open for new patients, but also expand it by eliminating the requirement that applicants be uninsured for six months before they qualify. Meant to deter people from dropping private coverage to take advantage of a government-sponsored plan, that particular feature has been criticized as a stumbling block for patients.

The money would come from another program in the health care law, the Prevention and Public Health Fund, which is supposed to be used for public health activities. In the GOP bill, called the Helping Sick Americans Now Act, all unallocated money from the prevention fund for 2013-2016 would be diverted.

That's no mere bookkeeping transfer because the Obama administration plans to use at least $300 million from the prevention fund to publicize the new health insurance markets coming this fall under the health care law.

Health and Human Services Secretary Kathleen Sebelius said she has had to resort to using the prevention fund because congressional Republicans have refused to provide the administration with the financing needed to put the health law into place. Sebelius says prevention money can legally be used for educational and community outreach purposes.

People who don't already get coverage on the job will be able to buy private insurance with new tax credits to help pay premiums. Nearly 30 million uninsured Americans are eventually expected to gain coverage through the broader law.

"The prevention fund is essentially a slush fund for Secretary Sebelius," said Rep. Michael Burgess, R-Texas. "How about using some of the money to take care of people outside your door?"

Burgess said the PCIP program is an "Obamacare" poster child: "big promises to people, and at the end of the day it's not delivering."


(Copyright 2013 Associated Press. All Rights Reserved.)

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Asked by Ballad at 1:56 AM on Jun. 1, 2013 in Politics & Current Events

Level 45 (193,996 Credits)
This question is closed.
Answers (5)
  • That makes her in an even worse position because she probably won't qualify for subsidies when the health care law kicks in Jan 1.

    She's not as screwed as the low income people, though. There are 2 lines. Everyone above the top does not get subsidized because they make too much. Everyone below the bottom does not get subsidized because they government is forcing them on Medicaid and refusing to give them a choice unless they pay entirely out of pocket. Except...a bunch of states are passing legislation to cut their medicaid programs so that there will be no room for these people and no coverage available to them. All well and good - let them fight it out, except as of Jan 1, the low income people in those states will still be required to have insurance or they're liable for tax evasion, regardless of how hard their state of residence digs in its heels.

    Answer by NotPanicking at 11:56 AM on Jun. 1, 2013

  • Another fallacy is the "average rate" because while insurance rates were steadily climbing prior to the law being passed, the rates have jumped even more after in anticipation of what's to come. Even if the woman in the article were able to secure a PCIP it would likely not be affordable. Since she is a small tow lawyer, it sounds as though she makes a living but isn't rolling in the dough. That makes her in an even worse position because she probably won't qualify for subsidies when the health care law kicks in Jan 1. Every Dr. I have asked about this law hates it. They say it will result in higher prices for the consumer and result in less care. IMO, the law was never about helping anyone with their health, it was about controlling a huge percentage of our economy.

    Answer by QuinnMae at 10:09 AM on Jun. 1, 2013

  • At least they removed the language of jail time for not having a policy

    But it's going to be trillions of dollars in fines racked up just in the first few years. And the IRS isn't generally nice about them, they compound the interest on them like a payday loan office.

    Answer by NotPanicking at 1:50 PM on Jun. 1, 2013

  • The bullshit is that he shouldn't have had to ask for emergency funding in the first place.

    Answer by Ginger0104 at 3:14 AM on Jun. 1, 2013

  • True, I did not think about the states that didn't take the expansion. It will be equally bad for them. At least they removed the language of jail time for not having a policy. How long does the medicaid expansion money come from the federal government? Isn't the reason that many states did not take it is because once those federal subsidies for the states stop coming that the states will be responsible for continuing the coverage at their own cost which means a larger tax liability for their residents?

    Regardless, I've been against this bill since the beginning.  I have never questioned that we needed health insurance reform, the debate has always been in what capacity.


    Answer by QuinnMae at 1:19 PM on Jun. 1, 2013