NEWSHEALTH INSURANCE

Below is a guest post from Ryan Carroll, from Bealeton, Virginia, about why she created a petition to ask Aetna to pay for her surgery. You can see her petition here.

As a young teenager, I was a gymnast and a competitive cheerleader. My nickname was “The Toe-Touch Queen” because I could bust out roughly 15 perfectly executed toe-touch jumps. If only I had a crystal ball to look into the future…

Around the age of 17, I began to develop mild hip pain. Specialists told me I had mild arthritis and gave me prescriptions for medication and physical therapy.

Although these treatments helped, they didn’t help for long. As the years passed, I learned to deal with the hip pain. Hot baths, ice, Motrin… these became part of my daily routine. I accepted it as part of my life, and moved on.

In 2001, I married my best friend. He was (and still is) an officer in the U.S. Army. He has been deployed twice since we were married, and he is proud to protect and serve. We had always wanted a big family, so we started right away. Through international adoption and natural conception, we’ve been blessed with four beautiful children. My kids are my life. I live and breathe for them, and ultimately wish I could be the active and healthy mother that they deserve.

In 2010, with my husband on a 12-month deployment in the Middle East, I had my hands full with my four energetic kids. Although my hip pain had always been there, nagging at me, it really began to intensify. 



It seems like a good idea. Invest in the expansion of our nation's community health centers (CHCs) so that low income workers without adequate health insurance would have a regular doctor to visit, instead of the only other alternative, high-cost hospital emergency rooms. Keeping this workforce healthy and on the job would also maintain productivity in our recovering economy.

Unfortunately, the federal funding to grow health center capacity is in doubt right now as Congress debates a new budget. House Republicans have proposed cutting $1.3 billion from health center funding.

This week, new research, from the Geiger Gibson/RCHN Community Health Foundation Research Collaborative, pinpoints just how much we stand to lose in health care efficiency savings if the funding is cut as proposed; $15 billion. Put another way, for every $1 invested in CHC expansion, there is a potential savings in health care costs of $11.50.

Just as our Community Health Centers were fending off state budget cuts of over $90 million, they are under attack again from an approved U.S. House budget bill that has approved cuts of $1.3 billion. While the Senate considers the bill, we all need to understand the full impact of these cuts on health care's best kept secret.

These reductions will have profound effects on the mission and capacity of your local community health centers including:

- eliminating capacity of health centers to serve 11 million patients over the next year;
- ending funding for 127 new health centers in under served districts across the country whose residents have long waited for access to doctors and health care services;
- forcing health centers to lay off 10,000 employees in rural and urban communities nationwide.

The country may be divided politically, but states do have one thing in common: budget shortfalls. And finding ways to plug the holes in expenditures without new sources of revenue means popular health programs are often under the ax.

Last month, we brought you the news of one such proposal in Wisconsin. Newly-elected Governor Scott Walker promised on the campaign trail to cut funding for the state's popular Medicaid program, BadgerCare.

Now it seems he's living up to  his promises. A recently introduced budget repair bill would give the administration "sweeping powers" to rewrite the Medicaid program and change laws regarding medical care for children, adults, the elderly and the disabled.

"It's a shockingly broad delegation of legislative authority to the Department of Health Services. This is the authority to do almost anything to substantially reduce eligibility for children, parents and childless adults, to increase premiums, to change renewal processes, to reduce services, and to change rates. It covers everything," Joe Peacock, research director for the Wisconsin Council on Children and Families, told the Milwaukee-Wisconsin Journal Sentinel.

Members of the group Arizona 98 are asking supporters to contact Governor Brewer's office this Valentine's Day to urge her to "have a heart" and finally restore funding for the transplant funding program she cut last year.

The group was started after Brewer cut coverage for 98 organ transplant patients enrolled in state's Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS).

Steven Daglas, co-founder of the group, suggests calling or emailing Governor Brewer's office with this message: "Arizona legislators on both sides of the aisle now agree funding exists to restore the eliminated organ transplants for AHCCCs patients. Prominent physicians and surgeons agree AHCCCS medical data shows heart, liver, lung, pancreas and bone-marrow transplants work. On this Valentine's Day, please have a heart and restore Arizona transplant funding NOW!"

Daglas also has a petition on Change.org, which is asking Brewer to restore funding for the program, that has already gathered over 1,890 signatures.

It was big news last month when a Federal Court in Florida ruled that the health care law was unconstitutional, but in the grand scheme of things, it doesn't mean much. Currently, two lower courts have upheld the law's legality, one court has found the individual mandate unconstitutional and the FL case ruled the entire law illegal. That makes it about 2-2.

So the law is likely headed for the Supreme Court to ultimately arbitrate its fate. And the GOP wants to expedite this process; 28 Republican Governors recently sent a letter asking Obama to support a fast-tracked appeal of the lawsuits that challenged the Affordable Care Act.

But many advocates and groups are angry that their state government is spending precious time and money pursuing these lawsuits instead of moving forward with implementation. One of these groups in Progress Ohio. They have started a petition on Change.org asking their Attorney General, Mike DeWine, to stop wasting taxpayer dollars on health care lawsuits.

As the Republicans continue their fight to dismantle health care reform, only 16 House members have opted out of their government-sponsored health care. So today, two new ads are calling out specific members on their hypocrisy -- and letting their constituents know that the Representatives aren't always voting in their best interest.

Americans United for Change and DailyKos are sponsoring the local radio ads, which target Wisconsin Rep. Paul Ryan and New Hampshire Rep. Charlie Bass for their vote to repeal the health care law.

"Congressman Bass gets affordable health care, with protections against insurance companies cutting him and his family off. No lifetime limits. No annual caps. No preexisting conditions. But last month Bass voted to deny you and your family these same protections. That’s not equal. That’s not fair," one ad begins (listen to the ad in full).

As much as our country fawns over babies and the unborn, pregnant women are often treated like second-class citizens, at least by the insurance industry. For those women not covered in an employer group insurance policy, access to care is parsed to the point of non-existence.

Last year, an investigation by the House Energy and Commerce Committee found that the individual health insurance market regularly denies pregnant women coverage and limits their ability to purchase maternity care. The four largest for-profit insurance companies listed pregnancy as a medical condition "that would result in automatic denial of individual health insurance coverage."

In California, one legislator is looking to change that. Senator Noreen Evans has introduced SB 155, which would ensure health insurance access for pregnant women. Currently, group insurers and HMO's are required by law to cover maternity services, but individual plans aren't. As a result, the number of individual health plans that included maternity coverage dropped from 82 percent in 2004 to just 19 percent in 2009.

In Arizona, the situation for transplant patients has gotten so dire that students are holding benefit concerts to help pay for life-saving treatments denied by the state.

Recently, students at Seton Catholic Prep High School raised $10,000 for their assistant basketball coach, Tiffany Tate, who has cystic fibrosis, a chronic lung disease. Diagnosed at four months, Tate, now 27, was enrolled in the state's organ transplant program until Governor Jan Brewer cut funding last year.

Tate had qualified for a double lung transplant, but after being dropped from the program, the surgery was exorbitant -- $250,000 out-of-pocket. As covered on the Examiner.com, the community has held various fundraising programs to help pay for her life-saving operation -- golf tournaments, a silent auction and donations.

The students did their part for the coach by holding a benefit concert and raising funds online through the National Transplant Assistance Fund.

Yesterday, patients, nurses and consumer advocates protested in front of Blue Shield's San Francisco headquarters, calling out the company's refusal to delay their massive rate hikes and their penchant for denying millions of health care claims. But even before the protesters had a chance to pack up, the insurer did an "about-face", agreeing to halt the hikes.

The company still might be able to go ahead with their premium increases for individual policyholders -- raising rates by as much as 59 percent -- but it does show that they are responding to public outrage over their defiance.

Last month, California's Insurance Commissioner Dave Jones' requested that four companies delay an increase in their rates so he could review their legality. Aetna, Anthem Blue Cross and PacifiCare all agreed, but Blue Shield refused. This was insult to injury for some policyholders, who had seen their rates upped three times since October; some policyholders received the news of the rate hikes all at once.