Archive for the ‘Access to Health Care’ Category

Waiting for 2014: One Family’s Story

Thursday, August 23rd, 2012

When Joshua Lemacks of Richmond, Virginia takes the field for one of his Little League games, the other team may not be overly impressed with his batting average stats, but those who know him realize that he has beaten extreme odds just to be standing on that field with his teammates.  What the other team doesn’t know is that if Joshua and his parents hadn’t batted 1000 in his early years, he wouldn’t be alive today.

Nine years ago, soon after Joshua was born, a fetal cardiologist came into the room with a box of tissues and told his parents that their newborn’s heart defect was 100% fatal. Later, the cardiologist offered them somewhat better odds if Joshua underwent three high-risk surgeries, one right after delivery.  His odds of surviving the first surgery were about 5 percent. Joshua’s parents, Jodi and Mark, opted for the surgeries because they wanted to give their baby the best chance they could.  Even though they were insured, they incurred monumental out of pocket costs.

Today, Joshua has not only beaten those odds, he is thriving. “He’s as healthy as a horse,” Jodi says. He plays baseball and golf and is a very happy child who seems like any other active little boy except for the scar on his chest and the medical bills that have piled up for his family.

Even when Josh is healthy, the family’s medical bills add up. Josh has, effectively, “half a heart,” as Jodi puts it, and with today’s technology, his defect cannot be “fixed.” He needs regular check-ups, but he also needs to see a cardiologist at least once a year and undergo expensive testing.  Also, while he doesn’t get sick more often than other children, normal childhood illnesses hit him harder than they do others because his heart can’t work as effectively.  Jodi estimates their health care expenses to be as much as $17,000 in out-of-pocket costs, including premiums, in good years when Josh is relatively healthy. This is a substantial portion of their family income. Even though it’s comprehensive medical insurance, the premiums and co-payments required to obtain needed medical care are prohibitive.

This affects not only Josh but the whole family. When Josh’s older brother hurt his arm in an accident during a family trip to New Orleans, they debated going to the emergency room for x-rays because of the cost. They did take him – he’s their son, after all – but, just as they feared, they got “nailed with bills” because their plan only covered a fraction of the cost.

“I feel trapped” in this health insurance policy, Jodi says. Even though she has a better, more generous group plan through her job at a national non-profit, Jodi is afraid to move her kids and husband onto it. Why? Because when the family enrolled in their current policy, Joshua hadn’t been born yet. And he hadn’t yet had his diagnosis of hypoplastic left heart syndrome. As a result, the insurance company’s underwriters assigned him the healthiest possible risk category – a “1” in insurance terms. As high as they are, their premiums are set as if Joshua were a “normal,” healthy child.

But that would not be true if they were looking for a new individual policy on the market today. An insurance underwriter would take one look at Josh’s medical history and run in the other direction. If the family obtains a new policy that includes Joshua, they can expect to pay high rates because of Joshua’s illness– as much as $3100 per month in Virginia, their home state. So Jodi is afraid to move him off their current policy and onto her group plan. If she were to lose her job-based insurance for any reason, they almost certainly could never find an affordable new policy for Joshua.

Because of Joshua’s condition, he will inevitably need long-term monitoring and care. His heart problem cannot be “fixed.”  Kids with this problem may develop arrhythmias, may need a pacemaker, and can develop liver disease, among other complications. Because the oldest person with this condition is only in his 30s, no one really knows what the life-expectancy is, but we do know care over their lifetime will be costly.

With the Affordable Care Act comes new hope for Joshua and his parents. Beginning January 1, 2014, insurance companies will no longer be allowed to charge more to cover Joshua because of his heart condition. The family will pay the same premiums as a family without any health problems.

And Jodi is looking forward to the new state-based marketplaces called insurance exchanges, which will, for the first time, offer web-based tools so she can make apples-to-apples comparisons among different health plan options to select a plan that has the doctors and care Joshua needs.

We asked Jodi what it would mean for her to have guaranteed access to policies in which Joshua couldn’t be discriminated against based on his health status, and an exchange where she could compare her options. She responded: “That gives me choices. I also think it will be more competitive. Right now I’m stuck. I don’t like our current policy, but I can’t move Joshua anywhere else. But if I can compare plans on an exchange, maybe there is one out there that covers a bit more of what we need. That would give me the freedom to choose it.”

In addition, because the family’s income is less than 400% of the federal poverty level, they are likely to qualify for the ACA’s tax credits to help defray the cost of their insurance premiums. In addition, health plans will be required to cover a comprehensive set of benefits and limit families’ out-of-pocket costs.

Jodi imagines a future for Joshua under the ACA in which he can embark on a career that matches his skills and passions, secure in the knowledge he can get the health coverage he needs. He won’t have to choose a job just because it offers a good health plan. “He can start out of college…and he’ll have choices,” she says. “He is such an amazing child, and we love him so much. Like any parent, we want the absolute best for him.”

Thanks to the support of the Robert Wood Johnson Foundation, the AHA is proud to be a part of the Georgetown University Health Policy Institute’s “Real Stories, Real Reforms” project.  You can read more profiles of everyday people across the country who will – or have already – benefited from new consumer protections under the Affordable Care Act on the CHIRblog .  This post – about Joshua and his family – marks the first story in the series.  We hope you’ll follow future stories about the impact of the Affordable Care Act.

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Updated! 57 Co-sponsors for the HEART for Women Act. Can we get to 100?

Friday, July 20th, 2012

Check out the list of current co-sponsors of the HEART for Women Act. These Members of Congress have taken an important step in demonstrating their support for improving the prevention, diagnosis, and treatment of heart disease and stroke in women.

Have your legislators joined the fight against our nation’s No. 1 killer of women yet?

Help us reach 100 Congressional supporters of the HEART for Women Act by asking your elected officials to co-sponsor the bill today!

Current Co-sponsors:

Sen. Lisa Murkowski (R-AK)

Rep. Mike Ross (D-AR-04)

Rep. Lois Capps (D-CA-23)

Rep. Joe Baca (D-CA-43)

Rep. Janice Hahn (D-CA-36)

Rep. Barbara Lee (D-CA-09)

Rep. Laura Richardson (D-CA-37)

Rep. Linda Sanchez (D-CA-39)

Rep. Jackie Speier (D-CA-12)

Rep. Maxine Waters (D-CA-35)

Rep. Lynn Woolsey (D-CA-06)

Sen. Richard Blumenthal (D-CT)

Rep. Jim Himes (D-CT-04)

Rep. Eleanor Holmes Norton (D-DC-AL)

Rep. Corrine Brown (D-FL-03)

Rep. Debbie Wasserman Schultz (D-FL-20)

Rep. Leonard Boswell (D-IA-03)

Rep. Judy Biggert (R-IL-13)

Rep. Jesse Jackson, Jr. (D-IL-02)

Rep. Jan Schakowsky (D-IL-09)

Rep. Robert Dold (R-IL-10)

Rep. Andre Carson (D-IN-06)

Sen. Susan Collins (R-ME)

Sen. Olympia Snowe (R-ME)

Sen. Barbara Mikulski (D-MD)

Rep. Elijah Cummings (D-MD-07)

Sen. John Kerry (D-MA)

Rep. Edward Markey (D-MA-07)

Rep. James McGovern (D-MA-03)

Rep. John Olver (D-MA-01)

Sen. Debbie Stabenow (D-MI)

Rep. Hansen Clarke (D-MI-13)

Rep. John Conyers (D-MI-14)

Rep. Betty McCollum (D-MN-04)

Rep. William Clay (R-MO-01)

Rep. Russ Carnahan (D-MO-03)

Sen. Frank Lautenberg (D-NJ)

Sen. Robert Menendez (D-NJ)

Rep. Albio Sires (D-NJ-13)

Rep. Gary L. Ackerman (D-NY-05)

Rep. Nita Lowey (D-NY-18)

Rep. Eliot Engel (D-NY-17)

Rep. Brian Higgins (D-NY-27)

Rep. Steve Israel (D-NY-02)

Rep. Carolyn Maloney (D-NY-14)

Rep. Louise Slaughter (D-NY-28)

Sen. Kay Hagan (D-NC)

Rep. David Price (D-NC-04)

Rep. Marcy Kaptur (D-OH-09)

Rep. Jim Gerlach (R-PA-06)

Rep. Todd Platts (R-PA-19)

Sen. Tim Johnson (D-SD)

Rep. Charlie Gonzalez (D-TX-20)

Rep. Silvestre Reyes (D-TX-16)

Rep. James Moran (D-VA-08)

Rep. Cathy McMorris Rodgers (R-WA-05)

Rep. Gwen Moore (D-WI-04)


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AHA CEO Applauds Supreme Court Decision on Health Reform

Thursday, June 28th, 2012

Washington, D.C., June 28, 2012 — American Heart Association CEO Nancy Brown issued the following statement today on the U.S. Supreme Court’s ruling upholding the Affordable Care Act: 

“The historic decision handed down today will benefit America’s heart health for decades to come. Questions about the Affordable Care Act’s constitutionality have overshadowed the law’s progress. With this ruling, that uncertainty has finally been put to rest. 

By upholding the law, the nation’s highest court has sent a clear message that patients should be the first priority in an ever-changing healthcare arena. The court’s action in support of the ACA helps remind us what’s really important – enabling all Americans to obtain affordable, quality health care. We can now build on the significant advances already achieved under the act and truly transform our healthcare system. 

Because of this ruling, the ACA can be fully implemented to help reach the American Heart Association’s 2020 goal to improve the cardiovascular health of all Americans and, more immediately, prevent 1 million heart attacks and strokes over the next five years through the Million Hearts initiative. Under the law’s robust provisions, we are expanding access to preventive care and medicines to reduce an individual’s risk factors; placing a stronger emphasis on community prevention and wellness; and providing access to the care patients need to recover after a heart attack or stroke so they can lead longer, more productive lives. 

For the 122 million Americans with pre-existing conditions, including the 7.3 million with some form of heart disease or stroke who are uninsured, this decision will likely be met with a great sigh of relief. No longer will they be denied coverage or charged higher premiums because of their health status. Beginning in 2014, these Americans will finally be able to attain the lifesaving care they desperately need at a price they can afford. 

The ACA has also placed an extraordinary emphasis on the one thing that can ultimately conquer heart disease and stroke – prevention. For individuals, the law will continue to provide screening services that help keep risk factors such as high blood pressure, cholesterol, obesity and tobacco use in check. At the state and community levels, the Prevention and Public Health Trust Fund will continue to provide the tools and resources Americans require to eat better, be more physically active and live tobacco-free. 

Each and every one of us will need health care at some point in our lives. With this momentous decision, the Supreme Court has ensured that when we are patients, we can focus on our healing and recovery, instead of worrying about whether we can obtain or afford the quality care we all deserve.”

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Updated!:54 Co-sponsors for the HEART for Women Act. Can we get to 100?

Wednesday, June 20th, 2012

Check out the list of current co-sponsors of the HEART for Women Act. These Members of Congress have taken an important step in demonstrating their support for improving the prevention, diagnosis, and treatment of heart disease and stroke in women.

Have your legislators joined the fight against our nation’s No. 1 killer of women yet?

Help us reach 100 Congressional supporters of the HEART for Women Act by asking your elected officials to co-sponsor the bill today!

Current Co-sponsors:

Sen. Lisa Murkowski (R-AK)

Rep. Mike Ross (D-AR-04)

Rep. Lois Capps (D-CA-23)

Rep. Joe Baca (D-CA-43)

Rep. Janice Hahn (D-CA-36)

Rep. Barbara Lee (D-CA-09)

Rep. Laura Richardson (D-CA-37)

Rep. Linda Sanchez (D-CA-39)

Rep. Jackie Speier (D-CA-12)

Rep. Maxine Waters (D-CA-35)

Rep. Lynn Woolsey (D-CA-06)

Sen. Richard Blumenthal (D-CT)

Rep. Jim Himes (D-CT-04)

Rep. Eleanor Holmes Norton (D-DC-AL)

Rep. Corrine Brown (D-FL-03)

Rep. Debbie Wasserman Schultz (D-FL-20)

Rep. Leonard Boswell (D-IA-03)

Rep. Judy Biggert (R-IL-13)

Rep. Jesse Jackson, Jr. (D-IL-02)

Rep. Jan Schakowsky (D-IL-09)

Rep. Andre Carson (D-IN-06)

Sen. Susan Collins (R-ME)

Sen. Olympia Snowe (R-ME)

Sen. Barbara Mikulski (D-MD)

Rep. Elijah Cummings (D-MD-07)

Sen. John Kerry (D-MA)

Rep. Edward Markey (D-MA-07)

Rep. James McGovern (D-MA-03)

Rep. John Olver (D-MA-01)

Sen. Debbie Stabenow (D-MI)

Rep. Hansen Clarke (D-MI-13)

Rep. John Conyers (D-MI-14)

Rep. Betty McCollum (D-MN-04)

Rep. William Clay (R-MO-01)

Rep. Russ Carnahan (D-MO-03)

Sen. Frank Lautenberg (D-NJ)

Sen. Robert Menendez (D-NJ)

Rep. Gary L. Ackerman (D-NY-05)

Rep. Eliot Engel (D-NY-17)

Rep. Brian Higgins (D-NY-27)

Rep. Steve Israel (D-NY-02)

Rep. Carolyn Maloney (D-NY-14)

Rep. Louise Slaughter (D-NY-28)

Sen. Kay Hagan (D-NC)

Rep. David Price (D-NC-04)

Rep. Marcy Kaptur (D-OH-09)

Rep. Jim Gerlach (R-PA-06)

Rep. Todd Platts (R-PA-19)

Sen. Tim Johnson (D-SD)

Rep. Charlie Gonzalez (D-TX-20)

Rep. Silvestre Reyes (D-TX-16)

Rep. James Moran (D-VA-08)

Rep. Cathy McMorris Rodgers (R-WA-05)

Rep. Gwen Moore (D-WI-04)

 

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AHA CEO Nancy Brown Joins Other Partners Supporting the Affordable Care Act During Supreme Court Hearings

Wednesday, March 28th, 2012

Health coverage is easy to get if you’re healthy. The problem is when you’re sick or have a history of illness.

For decades, people with life-threatening chronic diseases such as cancer, diabetes, heart disease or stroke faced numerous barriers to getting the care they needed. Insurers could deny coverage to anyone with a pre-existing condition, terminate coverage when the cost of a patient’s care exceeded arbitrary dollar limits, or raise premiums to unaffordable levels in response to a diagnosis. As a result, patients had to skip or cut short their treatment because of costs, or go deeply into debt to pay for needed care.

The patient protections enacted into law in 2010 are changing that, enabling more Americans to afford lifesaving care. These protections provide patients with the best chance to beat their illness. When fully implemented in 2014, they will require insurers to cover people with pre-existing conditions, eliminate dollar limits on the coverage a patient can receive and ban the practice of inflating premiums for people with health concerns.

The law makes these protections possible by requiring that most Americans buy health insurance. By ensuring that coverage extends both to healthy people, who are less expensive to insure, and to those who are sick, who cost more, the law helps to keep costs down for those who need care the most. Unfortunately, the “individual responsibility” requirement has been attacked as unconstitutional, posing a grave threat to the law’s critical patient protections. Federal appeals courts are divided on the issue, and the U.S. Supreme Court hears arguments on the matter this week.

Our organizations, which represent tens of millions of people across the country with life-threatening chronic diseases, together submitted a friend-of-the-court brief asserting that the individual responsibility provision is essential to preserving the protections that patients desperately need and deserve.

We already know what a health care system without such a requirement looks like: Many healthy Americans opt not to buy health coverage until they are ill, and costs skyrocket as insurance pools fill with people in urgent need of treatment and care. People with pre-existing conditions are charged exorbitant rates for health coverage, putting critical care out of reach for many American families. As a result, many people with a chronic illness must resort to emergency room care, which lowers their chances of surviving their illness and drives up costs system-wide.

Many of those who want the individual responsibility requirement struck down also express support for the patient protections that the provision makes possible. Several states have tried such an approach by enacting insurance protections for patients with pre-existing conditions without compelling healthy people to enter the insurance market as well. These states are now among the most expensive in the country in which to buy insurance, and two of them, Kentucky and New Hampshire, ended up repealing those protections because of increasingly unaffordable premiums.

Half of all non-elderly Americans are living with a pre-existing medical condition. They need the protection from discrimination by insurers that the Affordable Care Act provides. Our hope is that the Supreme Court will enable all Americans to benefit from the promise of access to guaranteed, affordable and adequate insurance.

It is a promise our nation must keep.

Article first published on CNN.com and was co-authored by Larry Hausner, CEO, of the American Diabetes Association, and John R. Seffrin, CEO, of the American Cancer Society and American Cancer Society Cancer Action Network.

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AHA Statement on the 2nd Anniversary of the Affordable Care Act

Friday, March 23rd, 2012

Washington, D.C., March 22, 2012 — American Heart Association CEO Nancy Brown issued the following comments today on the second anniversary of the Affordable Care Act, signed into law on March 23, 2010:

“As the Affordable Care Act (ACA) turns 2, the heart health of many Americans continues to benefit from the law’s improved coverage. The American Heart Association’s goal by 2020 is to improve the cardiovascular health of all Americans by 20 percent, and to reduce deaths from cardiovascular diseases and stroke by 20 percent. The ACA, along with the unique public-private partnership, “Million Hearts,” are both key to helping us attain these important goals.

By 2030, 40.5 percent of the U.S. population is projected to have some form of cardiovascular disease, which will cost the nation’s healthcare system $1 trillion annually. We can avert this health and economic tragedy in the future if we practice strong prevention today. Prevention plays a critical role in conquering heart disease and stroke — the nation’s No. 1 and No. 4 killers — and in reducing the enormous costs associated with their treatment. If Americans can eliminate traditional risk factors such as obesity, high blood pressure and high cholesterol levels by the time they reach middle age, then they have a very low risk of ever having a heart attack or stroke. The Affordable Care Act is helping Americans improve, achieve and maintain ideal heart health through a greater focus on prevention. Last year, under the new law, 86 million Americans received at least one new free preventive service, including 32 million Medicare beneficiaries. Among Medicare beneficiaries, 20 million people were screened for high cholesterol in 2011.

The ACA also places an extraordinary emphasis on helping communities focus on prevention and wellness. The Million Hearts initiative, launched last fall, sets a goal of preventing 1 million heart attacks and strokes over the next five years by harnessing tools and resources made available by the ACA. For example, states and communities have already received $1.2 billion from the Prevention and Public Health Trust Fund to transform communities and help people live healthier lives through tobacco-free living, physical activity and healthy eating, and prevention and control of high blood pressure and high cholesterol.

An estimated 7.3 million Americans who suffer from cardiovascular disease are uninsured and are often denied the coverage they need because of their medical conditions. But under the law’s Pre-Existing Condition Insurance Plan (PCIP), heart attack and stroke patients who have been uninsured for at least six months have been able to gain access to comprehensive insurance coverage. Of the 50,000 PCIP enrollees, an estimated 15 percent have heart disease, stroke or another form of cardiovascular disease.

As the nation’s highest court takes up the Affordable Care Act, we hope the justices will remember that these broadly supported patient protections could be undermined if the law’s minimum coverage requirement is struck down. Without this requirement, the promise of guaranteed, affordable health insurance may never be realized by all Americans, including those with heart disease and stroke who desperately need it.”

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Urge Congress to Protect Women’s Heart Health

Tuesday, March 13th, 2012

Cardiovascular disease remains the leading killer of American women, but sadly, the life-saving WISEWOMAN program only has enough funding to reach at-risk women in 20 states with the tools they need to prevent heart disease and stroke. Meanwhile, millions of women around the country are forced to wait.

Members of Congress can help this proven prevention program expand into more states and reach more women, but they need to hear from you what it will take.

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Tell Your Members of Congress that AEDs Save Lives

Tuesday, March 13th, 2012

The President has once again proposed eliminating funding for a life-saving program that places automated external defibrillators (AEDs) in small communities and rural areas. Last year, Congress saved this program and they can do it again, but they need to hear from you today.

Ask your member of Congress to support funding for increased AED placement that will save more American lives.

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Nearly 50,000 with Pre-Existing Conditions Covered Under Health Reform Law

Thursday, February 23rd, 2012

The Department of Health and Human Services (HHS) released a new report today finding that the Pre-Exisiting Condition Insurance Plans (PCIP) created under the Affordable Care Act will enroll close to 50,000 people. These PCIPs help those Americans who are barred from private insurance do to a pre-existing condition and who don’t qualify for public programs, like Medicare and Medicaid.

“For too long, Americans with pre-existing conditions were locked out of the health care system and their health suffered. Thanks to health reform, our most vulnerable Americans across the country have the care they need,” said HHS Secretary Kathleen Sebelius.

In 2014, insurers will not be allowed to refuse coverage do a pre-exisiting coverage, but these PCIPs fill-in the gap until that year. All 50 states have these plans in place for their residents.

Click here to read the full statement by HHS.


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State of Women’s Heart Health Webinar

Friday, January 27th, 2012

Did you know that more women die of heart disease than all forms of cancer combined? Heart disease is often silent, hidden and misunderstood- but we can each do our part to learn about our risk factors, make changes, and share the truth with others.

So, kick of American Heart Month by joining us for a national discussion on the State of Women’s Heart Health! You’ll hear from some of our nation’s leading health experts about the latest heart disease and stroke research and prevention efforts.

_________________________________________________

WHO: You!

WHAT: A national webinar with Department of Health and Human Services Secretary Kathleen Sebelius, cardiologist Dr. Nanette Kass Wenger, and fellow survivor-advocates to learn about the new Million Hearts initiative and some of the latest advances in women’s heart research.

WHEN: Wednesday, February 1st, 2012 at 5:30-6:30 pm EST (4:30-5:30 pm CST)

WHERE: Your computer

HOW: Register today!  You will receive a confirmation email with log-in details.

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The experts will take some of your questions at the end of the call, so come prepared to participate in the discussion!

We are looking forward to having you join us for this exciting American Heart Month event!

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