Healthcare Reform: For Her, a Long-Awaited Lifeline

After struggling for years, a sickle cell anemia sufferer may finally get coverage


About 90 days after the president signs the health care bill, Jon’ette and other Americans with pre-existing conditions will be able to purchase coverage in a newly established high-risk insurance pool. It’s expected that the pool will be created by the end of August 2010. Anyone with a pre-existing condition who has not had health coverage for six months, like Jon’ette, would be able to purchase coverage regardless of their medical history. Insurance in the high-risk pool will be subsidized on a sliding scale based on income, with maximum out-of-pocket costs set at $5,950 for an individual and $11,900 for a family.

The high-risk pool would remain in effect until 2014, when the healthcare exchange should up and running. At that time, the high-risk pool will be shut down and Jon’ette will have her choice of healthcare plans, as insurers will be barred from denying coverage based on pre-existing conditions. She won’t have to worry about maxing out her benefits either, as lifetime coverage limits will be banned. Based on her age and income of $40,000 per year, Jon’ette’s premiums would be capped at 9.8 percent of her earnings: $2,917 per year or $243 per month, according to the Kaiser Family Foundation Health Reform Subsidy Calculator. She would still have some out-of-pocket costs for co-pays and deductibles, but nothing near the $12,000 she can now pay per year for her health care needs.

 

Plus:

Jenna Smith and her husband lost their farm and spent more than $100,000 covering healthcare expenses related to her Lyme disease. 

 

His cancer bills nearly cost them their home; the new legislation will provide relief, but they’ll have to wait four years to get most of it.

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