One of the major benefits of the Affordable Care Act is that insurance companies cannot deny coverage to people with pre-existing conditions. However, The Washington Post is reporting that insurance companies have found a way to discourage people with expensive pre-existing conditions from signing up for their policies.
Some plans sold on the online insurance exchanges, for instance, don’t cover key medications for HIV, or they require patients to pay as much as 50 percent of the cost per prescription in co-insurance — sometimes more than $1,000 a month.http://www.washingtonpost.com/....
“The fear is that they are putting discriminatory plan designs into place to try to deter certain people from enrolling by not covering the medications they need, or putting policies in place that make them jump through hoops to get care,” said John Peller, vice president of policy for the AIDS Foundation of Chicago.
It is very important that people with expensive chronic conditions, such as AIDS and MS, be able to obtain affordable coverage under the Act that covers their medications. Otherwise, people with these conditions will face the same sort of problems that they face under the pre-ACA system--not being able to obtain the treatment that they need for their medical conditions. That is because the cost of some of these medications are prohibitive for the average American unless these drugs are covered by insurance.
Paul Prince, 52, a former information technology manager from Houston, said he was surprised that some of the health plans in the new federal marketplace wouldn’t pay for one or more of his HIV medications. The policy that seemed to provide the best coverage, he said, would cover only about two-thirds of his monthly $2,400 drug tab, leaving him responsible for $840.http://www.washingtonpost.com/....
“There was no way I could pay that,” said Prince, who is studying to become a teacher after being laid off from his previous job and losing his insurance.
This is a serious problem with the ACA, something which needs to be fixed urgently, as the medications taken by people with chronic conditions allow them to function with a decent quality of life that would be absent without the medications (and in some cases the medications are needed to keep people alive).
I see several possible solutions for the problem. The government could mandate that insurance companies cover certain prescription drugs, the government could pay for these medications directly, or they could limit what drug companies could charge for these medications. Unfortunately, I don't see any of these solutions being passed by the Republican House of Representatives.