I too share the frustration of our country’s increasing debt, more bureaucratic regulations to follow and political system gripped in gridlock. Years ago I realized that I could not change the system; I can only work within it. While I alternate between blind optimism and alcohol to ameliorate the angst of a broken political system, I find no solace in painting the canvass of America with a broad brush of hate.
Recently I read two comments, somewhat representative of the political polarization of our citizens, that were directly at odds with the tasks that faced me. Both comments were made in regards to business closings in California.
- I’m so disgusted with the way politics is in California..and the US…when the liberals took over everything went to hell…sorry.
- The lunatics have taken over the asylum……
Working the liberal changes
On my morning “To Do” list was researching how the new coverage for autism treatment in California would help a mother who had grave concerns for her little boy and preparing paper work for a gentleman without health insurance to participate in California’s Pre-Existing Condition Insurance Plan program. Neither of these options was available to these folks 4 years ago.
Help for Autistic children
Under SB946, California mandated that health insurance plans cover treatment for autism through Applied Behavioral Analysis (ABA) as of July 1, 2012. However, getting approved for treatment is not as simple as walking into a doctor’s office with a sore throat. There is a specific set of steps that must be followed before the health insurance will recognize the condition and approved treatment.
Liberal options provided
Even though it is mandated, every health insurance carrier is a little different on how they approach the condition and treatment. There are some insurance plans that are exempt from having to provide coverage such as self-funded large group plans. This can instill true exasperation for a parent that just wants to get their child on the best mental health foundation possible. Without the ABA mandate, parents are looking at virtually no care for their children as proper diagnosis and treatment can be expensive.
Middle income challenges
My other challenge was pulling the paperwork together for a gentleman that was without health insurance. After he lost his job, he was on COBRA until that was exhausted. The guarantee issue HIPAA policy was twice as much as the COBRA plan premiums. As a new father with no job he opted to conserve his cash and go without health insurance. He has since picked up a new job but it didn’t offer health insurance.
Bridging the gap until 2014
His pre-existing condition prevented him from being issued an individual policy from a California health insurance company. He knows he has to stay healthy to be a good father for his new daughter. The Pre-Existing Condition Insurance Plan created under the Affordable Care Act will allow him to get health insurance at an affordable rate. The premiums are more than a standard individual plan but less than the HIPAA plans. When the ACA is fully implemented in 2014, the whole pre-existing denial will go way.
Lunatics for politicians
I guess you could say that the lunatics and liberals have created health insurance options for normal people in California and the United States. This is your opportunity to un-friend me, un-follow me, de-list or dis-connect from me; I am proud that government leaders have created programs and opportunities to get treatment for our children and health insurance for parents. I raise my mug of coffee to the lunatics and liberals who understand the barriers and hurdles we all face when it comes to health insurance in America.