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No More Denials For Pre-Existing Conditions

Updated: Wednesday, September 18 2013, 08:07 PM CDT
No More Denials For Pre-Existing Conditions story image
By: Grace White
Follow Grace on Twitter @Grace__White & on Facebook

At 28-years-old, Sarah Pascual never expected this.

"When I first found it, I was in disbelief," she said.

She was diagnosed with breast cancer and she's uninsured.

"It's very stressful to go look for medical help when you don't have insurance. You are constantly thinking in the back of your mind, how am I going to pay for this?"
 
Starting in 2014, for patients like Pascual, that's supposed to change. Under the Affordable Care Act, health insurance plans can't refuse to cover you because of pre-existing conditions.

"Hopefully we will see an improvement in health, it's a two way street, people have to take responsibility but hopefully they won't have the hurdle of I can't find coverage," said Dr. Katherine Safford, medical director for WINGS, a non-profit that assists uninsured breast cancer patients.

That coverage comes with a cost.

"I expect that if all of a sudden they have to take on people with illnesses they weren't paying for before... that means their costs go up and their premiums have to go up," said Dana Forgione, a professor at U.T.S.A.

Forgione expects overtime costs will come down.

"Long term you would hope they will come back down again as more people enter the system, more people are paying into the system and you don't have that exacerbation of disease states that are caused by the waiting periods," he said.

In the meantime, Pascual is getting creative.

Instead of monetary donations, she's asking family and friends for blood donations.

It's a program University Health System uses to give patients discounts on their mounting bills.

"I am hopeful that one day there can be a universal health care that won't discriminate against pre-existing conditions," she said.
 
Pascual says she doesn't want to be defined by her breast cancer

Join us next Wednesday for a look at how healthcare reform affecting patients in our area with diabetes.

In the meantime, you can find more information about the new laws on our website.

We've dedicated a special part of our site, just click on Insuring Texas' Future.

No More Denials For Pre-Existing Conditions
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October 1, 2013

1. Additional Funding for the Children's Health Insurance Program (CHIP)

2. Under the new law, states will receive two more years of funding to continue coverage for children not eligible for Medicaid.


January 1, 2014

1. The Health Insurance Marketplace is established

2. You must buy coverage or pay a fee to offset costs of caring for uninsured Americans.

3. Medicaid program expands. Federal government to pay 100% of costs for first three years.

4. Tax credits given to people who can't afford care.

5. Ensures coverage for individuals participating in clinical trials

6. Annual limits on insurance coverage eliminated.

7. No discrimination due to pre-existing condition or gender

8. Small business health insurance tax credit increases

Read more at: http://HealthCare.gov



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