The Sacramento Bee had front-page coverage, by reporter Bobby Caina Calvan, of a specific angle on health reform, and the need for coverage to have some cap on out-of-pocket expenses. Otherwise, the patient who has been paying premiums is still faced with unlimited financial risk and burden.
The major federal health reform bills, like H.R.3200, all require coverage to have a maximum out-of-pocket limit, up to $10,000. At the state level, Health Access California is sponsoring AB786(Jones), which would also require a cap, in addition to labelling insurance plans so people can better comparison shop.
Why is this necessary? Because there are some dubious plans being sold right now:
Burwell was weeding her backyard vineyard last summer when she was bit by a rattlesnake. She rushed to a Chico hospital for antivenin and morphine, which eased the pain during an overnight stay.
Then came the unexpected sting of a $73,000 hospital bill – and shock upon learning her health insurance would cover a mere $3,000.
“It was one of the longest, most stressful periods in my life,” said Burwell, a self-employed wine shop owner whose financial security was shattered by the snake bite.
“I’m probably a typical insurance purchaser,” said Burwell, who had to scramble to find a solution for the steep bill. “I believed what I was told by the person selling it to me….”
Burwell, 60, thought she was getting a deal four years ago when her COBRA coverage ran out and she found a low-cost, low-deductible plan. She bought a policy from a friend – an insurance broker who, she said, was looking out for her.
Burwell’s policy was underwritten by a Texas-based firm that initially charged her a $281 monthly premium. She had a $500 deductible and was promised $50,000 in hospital coverage. She didn’t realize the hospitalization coverage
was capped at $3,000 a day.
The story is worth the read. In addition to AB786(Jones), it’s good that the health reform bills in Congress answer the challenge of the article’s title, “Don’t forget us, underinsured say.”