Affordable Care for People with Disabilities

Asclepios -- Your Weekly Medicare Consumer Advocacy Update from the Medicare Rights Center

Affordable Care for People with Disabilities
January 14, 2010 • Volume 10, Issue 2

People call the Medicare Rights Center hotlines with all kinds of health care problems. Their drug plan has denied coverage of an important medicine, for example, or they are confused about how Medicare works with their employer insurance. For these types of calls, our volunteers and caseworkers can help.

Other problems do not have a straightforward solution. Right now, people with disabilities who are stuck waiting for their Medicare coverage to begin have few options. Many receive just a little too much in their disability check to qualify for Medicaid. Others cannot afford the premiums, deductibles and copayments under the COBRA plans they have from a former employer. Those without coverage are denied insurance on the private market because of their pre-existing conditions. People use free drug samples from their doctors or appeal for charity care from their hospitals to get by, or go into debt paying for treatments out of pocket. Even then, many people with disabilities go without care during their two-year wait for Medicare.

If Congress passes health reform, that will change.

When health reform takes effect, people with disabilities will have options that do not exist today. Insurers will no longer be able to deny coverage based on pre-existing conditions and people with low and moderate incomes can receive assistance paying for coverage.

The biggest issue facing congressional leaders now trying to blend the House and Senate bills is how affordable that coverage will be.

More than half of the people with disabilities in the two-year wait for Medicare are over 50, so it is crucial that the final bill incorporate the lower limit on age rating—how much more insurers can charge for coverage based on the age of consumers—that is in the House bill.

The vast majority of people with disabilities also have low incomes—two-thirds earn less than twice the federal poverty level. That makes it essential that lawmakers adopt the House bill’s broader expansion of Medicaid, and the more affordable limits on copayments and premiums for low-income people who receive coverage through plans sold over a new health insurance exchange.

We need to make sure Congress knows how important these affordability provisions are for people with disabilities. The Coalition to End the Two-Year Wait for Medicare wrote congressional leaders this week. We need you to write your senators and representative as well and tell them to make coverage affordable for people with disabilities.

Medical Record

“The burden of the waiting period is greatest for those living in or near poverty: they are the least likely to have health coverage from their former employer or the employer of their spouse and the most likely to be unable to afford the medical care they need. As you work to reconcile the House and Senate legislation, we urge you to make sure that people with disabilities in the waiting period have access to health insurance that provides affordable medical care.” (Letter to Speaker Pelosi and Majority Leader Reid, Coalition to End the Two-Year Wait for Medicare, January 2010)