Health Reform Leaves Disabled Disappointed in 2010

Don’t look now, but because of budget constraints, health reform may not have enough budget to support aid for disabled workers.

Unable to afford medical insurance and disabled by chronic back pain, Lea Walker hoped health care reform would close a 2-year coverage gap that has left her and millions of other workers to fend for themselves.

Bad news. It won’t.

What’s Wrong?

Although improvements will be made, legislation that’s moving to final passage in Congress isn’t cut and dried on disabled coverage and some of the neediest could find themselves still in limbo.

For Walker, in 2007, the government declared Walker, a home health nurse, too sick to work. She started receiving monthly disability checks from Social Security, but found she would face a long arduous 24-month wait for Medicare. Insurance from her husband was astronomical at $800.

An estimated 1.8 million disabled workers wallow in the Medicare coverage gap, a cost measure instituted around 40 years ago. Many became uninsured. Lawmakers had wanted to close the gap as part of health care reform, but concluded it would be too costly.

“I’m very disappointed,” said Walker, 61, who has difficulty even walking to her front door.

Although her own wait will be over in April 2010, she’s been unable to pursue surgery that could help her, and had to rely on a sympathetic doctor for free medication samples.

Budget Constraints

This failure to rescind the Medicare waiting period shows the difficulties faced by Democratic lawmakers to keep the costs of the legislation from exploding. If the bill passes Congress and is signed by Obama, an estimated 18 million eligible Americans would still remain uninsured, many still unable to afford coverage, even when it’s fully in place in 2019.

“I think everyone needs to realize this is going to be a first, very major step toward health care reform and then there will be a need to come back in the next several years and make midcourse adjustments,” said Sen. Jeff Bingaman, D-N.M., who pushed unsuccessfully to phase out the waiting period.

“I think what we are hopefully going to be able to do with this bill is fix an awful lot of the problem,” Bingaman added.

Legislation would provide two alternatives to tide over disabled workers in the Medicare waiting period. But it’s not clear how well that would work.

Stopgap Measures

Starting 2010, people who can’t get affordable private insurance because of medical problems could buy a policy through a new high-risk insurance pool.

But there’s a catch. The Senate bill would require patients to be uninsured for six months. The House bill would allow people to be covered immediately in cases of medical necessity. Right now lawmakers will have to work out the difference.

By 2014 at most, disabled workers would be able to buy coverage in new health insurance markets called exchanges. Open to individuals and small businesses, the markets would take over the role of the high-risk pools.

New consumer protections would take effect, prohibiting insurers from turning down people with health problems, or charging them higher premiums. Government subsidies would start to flow to consumers in the exchanges. Medicaid would be expanded to pick up adults near the poverty line.

Yet potential problems already have appeared.

Drying Up

The $5 billion that the Obama administration and Congress earmarked to finance the insurance pool may fall short of the need, according to a report by economic analysts at Medicare. They project the funding would run out in 2011 or 2012, and this will affect an estimated 375,000 frail individuals.

It’s not yet clear how comprehensive the coverage would be once the bill is fully phased in.

“If you look at the bill in terms of perfection, there are many shortcomings,” said Stephen Finan, policy director for the American Cancer Society Cancer Action Network. “But if you look at it relative to the status quo, it represents a very significant improvement for people with serious medical conditions.”

Walker, the North Carolina nurse, doesn’t see it that way. Workers pay Medicare taxes throughout their careers, and should be able to get coverage if they become disabled.

“It’s atrocious that in America we would have people with medical problems bad enough that they can’t work, and they’re not be able to afford to seek medical help,” she said. “I just can’t believe they didn’t cut out the two-year wait.”

Why Not Take Matters Into Your Own Hands?

I’ve recently started writing about Robert Kiyosaki, a millionaire investor and writer of the famous book, “Rich Dad Poor Dad”. If you haven’t read his book, you should. Just because it can help you think out of the box, if anything.

Kiyosaki had always been saying that insurance isn’t a bad thing. It’s just that you shouldn’t be relying on anybody to keep you out of trouble, especially when it comes to your financial protection.

If you’re only relying on insurance, it could work but you’ll never be financially wealthy enough to not worry about whether you’d get support or not from your employer or the government.

He’d be telling to make your own money so you wouldn’t have to worry about money anymore. He (and I would too) would tell you to cut expenses down to the essentials, put aside some money for investments and keep yourself secure by using insurance such as health insurance for unforeseen circumstances.

If you take action, it will certainly be worth more than waiting for someone to save you.

In my opinion, you shouldn’t wait for the government to save you. Go take matters into your own hands.

More Power To Us,

Erwin Chua

Consumer Advocate

Life Insurance Quotes For Consumers

“Insurance is Personal.”

Source: Lexis Nexis

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