The federal healthcare reform act provides the framework, the outline, of what the new system is supposed to be like. But states have to pass their own laws to align with the feds so that states have jurisdiction. Tuesday saw a major step for Californians with pre-existing medical conditions.
Caroline Cunningham of Studio City has lupus and glaucoma. She could never buy health insurance on the individual market because of her pre-existing conditions.
"I had to pay for medicines myself. Labs myself. Doctor's visits myself. It just became impossible," said Cunningham.
President Obama's federal healthcare reform act helped her because she was able to pay for coverage as part of a new high-risk pool for sick people like her.
But the program is only temporary until the Affordable Care Act is fully implemented in 2014, when millions of Californians who don't have employer-based insurance have to go buy their own. Cunningham fears no one will want her and those like her who are considered too expensive.
"In essence, they're blamed and blacklisted for having a pre-existing condition," said Cunningham.
With Cunningham's testimony about her experience, the state Assembly Health Committee approved a measure by Assemblyman Bill Monning (D-Carmel) that bans insurance companies from denying coverage to people with pre-existing conditions.
Insurers don't like the proposal as written because what if the individual mandate is struck down by the U.S. Supreme Court? Then they'll end up with a pool of just sick people. They say healthy people also need to pay into the pool to make insurance work.
"People being insured use a lot of healthcare services and the other people increasingly don't buy coverage, knowing that if they ever need it, they can buy it at the last minute," said Patrick Johnston, president and CEO of the California Association of Health Plans.
Cunningham is happy she made the trip to the Capitol. "We need help. We don't need to be discriminated against," she said.
This proposal also prevents insurers from basing your premiums on how healthy you are or how old you are.
