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Leslie Elder had been fighting various cancers for years. Finally it all got to be too much. As Elder put it early this year

"I honestly don't know how much more I can endure... I sit in bed I cry a lot. I am still fighting for healthcare and still fighting foreclosure."
As her daughter put it
"I know she felt scared because there were no options. Why do something (about illnesses) when you know you can't get proper care to fix it?"
And partly as a consequence of such hopelessness, Leslie Elder
died in July at age 63 without insurance coverage.
Except it was all a tragic mistake.

Instead of fighting one recalcitrant government bureaucracy, she could have gotten treatment at relatively low cost via another.

Elder's family spent her final months fighting for Medicaid, with no clue that they qualified for Florida's high-risk pool...

I was under the impression that pre-existing (PCIP) didn't start until 2014," said Jim Elder in a recent interview with CNN... "It's just confused everybody. It certainly confused us."

It is confusing. I recently had a conversation with a Kossack who was confused about the difference between the Federal pre-existing condition plan (PCIP) set up by the PPACA (aka Obamacare, aka the new health care law) and state high-risk pools set up long before the PPACA was passed. It's a mess, and no one in their right mind should need to understand such minutae (for better or worse I am not in my right mind...)

Leslie Elder's family can rightfully blame Congress, the Department of Health and Human Services, and medical practitioners who don't bother to educate themselves about programs available to their patients. Kossacks can blame Republicans. Tea Party crazies can blame libruls. The public can even blame Google, because typing 'pre-existing condition' into Google search produces a confusing array of options instead of providing an obvious link to the PCIP site.

Regardless, the fact remains that, as with Leslie Elder, people are dying when they could be saved. And a little knowledge on your part can go a long way.


The basics are easy.  If someone


  • Has a pre-existing condition that prevents you from getting health insurance or the insurance that was offered you is prohibitively expensive, and
  • Has been or are about to be without health insurance for six months, and
  • Are a citizen or legal resident of the United States

then that person is eligible to be covered by the PCIP.

.

You can start by going here.

It's not necessarily inexpensive; there are co-pays and deductibles like most insurance, but the total amount you have to pay out-of-pocket is capped. You have a choice of plans; selecting the right one could save you money.

You can check rates here. For example, for a 45-54 year old living in Florida, >the monthly premium is $270/month for the Standard Plan or $363/month for the Extended Plan. The maximum out-of-pocket is $7000 or less.

No, that's not cheap. But there a huge difference between hopelessness -- facing medical bills of $20,000 or more a month to get treatment -- and having to come up with something like $800 a month inclusive.

Of course this is all insane. No one should have to figure out if they quality to have their life saved and whether they can afford it, and then be forced to fill out forms to see if the government agrees. We all know this.

But we also know the system isn't going to change overnight (or even overyear), so being able to use what's available is crucially important.

If you know anyone who's in the predicament of not being able to get health care because of a pre-existing condition, then be a good samaritan and help them see if they qualify for the PCIP. If you hear of someone who knows of someone in that situation, see if you can get this information to them.

Some 100,000 people have enrolled in the PCIP program, but more than 300,000 enrolles were anticipated. Leslie Elder was one of those they anticipated but she never heard about the program.

The PCIP will exist for another year and four months, until January 2014. At that point, the people of the United States willing by having re-elected Obama or at least a still-Democratic Senate, the provision of the PPACA forbidding insurers from denying anyone health insurance because of a pre-existing condition (or even charging them more for it), becomes law.

You still have plenty of time to save a life.

8:03 AM PT: More on Leslie Elder's story -- her fight with Aetna for coverage before she dropped it in this rec-listed diary.

Originally posted to jpmassar on Tue Sep 04, 2012 at 07:45 AM PDT.

Also republished by Progressive Policy Zone, Single Payer: The Fight for Medicare for All, Healthcare Reform - We've Only Just Begun, and Single Payer California.

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