With the change in the White House, I thought this would be a good time to explain the concerns that those of us with pre-existing conditions have over the next four years.
The intent of this blog is not to create banter between the two parties, but rather explain the concerns that those of us with pre-existing conditions have with the potential dismantling of the Affordable Care Act.
I have a pre-existing condition which is defined as a health condition that cannot be controlled and is already known before the start of a new health insurance plan.
My condition, cystic fibrosis, is a genetic lung disease that also affects the digestive system, reproductive system, sinuses and several other organs and/or bodily functions.
According to the Department of Health and Human Services, 50 to 129 million (19 to 50 percent of) non-elderly Americans have some type of pre-existing health condition.
The ACA or Affordable Care Act or Obamacare as it was known because it took flight during President Barack Obama’s presidency in 2014, helped many of us with preexisting conditions. It prohibited private health insurers from discriminating against people with preexisting conditions. Insurance companies were forced to offer the same benefits, at the same rates, with no waiting periods or denials.
This took a lot of concern away from families like mine with pre-existing conditions. Instead of worrying how we would get insured, we could focus our concerns on fighting our diseases.
In the past, we were consumed with the notion that we could be dropped, something that actually happened to me during this time. If you’re wondering how expensive having cystic fibrosis is, the CFTR modulator that I take called Trikafta costs over $300,000 per year.
This is not a typo. This drug has changed my life. My lung function is up 15%, I am taking deep breaths for the first time and my exhausting coughing jags have nearly disappeared. Trikafta is just one prescribed medication. I take many others and they are not cheap either.
Prior to 2014, it was not uncommon for patients with pre-existing conditions to get dropped by insurance companies because of how expensive their medications and procedures were.
Back then, Insurance companies in most states could lower their cost through pre-existing condition exclusions which means someone like me would be left in the dark. Per the Century Foundation, a nonpartisan organization in New York City and Washington, D.C., prior to the ACA, “Thirty-five states ran high-risk pools for individuals affected by these practices. Virtually all of these high-risk pools had strict eligibility limits, high premiums, and limits on coverage. An estimated 226,615 people were covered in them.”
Vice President-Elect J.D. Vance stated on “Meet the Press” back in October that the best method to cover people is to “not have a one-size-fits-all approach that puts a lot of people into the same insurance pools, into the same risk pools.” Vance also stated, “You want to make sure that people have access to the doctors that they need, and you also want to implement some deregulatory agenda so that people can choose a health care plan that fits them.” In other words, a young, “healthy” person would have access to cheaper insurance while someone like me who is high risk would be stuck paying higher premiums with insurance companies due to the exorbitant cost of our meds. Most everyone with a chronic disease cannot afford to be in that predicament. If this approach seems familiar, it was the formula used prior to the ACA going into law in 2014.
My cystic fibrosis/chronic disease friends and their families deserve the same coverage at the same prices as everyone else. We didn’t purposely get the diseases that we have. Hopefully, President-Elect Trump and Vice President-Elect Vance will see this and continue with the ACA the way it is or make moderate changes that do not affect those with pre-existing conditions. Otherwise, a lot of people are going to get sicker, and they will have difficulty affording the care that they need and deserve.
It is critical to our safety that we do not have to waste our energy on trying to secure a company that is willing to insure us at an affordable rate and save that energy instead to focus on fighting our pre-existing conditions.
Best Wishes,
Andy Lipman
#cfwarriorproject
#AffordableCareAct
#preexistingconditions