When the last resort isn’t available.

As much outrage as there is about rescissions, there’s a larger-scale problem of people being denied for pre-existing conditions. David Lazarus at the Los Angeles Times has a heartbreaking story of one such couple.

The state’s safety-net program for those denied for private coverage due to their health status is full. It has a waiting list of hundreds of people, despite never advertising. And as Lazarus says:

But it’s not easy to get into. It’s not comprehensive. And it’s not cheap.

He goes even further:

It currently takes as long as four months to be enrolled in MRMIP. And even then, you have to wait three months more for coverage of prescription drugs to kick in.

To accommodate more people, the state created a companion system, the Guaranteed Issue Pilot Program, which now provides coverage to about 6,000 people. But that program was closed to new enrollment after participating insurers balked at some of the state’s terms.

Under MRMIP, California taxpayers pay 40% of the premiums to enroll people in individual plans offered by Kaiser Permanente, Blue Shield and Anthem Blue Cross. Those premiums can run as much as 37% higher than market rates for similar individual policies because of the enrollees’ medical history.

And the $75,000 cap on annual coverage is among the lowest such limits among similar state programs nationwide.

The story does not mention that MRMIP is one of the many programs where the tobacco tax funds dedicated to the program is being diverted becomes of the budget cuts, so that waiting list will only expand–and some may need to be kicked off the program in the first pace.

The article talks about how federal health reform can help: preventing insurers from denying coverage due to “pre-existing conditions” in the first place, and creating a public health insurance option that would be a real option for patients.

At the state level, there’s a pending reform bill, SB 227, sponsored by Senator Elaine Alquist, chair of the Senate Health Committee, to provide some reforms of the MRMIP high risk pool, to opne it up to more people and remove that annual cap. But even that bill won’t be able to meet the real need that is out there. The conservative estimate is that over 400,000 are denied coverage due to their health status.

Just another reason for urgency on federal health reform…

Health Access California promotes quality, affordable health care for all Californians.
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