Now that the most controversial health care legislation in the history of this country has been instituted as the law of the land, let us take a look and see how it is functioning, and if everyone who is a patient is really being protected.
In a very insightful article written by Kelli Kennedy, of The Associated Press, an alarming incident has been uncovered concerning the issue of unjust treatment of patients who were subscribers to a plan offered by the Florida Insurance Exchange. Apparently four health insurance companies in Florida have engineered their premium rating system to drastically overprice coverage for individuals with AIDS and HIV.
The plan was to force the individuals with AIDS and HIV to pay as much as 40% more for their prescribed drugs, and not be eligible to receive the benefits from the flat co-payment pharmacy purchases, which for certain other customers is as low as $10 per purchase. The health insurance provider in Florida, known as Coventry One, is mandating certain customers pay a 40% co-insurance fee for all HIV related drug purchases, which is after the application of the policy’s $1,000 deductible.
Humana, Coventry One and Cigna, three of the four carriers in Florida involved in this situation, issued separate news releases stating their health plans follow the latest Health and Human Services laws, and cover all the necessary drugs needed for HIV treatment. The fourth carrier Preferred Medical did not issue a statement.
The only resolution to this problem stated was the following, “Health advocates are quick to point out that before the Affordable Care Act, many of their patients struggled to have health insurance at all. The law forbids insurers from discriminating against those with pre-existing conditions.”
The Affordable Care Act, (ACA) mandates that an individual policy holder cannot be charged more than $6,350 in expenses per year and a family cannot be held responsible for more than $12,700 per year. But with a serious illness those funds could be paid prior to the insurance funds kicking in.
Humana recently announced, “It expects government payments this year of $575 million to $775 million in 2014 to offset its outsized risk on the new clients who signed up under President Barack Obama's healthcare law. Many of them were previously uninsured. Humana is seeking to raise Obamacare premium rates by single to double-digit percentages for 2015, in part to offset declining risk payments next year. Humana is ‘just beginning’ to work with state and federal regulators on how the individual exchange business will transition off these payments, which mostly end after 2016.”So we have increased premiums, expensive pharmacy rates with the prospect of even higher rates in the future. Sounds like the same old song to me--- quite a legacy Mr. President.