The Sky Is Not Falling

Sunday, October 28, 2012
A Power of Attorney. The elderly couple wanted to give me a Power of Attorney. They were convinced that President Obama is going to win re-election and that their Medicare coverage is in jeopardy. What happens when(!) he changes Medicare and they don’t get into my office fast enough to be protected?

Can we give you a Power of Attorney to change our policies so that we have the right coverage?

It was Republican Week at my office. I can normally tell whether my clients are Democrats or Republicans just by the questions they ask. The talking heads on FOX create a climate of fear and misinformation on some parts of the Patient Protection and Affordable Care Act (PPACA). Rachel Maddow and Ed Schultz create a competing sense of dread and foreboding amongst their viewers.

I watch both channels so that I can anticipate my clients’ concerns.

My last post, Collateral Damage, noted the unintended consequences of a badly written piece of legislation. But, the PPACA has helped a lot of people. In the interest of fairness, we should spend a moment or two discussing a few of those victories. All of these examples are from last week. And all involved Republicans. Key details have been changed to protect the identities of all involved.

Bruce has been self-employed for over ten years. He was covered under his spouse’s health policy. When they divorced, he took full advantage of COBRA for the entire thirty-six months. The story then gets murky. Either a bad agent sold him a crappy policy or he cheaped out and purchased something that did not meet his needs. Either way, his health got worse, the mediocre policy didn’t pay for his care, and the premium became unaffordable. Bruce is now an unhealthy 56 year old with no insurance facing possible surgery.

Bruce will qualify for the Ohio High Risk Pool policy. The premium isn’t cheap, $428 per month. It would be far worse if there wasn’t premium support built into the legislation. The Ohio High Risk Pool is not for everyone. Not everyone qualifies. The rules are complicated. But the PPACA is a lifeline for Bruce and he wasn’t the only winner last week.

Jane is another Ohio High Risk Pool winner. She is 61. Jane was terminated by a major local employer last November. She could have been covered through COBRA if she could have afforded it. She couldn’t. She has a number of preexisting conditions that would result in an automatic decline if she applied for individual health insurance. Jane qualifies for the Ohio High Risk Pool policy and the $428 premium may be a challenge, but she has had a year without insurance. $428 is a gift.

The Ohio High Risk Pool plan is not placed through an agent’s office. I have nothing to do with it and I am not compensated for helping people access this insurance. Educating the uninsured is just part of doing the right thing.

Amanda has four sons, two in college, one in middle school, and her youngest is only 8. They are all healthy except for Billy, age 14. Billy is in remission, thank G-d, but he has had hundreds of thousands of dollars of medical care. He might not require additional expensive care. Who knows? I would have had a very hard time covering Billy three years ago. Today? No big deal. Amanda is healthy. The insurers will readily approve her. Billy and his brothers will go through underwriting to determine price, not insurability. The price will be a little higher, but the cost of insurance won’t even begin to reflect the potential cost of care.

The PPACA allows Amanda to purchase affordable health insurance for her entire family. To deny this is to deny reality.

I completely understood why the elderly couple was afraid. All day long they are bombarded with solicitations for different Medicare plans, pleas to support candidates who will fix Medicare, and television reports that the sky is falling. Whatever healthy skepticism they may have once had has been beaten down by the constant repetition of the same facts.

The elderly couple came to my office to be protected. What they need was to be reassured.  

DAVE  

www.bcandb.com