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This is a lightly updated reprint of a diary I published in late October. Since it is as relevant now as it was then, and there have been thousands of new Kossacks in the intervening months, I thought it might be useful to republish it. If you didn't read it then, please consider reading it now.

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I might have saved a life, as I detailed several months ago.

You might be able to as well. See if you agree.

There are plenty of reasons for Kossacks to argue about whether the PPACA, aka ObamaCare, aka the new health care law, is a good or bad thing. But there is no excuse for Kossacks, surely one of the most educated and politically aware set of people on the planet, to be ignorant about how the law might help their family members, friends and acquaintances.

And yet many of us are not well informed, as some are willing to admit on these pages:

Ask a few people what ((the PPACA)) means to them and their families, they don't know much more than 26 year olds are covered under their parents plan and pre-existing conditions cannot be excluded by insurers... they (and I) have no clue.
The question of who is to blame for this sorry state of affairs is neither here nor there. The point I'd like you to take away is

if you know one little fact about the PPACA, you may well be able to save someone's life or get them the treatment they need to make their life a ton better.

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What's the secret?

You need to know the basic facts about the PCIP -- The Pre-Existing Condition Insurance Plan, a part of the PPACA. Why do I think that this feature, in particular, is important? Because in the several months I have talked to four people who are either eligible or know someone who, it turns out, is eligible for the program, but didn't know that the program existed.

I am not a talkative person. I don't randomly go up to people and ask them "So, do you have a pre-existing condition and no health insurance?" And still I've encountered four people recently for whom that was true. If I can randomly encounter such people, then you might well encounter them too.

If you learn a couple simple facts about the PCIP -- or even just keep in mind that it exists -- you may be able to point someone towards getting life-saving or life-changing treatments.  Not for free, and that's unfortunate; but potentially for bazillions less that it would have cost them to purchase such treatment without this insurance, making help a possibility instead of an impossibility.

Okay, I've kept you in suspense too long. What are these facts you need to know about the PCIP?

That's it!

The PCIP program could well be the most obscure program in the entire Federal bureaucracy. It was projected to have some 300,000 enrollees by now, and yet it has less than 20% of that number currently. While it was unveiled by the Department of Health and Human Services with some fanfare a year and half ago, you never see it mentioned any more by them or in the press (except in my diaries!). Yet it has plenty of room for everyone you might encounter who qualifies.

So now you know.

The next time someone tells you about how they or someone they know is unable to get health insurance, don't JUST start ranting about the absurdity of America's health care system. After you're done saying how single-payer is better (it is), how Obama might have sold us out (let's not debate that here), and how Republicans think the best health care solution is for sick people to "die quickly" (assuming they think at all), ask a couple questions. Pry a bit. You might find out that the person in question could, within a month, start getting costly treatments that they could not possibly otherwise afford -- paid for by the PCIP. You might even save the person's life.

Start here.

Thank you.

Originally posted to jpmassar on Sun Feb 19, 2012 at 09:19 AM PST.

Also republished by SFKossacks, Single Payer: The Fight for Medicare for All, Healthcare Reform - We've Only Just Begun, and Dailykos Kossacks For Action.

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Comment Preferences

  •  Definitely important! (4+ / 0-)

    Thanks for the republish.

    A former coworkers now works for Californians for Patient Care. Seems to be a good organization with resources for Californians.

    California*, Conneticut, Iowa, Massachussets, New Hampshire, New York, Vermont, Washington. (and District of Columbia) *pending

    by cooper888 on Sun Feb 19, 2012 at 09:40:19 AM PST

  •  Let's start off the comments... (2+ / 0-)
    Recommended by:
    hazey, Words In Action

    "Looking for love insurance in all the wrong places..."

  •  Would be great candidate for handing out (1+ / 0-)
    Recommended by:
    jpmassar

    fliers at grocery stores, malls, street corners, libraries, coffee shops, etc.

    Is there a flier as simple as your presentation? Do we have a graphic artist who could produce a .pdf? Could we create a kickstarter program to raised funding for publication and printing of the flier?

    It would be great to pick a metropolitan area, produce and disseminate the fliers, then measure the before and after to measure the impact. That could then provide the data to go after grants and/or private funding to expand the program.

    This, too, shall pass. Just like the last global ecological cataclysm. C'est la vie, dude. Take a chill pill, recite the serenity prayer, go with the flow and the moderates into that "goodnight".

    by Words In Action on Sun Feb 19, 2012 at 10:22:12 AM PST

    •  Moerover, wouldn't this be a great model for (1+ / 0-)
      Recommended by:
      jpmassar

      kossacks to deploy on a number of issues? Wouldn't it be great for DKos to become and become known as this tremendous incubator for change?

      Of course, it takes some opinion leaders to champion it, IMHO.

      This, too, shall pass. Just like the last global ecological cataclysm. C'est la vie, dude. Take a chill pill, recite the serenity prayer, go with the flow and the moderates into that "goodnight".

      by Words In Action on Sun Feb 19, 2012 at 10:24:53 AM PST

      [ Parent ]

    •  Before and after of that metropilitan areas (1+ / 0-)
      Recommended by:
      jpmassar

      awareness and use of the program, I mean.

      This, too, shall pass. Just like the last global ecological cataclysm. C'est la vie, dude. Take a chill pill, recite the serenity prayer, go with the flow and the moderates into that "goodnight".

      by Words In Action on Sun Feb 19, 2012 at 10:47:18 AM PST

      [ Parent ]

  •  Another gem, jp. (2+ / 0-)
    Recommended by:
    jpmassar, Terranova0

    This, too, shall pass. Just like the last global ecological cataclysm. C'est la vie, dude. Take a chill pill, recite the serenity prayer, go with the flow and the moderates into that "goodnight".

    by Words In Action on Sun Feb 19, 2012 at 10:22:35 AM PST

  •  Great diary. This information could literally save (2+ / 0-)
    Recommended by:
    Terranova0, jpmassar

    lives.

  •  Wonderful (2+ / 0-)
    Recommended by:
    jpmassar, KenBee

    Fortunately, our health care is through an employer plan. Both my husband and I have 'pre-existing' conditions. In years past, my husband paid for his own health insurance, preferring his familiar practitioners over various employer's plans. Then the insurance company declined his private application, and we were forced to take a less comprehensive plan.

    Currently, we have great health insurance, but if we were to lose employer benefits, we'd try to use this program.

    The only problem is I don't think my husband could live for 6 mos without his medications in order to qualify.  We'd be forced to buy some kind of insurance or pay full cost for health care in the interim.  That may be why the program hasn't been fully utilized.

    “The most important trip you may take in life is meeting people halfway” ~ Henry Boye~

    by Terranova0 on Sun Feb 19, 2012 at 11:38:53 AM PST

    •  Indeed, the six month thing is a real killer, (2+ / 0-)
      Recommended by:
      Terranova0, KenBee

      figuratively and likely literally.

      It was put in to prevent "hordes" of people from signing up, overloading the program.  But it was written into the law; Sebelius has no authority to adjust or eliminate the waiting period duration.

      •  We'd have been (1+ / 0-)
        Recommended by:
        jpmassar

        part 'o that horde-- so it worked.  ;/

        If it helped just one person, I am grateful it is there. Every bit of cement helps fill the cracks.

        “The most important trip you may take in life is meeting people halfway” ~ Henry Boye~

        by Terranova0 on Sun Feb 19, 2012 at 12:25:36 PM PST

        [ Parent ]

  •  Here are the rates/benefits in my (1+ / 0-)
    Recommended by:
    jpmassar

    state for someone in my age group. I'm trying to figure out if people think this is reasonable/good coverage for people who are low income.

    Age: 55+ =  $425 $571 $441

    View a Summary of Benefits for the Standard, Extended, and HSA plans. (PDF – 810 KB)

    In addition to your monthly premium, you will pay other costs. In 2012, you will pay a $1,000 to $3,000 deductible, which varies by your plan option, for covered medical benefits (except for preventive services) before the plan starts to pay. A plan option may have a separate drug deductible. After you pay the deductible, you will pay a $25 copayment for doctor visits, $4 to $40 for most prescription drugs, and 20% of the costs of any other covered benefits you get. Your combined out-of-pocket costs for in-network and out-of-network covered services cannot be more than $7,000 per year. The maximum is even less if you use only in-network providers.

    •  Obviously it's not going fly for people who (1+ / 0-)
      Recommended by:
      KenBee

      are low income / low assets.

      But the maximum cost is around $10,000/yr.  So if you are able to afford that, but you otherwise can't get insurance because you have cancer or some equally horrible pre-existing condition, then you get to live instead of dying or going bankrupt because you can't afford the $100,000/yr it costs for treatment.

      Also note that, unless the PPACA is repealed or declared unconstitutional, you only have to pay out so much until 2014, when subsidized rates with no pre-existing condition exclusions apply to everyone.

      •  what does this mean? (1+ / 0-)
        Recommended by:
        jpmassar

        'But the maximum cost is around $10,000/yr.'

        comment before  says:
        'Your combined out-of-pocket costs for in-network and out-of-network covered services cannot be more than $7,000 per year.'

        confused, so what happens after $7000 or $10000 per year, coverage stops, coverage continues with no more out of pocket costs?

        my blue shield was about 600 a couple of years ago with no copays, this sounds similar, and not 'affordable' for poor people definitely.

        'Path2Health' is available in some norcal counties to some low income people....you should give a diary over to that, I can't puzzle it all out, I keep having 'questions' and stall.

        It's a program that I think may be a pilot program that will evolve into something else in/by 2014...a pre ObamaCare model maybe.

        From those who live like leeches on the people's lives, We must take back our land again, America!...Langston Hughes

        by KenBee on Sun Feb 19, 2012 at 01:58:07 PM PST

        [ Parent ]

        •  Coverage continues with no more out of pocket (1+ / 0-)
          Recommended by:
          KenBee

          costs.

        •  I didn't know about Path2Health. (1+ / 0-)
          Recommended by:
          KenBee

          The explanations on the web site seem fairly clear.  What is it that you are puzzling about?  Maybe I can decipher it for you.

          You have to live in one of the designated counties, not be eligibile for MediCal, and have an income below the Federal poverty level, to qualify.

          •  heh, thanks, I read it too.. (1+ / 0-)
            Recommended by:
            jpmassar

            I was hoping to hear more hands on experience, but it's so new many haven't heard about it even.

            I think it's a good start, it sure sounds good, but being poor and sick and having to navigate all that always seems such an uphill battle.

            The rates are Medicare or Medicare + 10%, there is dental care, out of area is ok, same day treatment (instead of waiting months  MONTHS!! dammit) for an infected tooth, same day treatment for mental illness and drug treatment too, some real needed changes from the way it's done around Sacramento for example..a comment about that here recently..ugh.

            Anyway, glad to inform, I can't wait to hear that it's helped somebody, (started 1/1/12) or even that they heard about it from me...and it worked for them.

            Here's hoping it works, those counties really need it.

            From those who live like leeches on the people's lives, We must take back our land again, America!...Langston Hughes

            by KenBee on Sun Feb 19, 2012 at 10:21:22 PM PST

            [ Parent ]

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