ObamaCare Clusterfuck: If you've got leukemia and good coverage, wait, and your policy will hit the lowest common denominator
2014 Individual Exchange Policies in Four States: An Early Look for Patients with Blood Cancer
The ACA rules do permit variation among exchange plans, and these variations can be significant for services important to people with blood cancer.
This variation among plans is high in the initial 2014 exchange launch, but the authors believe it may diminish in future years as competing insurers converge toward lower-cost and more restrictive features.
So if you like your plan, you won't be able to keep it.
Based on our review of four states— California, New York, Florida and Texas,we have the following high-level observations:
- Many QHPs include only a limited number of National Cancer Institute designated cancer centers or transplant centers in their networks. This could discourage enrollment in these QHPs or result in non-coverage of treatments that would otherwise be recommended for some patients with blood cancer. We note that expert care and clinical trials can be provided outside NCI-designated cancer centers.
- As expected, we found high cost-sharing levels for the silver and bronze plans, which most observers expect to be the most popular choices because they will have the lowest premium rates. Deductibles for silver and bronze plans were often at least $2,000 and at least $4,000, respectively.
- Within particular cities, there is significant variation in premium rates.
- Among the drugs that are important for people with blood cancer, there is variation from plan to plan in which drugs are covered. The annual out-of-pocket limits set for 2014–$6,350 for an individual policy and $12,700 for a family policy–are particularly important to people with blood cancer because their treatments can be very expensive. Some insurers offer plans in some states with lower out-of-pocket limits. However,the out-of-pocket limit does not apply to non-covered drugs or treatment centers.
Now, I have to admit that coverage of pre-existing conditions is a good (assuming you accept the private health insurance model). However, coverage is not the same as care, as the above points make abundantly clear. Under ObamaCare, care -- that is, whether you live or die -- is very much a matter of "luck of the draw," as Millman carefully explains: Care depends on which state you're in, as well as whether the narrow networks and narrow formularies include you and your treatment. And if your networks and formularies aren't narrow now, they will be.
NOTE Hat tip for the source to Mellon IIRC!!