I have purposely avoided this topic for as long as possibly (publicly) but there's no more hiding.
I speak openly and often about random things with my rheumatologist. Lately it has been the ACA. He tells me that his office and many others will no longer be taking Medicaid & Medicare patients. The Government is facing a 24% cut on the program(s). It's quite a shame that good doctors can't take more state patients due to Government cut-backs. I understand that doctors do need to pay their bills too.
Being an active Lupus Advocate I'm extremely concerned about my members of my support group. We have openly spoke about how the ACA/Health Care Reform will and has affected our members.
Many insurance plans, including Medicare Part D plans, place certain medications on a specialty tier, requiring patients to pay a percentage of the cost of the drug, which can be as high as 25-33%, as opposed to a fixed co-payment, resulting in high out-of-pocket costs. Specialty tiers were designed to control Medicare and commercial drug plan spending on prescription medications. However, these cost controls come with a high price tag for very sick patients; which includes lupus.
Many patients already can't afford to pay for their prescriptions so they are going without their important medication risking getting more sick due to the cost. Some of the insurance companies pulled dental and vision. Those 2 are crucial options when you have lupus because the drug Plaquenil can affect the retina of the eye and you need to have your eyes checked every 6 months. Lupus medication can affect your teeth and even making them so fragile that they break. When you don't have a dental or eye plan you do without due to the high costs then your quality of life declines.
One of my members mentioned that her spouses insurance pulled the pre-exisitng condition clause by making health care prohibitively expensive to make up for being forced to insure us. The ACA has amounted to enforced welfare for the insurance companies and works to their advantage and not to the consumers. America desperately needs health care reform but the ACA has fallen tragically short of the mark.
With 1.5 million Lupus patients just in the US and who knows how many other chronically ill individuals that will require constant health care? Capitol Hill, Congress, the Senate, and President Obama need to get aligned and think, "If these chronically ill people were my dads, brothers, mothers, sisters; is this the health insurance I would want them to have?"
I speak openly and often about random things with my rheumatologist. Lately it has been the ACA. He tells me that his office and many others will no longer be taking Medicaid & Medicare patients. The Government is facing a 24% cut on the program(s). It's quite a shame that good doctors can't take more state patients due to Government cut-backs. I understand that doctors do need to pay their bills too.
Being an active Lupus Advocate I'm extremely concerned about my members of my support group. We have openly spoke about how the ACA/Health Care Reform will and has affected our members.
Many insurance plans, including Medicare Part D plans, place certain medications on a specialty tier, requiring patients to pay a percentage of the cost of the drug, which can be as high as 25-33%, as opposed to a fixed co-payment, resulting in high out-of-pocket costs. Specialty tiers were designed to control Medicare and commercial drug plan spending on prescription medications. However, these cost controls come with a high price tag for very sick patients; which includes lupus.
Many patients already can't afford to pay for their prescriptions so they are going without their important medication risking getting more sick due to the cost. Some of the insurance companies pulled dental and vision. Those 2 are crucial options when you have lupus because the drug Plaquenil can affect the retina of the eye and you need to have your eyes checked every 6 months. Lupus medication can affect your teeth and even making them so fragile that they break. When you don't have a dental or eye plan you do without due to the high costs then your quality of life declines.
One of my members mentioned that her spouses insurance pulled the pre-exisitng condition clause by making health care prohibitively expensive to make up for being forced to insure us. The ACA has amounted to enforced welfare for the insurance companies and works to their advantage and not to the consumers. America desperately needs health care reform but the ACA has fallen tragically short of the mark.
With 1.5 million Lupus patients just in the US and who knows how many other chronically ill individuals that will require constant health care? Capitol Hill, Congress, the Senate, and President Obama need to get aligned and think, "If these chronically ill people were my dads, brothers, mothers, sisters; is this the health insurance I would want them to have?"
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