There has been much opinion vomited back on various
“news” programs about what the INSURANCE reform bill really means to us.
Misinformation has run rampant–from those who say that
65-year-olds will be given “death pills” so they will no longer burden the system
to how it will completely drive small businesses out of business with “forced”
Smarter people than I have really looked into what this bill
represents, and here’s what it comes down to:
1. It eliminates exclusion of pre-existing conditions such
In 6 months, the nearly 300,000 children living with
arthritis will no longer be denied coverage due to a pre-existing
condition. By January 1, 2014 this
law will take effect for the 46 million adults with arthritis as well. I wish
it were sooner, but at least it’s there.
2. It eliminates
restrictive annual and lifetime limits on coverage.
Because of the high cost of biologics, this provision is
good news for those with inflammatory forms of arthritis who quickly meet
annual maximums. Starting in 2014, the law will prohibit insurance companies
from placing annual limits – or caps – on coverage. Until then, the Secretary
of the Department of Health and Human Services will determine annual limits
starting late September 2010.
3. It allows adult children to stay on
their parents’ health insurance policies up to the age of 26.
This provision, which will take effect in less than six months, will allow adult
children to stay on their parents’ plans longer than most plans currently
allow. If you are a young adult trying to get your life going, finish college, find a job, this is crucial to ensure that you get to maintain your health and medical care until you are thoroughly “launched” in your life.
4. It bans insurance companies from
dropping people from coverage when they get sick.
This provision, which takes effect in six months, will
provide peace of mind to people with arthritis to know that they are not at
risk of losing their health insurance. When I lost my health insurance when I got laid off, private insurance companies REFUSED to insure my son though it was “illegal” to deny him coverage.
5. It improves access
to pediatric rheumatologists.
Through advocating for the Arthritis Prevention, Control and
Cure Act, the Arthritis Foundation has been seeking a solution to the shortage
of pediatric rheumatologists. As part of health care reform, a new pediatric
loan repayment program for pediatric sub-specialists was included to encourage
doctors to enter into fields such as pediatric rheumatology.
6. It closes the gap
in prescription drug benefits for Medicare Part D.
Currently, people on Medicare are responsible for 100% of
their prescription drug costs of up to $1,720 once their out-of-pocket expenses
on copays reach $2,830. This
$1,720 expenditure is called the “doughnut hole”. Effective this
year, the Medicare Part D drug program will provide a $250 rebate to Medicare
beneficiaries who hit the doughnut hole. Next year there will be a 50% discount
on brand name drugs for those who reach the doughnut hole. By 2020,
beneficiaries will receive discounts of 75% on brand name and generic
How can any reasonable person take issue with this? There
are more than 46 MILLION people in this country who suffer daily from the
ravages of arthritis.
More than 300,000 of them are children–that’s more
children than suffer from cystic fibrosis, muscular dystrophy and juvenile
There are 100 diseases in the arthritis family of diseases,
including lupus, scleroderma, pulmonary fibrosis, osteoarthritis, rheumatoid
arthritis, and so many more. One in
three people have some form of arthritis. The majority of the people
suffering from the disease do not have access to adequate care or medications
to treat their disease.
How can we as Americans look 1 in 3 of our friends and
family in the face and say that we don’t care that they live in pain every day
and that they don’t deserve quality care? How can we tell a child crying in the
middle of the night that he doesn’t deserve access to the medications that can
reduce his pain, prevent joint deformity and affect his growth and development
for the rest of his life? How can we tell a 30-year-old new mom that we don’t
care if her rheumatoid arthritis is so painful most days that she can’t even hold
her newborn? How can we tell a 16-year-old budding actor plagued with
juvenile arthritis since the age of 6 that her disease is so unsexy that even
the celebrities and athletes who have it won’t admit it (until they are forced to retire) because they would rather live in
silent pain than lose their 15 minutes of fame because all we care about in
this country is celebrity and titillating gossip?
This so-called “debate” is about so much more than insurance
reform. It’s about something so dark and twisty in this country that most
people don’t want to admit it: We just don’t give a damn about what’s really
important any more. We’d rather make sure that the rich can just keep on getting richer.
How’s that working out for ya?
The bill that was passed is not perfect by any means, but until the other side starts making some cogent arguments and begins to contribute to the process in a constructive way, this is what we’ve got.