In testimony before the House Energy and Commerce Committee, Susan Zurface, a 42-year-old woman with blood cancer, gave examples of five people who cannot get health insurance under ObamaCare’s underfunded Pre-Existing Condition Insurance Program (PCIP). Under the Helping Sick Americans Now Act, advocated by House Republicans, these five people could very likely be helped by ending an ObamaCare slush fund and transferring $4 billion to assist vulnerable Americans with pre-existing conditions and rare diseases.
A 42 year-old patient from Abilene, TX who was recently diagnosed with multiple myeloma and is uninsured. At the time of his diagnosis, his physician indicated that a stem cell transplant was needed to treat the patient’s blood cancer, but the procedure is expensive and requires health insurance coverage. He had been treated by the hospital through their indigent care program, however he has exhausted his benefits through that program until 2014. The patient applied to the PCIP and was denied as Texas had suspended new enrollees by late February. With no alternate options available, the patient is currently awaiting screening by the NIH for two clinical trials. Although the outcome is looking positive at this time, there is still no guarantee that patient will get the transplant that his physician feels is medically necessary. He now must meet the eligibility for the trial. This patient must travel a great distance for care, and it is unclear if family will be able to accompany him on this journey.
A twenty six year old patient in Boca Raton, FL was diagnosed with Hodgkin’s Lymphoma three years ago while he was still covered by his parent’s insurance policy. Now that he is 26, he has aged out of coverage and is showing signs of relapse. In order to get coverage in the private market, he would have to pay extremely high insurance premiums due to his pre-existing condition. He is in need of medical care and cannot wait six months to get health insurance. Enrolling in the PCIP program now would assist him and his family greatly.
A fifty eight year old female patient was diagnosed with follicular lymphoma in 2006. Her physician prescribed a ‘watch and wait’ approach. Her employer switched from a comprehensive insurance plan to a high deductible plan with no coverage for cancer care, including no coverage for standard medical screenings, and no coverage for chemotherapy. Prior to March 2, she applied for coverage under the PCIP and was rejected because she had been covered under an insurance policy within six months prior to the application date – even though the insurance policy did not cover cancer care. Her care has since depleted all of her family’s assets. LLS is providing her with co-pay assistance and attempting to connect her with additional sources that can help her access the care that she needs.
A fifty two year old female multiple myeloma patient from Anderson, SC, who is a recipient of Social Security Supplemental Income (SSI) benefits, was covered through COBRA after she was let go from her prior job. No private policy would provide health insurance coverage for her. The local LLS chapter referred her to the PCIP program, and the patient was rejected because she had been receiving health coverage under her COBRA plan within the last six months.
A fifty eight year old patient in West Palm Beach, FL was diagnosed with Acute Myeloid Leukemia in March of 2012. Her income exceeded Medicaid eligibility in November 2012, and disqualified her for the program. She is ineligible to apply for PCIP for six months, but needs insurance now to cover the cost of her medical care. (Testimony of Ms. Susan Zurface, Esq., House Committee on Energy and Commerce, hearing on “Protecting America’s Sick and Chronically Ill,” 4/3/2013)