GOP-backed health bill could put Louisiana residents at risk
15th May 2017 · 0 Comments
By Susan Buchanan
Contributing Writer
When 26-year-old Alicia Rollins, a biology grad student at the University of Louisiana at Monroe, couldn’t stay on her mom’s health insurance any longer, she looked for her own policy. She bought a plan under the Affordable Care Act or Obamacare last year, and had abnormal, cervical cells removed at what she felt was a reasonable cost. “I was diagnosed with stage 1 cancer then, and thankfully they caught it early,” she said last week.
A Republican-backed bill in Washington worries Rollins. After the House passed the Affordable Health Care Act or AHCA on May 4, Louisiana’s Democratic Congressman Cedric Richmond, said if enacted, it could be life-changing for millions of Americans—including those with pre-existing conditions, seniors, veterans and people on Medicaid. “The bill makes it easier for insurance companies to deny basic coverage,” he warned.
In early May, the non-profit Louisiana Budget Project in Baton Rouge predicted that under the House bill at least 466,500 of this state’s residents would lose health coverage over 10 years. The nation’s Medicaid program would be decimated, pressuring states to make up for lost federal revenue. “The bill would strip away legal protections for people who suffer from pre-existing conditions, such as cancer or diabetes, resulting in premium hikes that would make coverage unaffordable for those who need it most,” the LBP said.
As a student, Alicia Rollins wants affordable coverage. A year ago, she moved to Monroe and started grad school. “In August, I began to feel sick,” she said. Her Pap smear at a gynecologist’s office was abnormal. “The doctor said I needed a colposcopy, which involves looking through an instrument into the cervix,” she said. “When I turned 26 in September, I shopped for insurance. In the meantime, out of pocket I paid over $200 for the colposcopy and another $150 for a biopsy of that sample.”
After that, the gynecologist explained to Alicia that CIN or Cervical Intra-epithelial Neoplasia 1, 2 and 3 classify how much of the cervix is affected by abnormal cells. Treatment is typically given to remove CIN2 or CIN3 abnormal cells. “I was told I needed a cold knife cone biopsy or surgery to remove a sample of abnormal tissue from the cervix,” Rollins said.
In asking around at hospitals and clinics in Monroe, she couldn’t get a firm cost estimate for that procedure. “One staffer on a hospital surgery floor said it might be $10,000,” she said. “I knew I wasn’t eligible for Medicaid so I researched the best policies that I could afford on HealthCare.gov. I bought a platinum policy from Vantage Health Plan under the ACA. The premium was about $350 a month.” Vantage Health Plan is headquartered in Monroe.
Rollins had the cold knife cone surgery in December and was diagnosed with 1a1 cervical cancer afterwards. “The surgery removed the cancerous cells from my cervix,” she said.
How much did this cost under her ACA policy? “The gynecological surgeon charged $600, the anesthesiologist charged $973, and the hospital charged for blood tests, blood typing and other services,” Rollins said. “The fee from the pathologist who tested the sample was $381. The hospital bill was $7,000, and the whole bill was about $9,500.”
“In total for my surgery, I paid a $350 insurance premium and a $200 copay through the policy I bought under the Affordable Care Act, rather than $9,500 out of pocket,” she said. “I had two followup visits at the gynecological surgeon, with a $35 copay each time. And so far, the doctor’s seen nothing more to indicate cancer.”
Rollins said she’s among the legions of individuals who could be at risk if the Affordable Health Care Act approved by the House becomes effective.
Lydia Kuykendal, Louisiana government-relations director at the American Cancer Society’s Cancer Action Network in New Orleans, last week said the AHCA is bad for cancer patients. “The various patches being offered by lawmakers, including high-risk pools and financial assistance with premiums, don’t in any way offer the level of protection that the current law does,” she said. “This House legislation would allow insurers in states with high-risk pools to charge people with pre-existing conditions more, delay their coverage, or even limit their access to high-risk pools—just as they did before the current law was enacted.”
Before the ACA, three dozen states operated high-risk pools. The ACA established a temporary, national high-risk pool program in 2010 to cover uninsured people with pre-existing conditions until 2014 —when private policies were available under new rules preventing discrimination based on health status. Twenty-seven states decided to administer this Pre-Existing Condition Insurance Plan for their residents, while the federal government operated it for 23 states and DC.
Kuykendal said cancer patients and survivors, under the House legislation passed in May, might no longer be guaranteed coverage for chemotherapy, prescription drugs, prevention services and hospitalization. Unaffordable insurance and inadequate coverage would jeopardize needed cancer treatments.
Medicaid coverage expanded under the ACA. Recipients in Louisiana have grown since Governor John Bel Edwards, a Medicaid supporter, took office last year. Louisiana adults newly enrolled in Medicaid since mid-2016 exceeded 400,000 this past February, exceeding expectations, according to the state’s Department of Health. Medicaid expansion has increased access to regular, cost-effective primary care, Dr. Rebekah Gee, Louisiana’s health secretary said in February. Fewer residents have turned to hospital emergency rooms, saving tax dollars and other resources.
As one who benefited from Obamacare, Alicia Rollins advises others to take time to find the best, possible insurance in a sea of dizzying choices. “My research was cumbersome, but it saved me money and allowed me to address my health needs fairly quickly,” she said. Relieved that her cancer was detected at an early stage, she urges Washington lawmakers to provide universal coverage for Americans. “The United States is a world power and in so many ways a leader,” she said. “Other developing countries cover their citizens universally, and we should be able to do that too.”
The House repeal-and-replace bill unravels requirements that insurers cover certain Obamacare “essential” health benefits. The legislation gives states the option to pull out of an ACA provision that individuals with pre-existing conditions not be charged more by insurers. If the House bill becomes law, expectations are that older and less healthy individuals will see their premiums rise. The AHCA would phase out Medicaid expansion.
In the week of May 22, the Congressional Budget Office plans to release a score for the House bill. If the Senate passes its version, the two bills will have to be reconciled and voted on by the Senate and House again, before heading to President Trump’s desk.◊
