The following story is true. It was told to me by a Florida woman who wishes to remain anonymous.
“I knew I was going to watch my son die. I didn’t know I was going to have to pay to see him suffer while he did it!
My son has cystic fibrosis. He is 22 years old. With good medical care he can live a relatively normal life until he’s about 25.
When he became an adult, since he was uninsurable, the State of Florida had a health plan which covered him. Under the state’s program, health insurance companies doing business in Florida must offer plans, at a reduced cost, to people who were unable to obtain insurance on their own. To be covered by this plan, each year, all we had to apply for insurance,get rejected, and then apply to the state’s program, which required a copy of the letter of rejection in order to insure us. Because of his illness, getting this letter each year was no problem.
The state plan is still expensive, about $500 per month. Its best feature is that it has a $10 co-pay. Since the monthly breathing treatments that keep my son alive and active are more than $2,000 per treatment, a $10 co-pay per month is a great deal.
Once the new healthcare law goes into effect, my son will no longer have this state option. Since insurance companies must offer him insurance, we will no longer be able to provide the letter of rejection required.
To prepare myself, I spoke to several insurance companies in our state. I wanted to get an idea of what my son’s insurance will cost. All of them said the same thing. There are no price controls limiting what they can charge to cover my son. The lowest price I heard for a policy was $1,300 per month. Worse, all plans offered were going to be 80-20 plans. This means that we would have to pay at least $400 for my son’s monthly breathing treatment instead of the $10 co-pay we pay now. And, of course, on top of that, I would also have to pay 20% of the bill for doctor visits, tests, medication, treatments, etc., for which I now pay this same $10 co-pay.
Even worse, since, under the new healthcare law, lifetime maximums are now eliminated, most plans also plan to eliminate the annual caps on the amount out of pocket expenses. Now, after we spend a certain amount in a given year, for us it is $5,000, the insurance picks up 100% of the rest of our son’s medical expenses. Every year, we hit this maximum.
I spoke to the people at the state’s Department of Health. I was told that they are planning to dismantle the state’s program. I won’t be able to get the policy my son has had since he was 18.
The cost of my son’s care will ruin us. We have two other children. I don’t know what to do.”
Since people will no longer be able to provide letters of rejection, states across the country are planning on dismantling their programs requiring insurance companies to offer lower cost programs to insure the uninsurable. Under the new law, insurers can charge any price they want for individual high risk plans. Let the buyer beware!