Health
Sickest Patients Risk Losing Care Under New Health Law
By Gosia Wozniacka
The Associated Press
PORTLAND, Ore. (AP) — With federal
and state online health care marketplaces
experiencing glitches a month into imple-
mentation, concern is mounting for a
vulnerable group of people who were sup-
posed to be among the health law’s earliest
beneficiaries.
Hundreds of thousands of people across
the country with pre-existing chronic condi-
tions such as cancer, heart failure or kidney
disease who are covered through high risk-
insurance pools will see their coverage
dissolve by year’s end.
They are supposed to gain regular cover-
age under the Affordable Care Act, which
requires insurers to cover those with severe
medical problems. But many of them have
had trouble signing up for health insurance
through the exchanges and could find them-
selves without coverage in January if they
don’t meet a Dec. 15 deadline to enroll.
Administration officials say the federal
exchange, which covers more than half the
states, won’t be working probably until the
end of November, leaving people just two
weeks to sign up if they want coverage by
Jan. 1.
“These individuals can’t be without cov-
erage for even a month,’’ said Tanya Case,
the chairwoman of the National Association
of State Comprehensive Health Insurance
Plans, which represents the nation’s high-
risk pools. “It’s a matter of life or death.’’
High-risk pools were created by state leg-
islatures to provide a safety net for people
who have been denied or priced out of cov-
erage. The Affordable Care Act will forbid
insurers from turning away people in poor
health. And while coverage can be pur-
chased outside the exchanges, those
who qualify for subsidies can only get
them through a state or federal market-
place.
More than a dozen of the 35 states
that run insurance pools for people
with serious medical issues will per-
manently close their pools within a
month and half. Other states will keep
their pools running for a few more
months.
The federal pool covers about
100,000 people and was created in
2010 by the Affordable Care Act as a
temporary bridge until the law fully
kicks in. It will cease to exist at the end
of December.
“I’m scared. I’m in the middle of my
cancer treatment, and if my insurance ends,
I’m going to have to cancel the rest of my
treatment,’’ said Kelly Bachi, an Oklahoma
boat repair business owner who has breast
cancer and is covered through a pool.
Cancer treatment without insurance
would cost her about $500,000, she said.
Bachi has not been able to enroll via the
healthcare.gov federal website, although
not for lack of trying. She attempted to sign
up half a dozen times, was eventually able
to create an account, but was later blocked
from accessing the account.
Others _ including Jill Morin of Raleigh,
N.C., who has a severe heart condition and
is covered by her state’s pool _ have not
attempted to enroll.
“It’s the unknown, the uncertainty that
gets to me,’’ Morin, 42, said. “I don’t know
what my cost will be at the end of the day. I
don’t know if my two cardiologists and my
procedures are going to be covered under
the plan. There just isn’t enough informa-
tion on that website.’’
But, she said, she has no choice. She must
pick a plan soon because she can’t afford to
go without. She plans to go to an insurance
broker for advice, then contact the federal
call center to bypass the online marketplace
altogether.
State officials throughout the nation have
been scrambling to figure out how to help
people like Bachi and Morin.
Last week, the board of the Oregon Med-
ical Insurance Pool - which covers about
11,000 people - ordered the state to create a
contingency plan for its members because
the state’s online exchange still has not
enrolled a single person.
For now, the only way to enroll for cover-
age in Oregon is to fill out a 19-page paper
application. The state has so far received
just 7,300 such applications from all Orego-
nians, not just those in the pool, but it has
not yet processed any of them. The process
takes up to several weeks, so no one has
completed it and successfully enrolled,
Cover Oregon spokesman Michael Cox
The state’s online
exchange still has not
enrolled a single person.
For now, the only way to
enroll for coverage in
Oregon is to fill out a 19-
page paper application.
Page 6 The Portland Skanner November 13, 2013
said.
Oregon pool administrator Don Myron
said he hopes to speed up enrollment for its
members by mailing them a paper applica-
tion and following up to make sure they
filled it out.
In Indiana, the Department of Insurance
extended the high-risk pool coverage until
at least Jan. 31 because of difficulties with
the federal health insurance exchange. Its
pool covers about 6,800 people.
The move was crucial, officials said,
because people in the pool were not able to
schedule treatments without proof of health
coverage for the coming year. Indiana will
spend $6.3 million to extend the coverage.
In Wisconsin, the Health Insurance Risk-
Sharing Plan that covers 24,500 people is
rolling out an outreach effort to make sure
their members are signed up by the dead-
line, chief executive Amie Goldman said.
The state created a worksheet and directo-
ries of carriers to help people prepare for
enrollment, has sent postcard reminders and
is answering questions through its Face-
book page and weekly newsletters.
Many of those in high-risk pools across
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