Thursday, March 31, 2011

10 Reasons to Feel Good About Health Reform

John McDonough, Professor of Public Health at Harvard, explains the ten reasons why we should be feeling good about health reform at Kaiser Health News:

1. A lot of Americans are being helped by reform every day. Who? Four and a half million early retirees, 3.2 million seniors protected from the doughnut hole and 2 million more kids in Medicaid and CHIP; plus the uncounted millions who now have coverage of clinical preventive services, the many families that can keep adult children up to age 26 on their health plans, the consumers now protected by the prohibition of rescissions and many, many more. If these benefits are not recognized adequately by those receiving them, just wait until there is a genuine threat to eliminate them.

2. Because of the health law, a wave of innovation is now energizing the U.S. health system -- driving the most vibrant reform atmosphere ever. Affordable care organizations; medical homes; disease prevention and wellness initiatives; anti-fraud and abuse efforts, insurance exchanges -- these are all part of the series of dynamic change processes triggered by the overhaul. Even in terms of health care workforce reform, despite a congressional stalemate that is stalling the launch of the new Workforce Commission, the field is exploding with activity, according to George Thibault, president of the Josiah Macy Foundation, which focuses on workforce innovation. Contrast this dynamism with the funk following the 1994 collapse of the Clinton Health Plan.

3. The Obama administration has managed successfully the development of a lengthy list of complex and politically charged regulations to implement the law. Each process faced a chorus of critics predicting negative outcomes. Instead, skilled professionals at the Departments of Health and Human Services, Treasury and Labor, as well as the White House, mastered each controversy, worked through the minefields and established the parameters of a new health care marketplace that puts consumers and patients first.

4. The administration has demonstrated how flexibility can show strength, not weakness. Waiver approvals involving medical loss ratios and annual limits have been dissed by critics. Yet one can easily imagine their opposite complaints of rigidity had the administration denied any waivers. The key date is 2014, not 2011, and the Obama team has kept its eyes on that goal. President Barack Obama's embrace of state experimentation is another welcome sign that strengthens rather than undermines the measure's future.

5. As the dust settles, the constitutional challenges seem a lot less scary. The scorecard of major decisions is 3-2 in favor of the individual mandate. Charles Fried, Ronald Reagan's solicitor general, told a Senate panel: "The health care law's enemies have no ally in the Constitution." Increasingly it is clear that a decision based on the law will uphold the ACA's most controversial provision, and a ruling based on politics will go the other way. And if the mandate goes down, there are other approaches at hand.

6. All key stakeholders are all sticking with the law. No observable erosion in support has occurred among hospitals, physicians, pharmaceutical/biotech/medical device companies, labor groups or consumers. In January, House Republicans predicted substantial desertions by House Democrats, and wound up with only three Democratic votes for their repeal effort. The only visible chink is on the other side of the debate -- the business community's evident non-interest in hyping repeal. In state after state, the hard work of implementation is moving forward.

7. An improving economy will help. In 1988, Massachusetts passed a major health reform law, which preceded a major economic downturn by months. The ensuing collapse destroyed any chance for implementation. Conversely, had the Clinton health reform plan passed in 1994 while the national economy was still crawling out of a downturn, implementation in the mid-to late-1990s would have been much easier than that early Massachusetts experience because the nation was experiencing an economic boom. The best time to pass major health reform legislation is near the bottom of an economic downturn, with implementation happening when the economy is back on track. And that is how it will play out this time around for the health law.

8. The federal deficit is a growing advantage. When the overhaul was signed in 2010, the Congressional Budget Office estimated$143 billion in 10-year deficit reduction -- from 2010 to 2019 -- because of the law. In February, the CBO updated its 10-year deficit reduction estimate -- spanning 2012 to 2021 -- to $210 billion. That number will grow year by year as the measure's savings and revenues take full effect, making repeal harder and harder.

9. Public opinion is sharply against total repeal, with only 21 percent support according to the March Kaiser Family Foundation tracking poll. (Kaiser Health News is a program of the Foundation.) Overall numbers in public support are still sharply divided -- 46 percent unfavorable to 42 percent favorable. Yet on all key elements of reform, except for the mandate, the public supports the law and opposes repeal.

10. The single most devastating blow for implementation would be election of a president who supports the health law's repeal. Though it is a long way to November 2012, the odds-on favorite now (see Intrade at 64.0 percent -- 3/21/11) is the one candidate who supports full and effective implementation of the reform measure.


Thursday Themes

This is one of those weeks that seems to have an extra day in it. Here's the news:

It seems like the groundwork for a budget compromise has been laid, but compromise is a tough sell for the Tea Partiers in the House. The leadership and White House apparently have agreed to $33 billion in cuts, although they haven't agreed on exactly what to cut in order to get there. Tea Partiers are still calling for no compromise, and there's still that tricky issue of defunding health reform, environmental regulations, and Planned Parenthood. Dems still say they will block any such efforts. Senator Harkin says the Senate will not allow defunding of health reform. But Tea Partiers plan a demonstration outside the Capitol today to show GOP leadership that they are not interested in compromise. But VP Biden says a deal has been made. I guess we'll see.

Of course, this is just the 2011 budget. The 2012 budget brings a new set of issues. GOP budget chief Paul Ryan says that their proposal won't cut Social Security, but it will tackle Medicaid and Medicare.

The House GOP freshmen have decided to target AARP over its support of health reform. They claim that AARP has a conflict of interest because it sells Medicare supplemental policies. I suspect it's not really smart to try to take on AARP.

And in a new strategy to defund reform, House GOP want to subject the long-term funding authorized by the health reform law to the annual appropriations process, where they could kill the funding much more easily. Senate Dems surely would block this move.

Virginia's Attorney General says his health reform lawsuit has a 60% chance of prevailing.

Long-awaited regulations on accountable care organizations are expected to be released today. Want to know the basics about accountable care organizations or ACO's? Read FAQs here.

Under health reform, adults up to 133% of the federal poverty level will become eligible for Medicaid. In some states, like Connecticut, adults above that level already are covered, at a cost that's split evenly between the state and federal governments. Advocates are concerned that, when health reform is fully implemented, people above 133% of the federal poverty level will be moved from Medicaid to a subsidized private insurance policy through the Exchange. The concern is that this may not be as affordable for these consumers. So they support -- and I agree -- the creation of a Basic Health Program, which is another option under health reform. This Program would be federally funded. Providers oppose it because reimbursement rates under government-funded programs tend to be low.

As many as 1 in 5 people don't take prescribed medications because of the cost. This poses a severe health issue as people with chronic illnesses fail to follow doctor's orders due to cost. If you have trouble affording your meds, go to NeedyMeds, click on brand name or generic, find your medication by letter of the alphabet, and apply to get it free or at a discount.

A new initiative has been launched to encourage women to be tested for heart disease.

And that's it for this Thursday morning. Have a great day. Jennifer

Wednesday, March 30, 2011

Two Victories

The White House released the following two announcements this afternoon that I thought warranted sharing:


WASHINGTON – The U.S. Department of Housing and Urban Development today announced that Charles Schwab Bank has agreed to pay $30,000 settling allegations that the bank refused to accept a loan application from the adult son of a Metairie, Louisiana woman with disabilities. The son, who was acting with his mother’s power of attorney, tried to apply for a loan on his mother’s behalf, but was told that the bank did not accept powers of attorney for “incapacitated borrowers.”

“Lenders must ensure that their policies take into account the needs of all borrowers and do not discriminate against persons with disabilities,” said John TrasviƱa, HUD Assistant Secretary for Fair Housing and Equal Opportunity. “HUD will continue to work with lenders to make sure that their policies and practices make lending opportunities available to everyone.”

The settlement follows a HUD investigation of a complaint against the San Francisco-based bank from a woman with disabilities who said the bank rebuffed her son’s attempt to submit a loan application over the phone on her behalf. The son alleged the bank advised him that it does not accept a power of attorney for “incapacitated borrowers” during the application process and refused to accept the loan information the son offered, despite the fact he had power of attorney for his mother. The Fair Housing Act <> makes it unlawful to have policies that discriminate or have a discriminatory effect against persons with disabilities.


WASHINGTON – The Justice Department has reached a settlement with Inova Health System to ensure effective communication with individuals who are deaf or hard of hearing in the provision of medical services. The agreement, under the Americans with Disabilities Act (ADA) and the Rehabilitation Act, resolves a complaint that Inova failed to provide sign language interpreters to an expectant mother and others who are deaf and need interpreters to communicate effectively with health care providers.

The department’s lawsuit, filed yesterday with a consent decree in the U.S. District Court for the Eastern District of Virginia, alleged that Inova Health System violated the ADA and the Rehabilitation Act by failing to provide appropriate auxiliary aids and services, including sign language interpreter services, to deaf individuals at Inova Fairfax Hospital. Because of the hospital’s failure to provide sign language interpreter services, deaf individuals were denied the benefit of effective communication with hospital staff, the opportunity to effectively participate in medical treatment decisions, and the full benefit of health care services provided by Inova Fairfax Hospital, according to the complaint.

“The ADA protects the right of individuals who are deaf or hard of hearing to be able to access medical services, and this settlement is the latest example of the Justice Department’s unwavering commitment to enforcing the ADA,” said Thomas E. Perez, Assistant Attorney General for the Civil Rights Division. “This settlement also demonstrates Inova Health System’s commitment to provide effective communication to people who are deaf or hard of hearing.”

“This settlement shows that Inova and the government share the same goal – making sure that deaf and hard of hearing patients can communicate with their doctors, especially at critical moments in their medical care,” said Neil H. MacBride, U.S. Attorney for the Eastern District of Virginia.

The consent decree, which must be approved by the district court, requires Inova Health System to pay $95,000 to aggrieved individuals and a $25,000 civil penalty; provide training to hospital staff on the requirements of the ADA and the Rehabilitation Act; and adopt specific policies and procedures to ensure that auxiliary aids and services are promptly provided to patients or companions who are deaf or hard of hearing. Inova Health System has also separately agreed to pay a total of $25,000 to two other aggrieved individuals.

The ADA and Rehabilitation Act prohibit discrimination against individuals with disabilities by hospitals. Among other things, the ADA requires doctors, hospitals and other health care providers to provide equal access to patients and companions who are deaf or hard of hearing. When medical services involve important, lengthy or complex oral communications with patients or companions, hospitals are generally required to provide qualified sign language interpreters and other auxiliary aids, free of charge, to individuals who are deaf, are hard of hearing or have speech disabilities. The appropriate auxiliary aid to be provided depends on a variety of factors, including the nature, length and importance of the communication; the communication skills and knowledge of the individual who is deaf or hard of hearing; and the individual’s stated need for a particular type of auxiliary aid.

Those interested in finding out more about this settlement or hospitals’ effective communication obligations under the ADA may call the Justice Department’s toll-free ADA information Line at 800-514-0301 or 800-514-0383 (TDD), or access its ADA website at <> . ADA complaints may be filed by email to <> .

Afternoon Update

So there are enough doings about the budget that I thought I would update you now rather than waiting until tomorrow morning.

The conservatives in the House have introduced legislation that would automatically make the House GOP budget law if the government is close to a shut-down. Of course, this is entirely symbolic; if the Senate didn't pass the House budget, they won't pass this, either. But onward the House GOP goes, with freshman GOP announcing that they will hold a protest at the Senate for not passing their bill. And the harm that would come of a shut-down is starting to sink in. Although there are contingency plans, a shut-down would threaten the social safety net.

But the kind of cuts the GOP are insisting on would threaten not only our domestic interests, but also our foreign policy.

So we have to hope that the parties will talk and reach a compromise, as some are trying to do.

And while I'm at it, on health reform, the Tea Partiers are having some impressive success in blocking implementation of health reform.

And there -- you're up to date! Jennifer

Jonathan Cohn: High Deductible Plans

The ever fabulous Jonathan Cohn writes about high deductible health insurance plans. Conservatives think these are good things. If consumers have to worry about how much their health care costs, they won't use as much of it. But is that really a good thing, Cohn asks? Not so much. People skimp on important health care -- like prevention -- and that leads to more expensive illness down the line. Jennifer

Hump Day Headlines

I am looking forward to meeting with my wonderful colleagues to talk about how we think the new Exchanges ought to operate. Here's a primer on Exchanges courtesy of WaPo.

But first, the news:

Again, more evidence that the budget battle in Congress isn't really about the budget at all; it's about defunding health reform and Planned Parenthood -- and throw in gutting environmental regulations, as well. Speaker Boehner says "it's not just about funding." Is it legit to refuse to pass a budget because of items that have nothing to do with the budget? Then again, WaPo reports that the House GOP is looking for moderate Dems to form a consensus view so a budget can be passed without the conservative Tea Partiers in the House, who will defect if the social programs are not cut. This deal would involve about $30 billion in cuts -- something the Senate could live with. Speaker Boehner is in a bind; if he sticks with the Tea Partiers, he's leading us to a shut-down, but if he compromises with Dems, the Tea Partiers will revolt. Majority Leader Eric Cantor is moving right as Boehner moves towards a deal. But there's real fear of a government shut-down. So much so that Senate leader Reid has said he'll look at the social policy riders. And GOP Senator Lindsey Graham urges Speaker Boehner to compromise. Meanwhile, some conservatives are calling it a slow down rather than a shut down, as if that makes it better.

And in other news, the Senate will vote on 3 versions of 1099 (bookkeeping requirement) repeal today. This is one of the pieces of health reform that needs fixing, and it's taking way too long.

Trade groups, including the US Chamber of Commerce, want to halt health reform implementation until the Supreme Court rules. Not gonna happen. Oh - and by the way, these groups oppose health reform generally, so it's not just about a time frame.

A new report shows disparities in health care in the DC metro area, with the poor, less educated, and single-parent households struggle to get care.

As you know, Mitt Romney was Governor of Massachusetts when universal, mandatory health care coverage became law. He's being criticized for that now, as he readies for a Presidential bid. Well, yesterday, the architect of the Massachusetts law said "RomneyCare" not only was a great step forward, and not only did it pave the way for the federal health reform law, but Romney was a full participant and supporter. MIT's Jonathan Gruber says Romney's opposition to health reform now is entirely political.

Do teens have special health care needs that should be addressed by specialists in adolescent care?

And that's it for this Wednesday morning. Have a great day! Jennifer

Tuesday, March 29, 2011

Tuesday's Tidbits

It's getting ugly in Washington over the budget. Let's see what's in the papers:

Congress is at an impasse on the budget. They can't decide on the starting point for negotiation -- do we cut from current spending levels, or do we start from the House bill that cut $61 billion and defunded health reform and Planned Parenthood? The Dems say we cut from current spending levels -- and they've already cut $10 billion in the last two temporary budgets. The GOP says discussions have to start from their proposal, which contains the poison pills of defunding, which the Dems are not prepared to consider. Are we heading towards a show-down and/or a shut-down? The Wall St. Journal says a shut-down is likely. Politico says it's really about the "riders" -- defunding health reform and Planned Parenthood -- because the GOP has to please the Tea Partiers. Conservatives are, indeed, challenging the GOP leadership and expecting huge cuts in Medicaid and Medicare for the 2012 budget -- which they haven't started even looking at yet. Dems are trying to force GOP leadership to choose between the Tea Party conservatives or a compromise deal that would alienate the Tea Party -- and it's not clear that the GOP would have the votes in the House without the Tea Partiers. What would a shut-down look like? HuffPo describes it here.

And several religious leaders have gone on a hunger strike to protest the GOP budget cuts to the safety net programs that care for the poor, the sick, the elderly. They say the budget is a moral document.

Meanwhile, the cost of health reform won't really be known for sure until HHS announces the "essential benefits package" -- what has to be covered by the plans offered through the Exchange. The Institute of Medicine is working on proposals. But it's going to be tricky -- being generous enough so people aren't outraged by limitations on benefits, while being limited enough not to break the bank. This is one of the most important pieces of health reform, and we're all sitting on the edge of our seats waiting to see how it plays out.

A new report says Medicaid is wasting money on brand name drugs when it could have used generics.

The federal Office of Policy and Management has asked insurers to provide incentives to federal government employees for wellness programs.

Despite the national debt, although members of Congress may return all or part of their salaries, none of the millionaires in Congress does so.

Michigan -- a state with HUGE unemployment -- has cut unemployment benefits by 6 weeks. Does this make sense to anybody?

Nurses are playing an increasingly greater role in health care -- especially primary care.

A new study shows that roughly half of men don't go to the doctor. Not even for an annual check up. Which means they don't get preventive care. Which means when they get sick, it may be too late.

Some say the way to combat rising health care costs is through innovation. One option is medical homes, where the patient and primary care provider coordinate care, plan care, and oversee the whole patient. Intensive care units are getting a makeover. Mobile technology for medicine is a booming industry, like cell phone-sized portable ultrasound machines. And then there are accountable care organizations -- large groups of providers making one-stop medicine the goal.

Hospitals increasingly use palliative care -- care that makes you feel better by dealing with pain, shortness of breath, fatigue -- and result in better health outcomes.

Most doctors who write clinical guidelines have conflicts of interests, a new study shows. This study was in cardiovascular medicine.

And that's today's news. Jennifer

Monday, March 28, 2011

Monday Moaning

Monday came extra early this week. My feet still hurt and my body is still tired after all the Team McCready partying on Saturday. I guess it's back to the grind, so here's the news:

According to a new study, Americans spend about 19.9% of an average family's household income on health care related costs. That number includes over-the-counter costs, alternative medicine, and so on.

And in another new study, it's shown that high deductible health insurance plans do cut health costs, but they also keep people from getting preventive care, immunizations, and other services that would improve their health. A good trade-off? Uninsurance to under-insurance? I don't think so

As Congress returns this week, we will be back to the budget. There's a lot of hand-wringing over the national debt. Still, the parties remain far apart. The Dems are coming up with more cuts, but it may not be enough to satisfy the GOP. As Ezra Klein reports, the hard part isn't the money; it's about the things attached to the budget bill, like defunding health reform and Planned Parenthood. Social conservatives say their issues are central to the economy. For example, they say health reform is a budget buster. And it looks like the GOP is ready to take aim at entitlements -- Medicare and Social Security.

And the states and cities are under the budget knife, as well. Health services are cut in municipalities plagued by the housing bust. And HHS offers the States a list of things they can cut from Medicaid.

A new report provides alternatives to the requirement that everybody purchase insurance.

Some of the rules for changing health insurance appeals have been put on hold -- the rules the insurers have been fighting about, like providing notices in other languages and handling expedited appeals in 24 hours.

So-called mini-med plans -- plans sponsored by employers with low wage workers like McDonalds that cover very limited benefits -- have been granted waivers under health reform until 2014, on the theory that some insurance is better than none.

The GOP going after AARP for its support for health reform? Not smart. And GOP presidential hopefuls are also going after health reform.

How innovation will help stop infections at hospitals and lead to better health care.

Celebrities with diabetes say if they can live with it, so can you.

And that's it for this Monday morning. Have a great day! Jennifer

Saturday, March 26, 2011

Special Saturday Edition

I don't usually blog on Saturdays, but today is very special. Today, the NY Times ran Bob Herbert's last column. He is moving on to write longer pieces and a book. I will miss him.

His last column explains how America has lost its way, spending billions of dollars on wars abroad when our citizens don't have jobs and health care and basic needs. He is as eloquent as always as he sounds the alarm that has been going off in my head for a while now, and especially since we entered Libya.

Don't miss his last column. It's quite special. Even if you disagree, I think you will appreciate his passion and commitment. Jennifer

Friday, March 25, 2011

More Health Reform Victories

Today's the last day of the week in which we have been celebrating the successes of health reform. So here are another couple of stories:

Doris called from Missouri. She has a fourteen year old son with ulcerative colitis and she could not find him insurance anywhere due to his pre-existing condition.

Lucky for Doris, she called me in August 2010. On September 23, 2010, the Affordable Care Act’s consumer protections would kick in, I explained. That meant that she would be able to find her son insurance because insurers no longer could refuse to cover children under age 19 with pre-existing conditions.

Due to the Affordable Care Act, Doris’s son is insured.


Miriam called from West Virginia. She’s a college student with Crohn’s disease. She’s doing really well on Remicade treatments, but she lost her insurance and does not know what to do.

We went at this from many directions. With a pre-existing condition, she could get into the new Pre-existing Condition Insurance Plan, but that is a little too expensive for her. Still, there was nothing else.

Until I asked: Do your parents work? Do they have insurance?

Miriam had aged out of her parent’s policy a couple of years earlier. However, she is not yet age 26.

And there was the answer. Under the Affordable Care Act, she had to be offered an opportunity to go back on her parent’s policy. Her parent contacted their employer’s human resources department and Miriam was re-enrolled in her parent’s policy as a dependent for even less money per month than the Pre-existing Condition Insurance Plan would have cost.

Miriam will now have insurance coverage until she reaches age 26, thanks to the Affordable Care Act.

So you can oppose health reform if you want, but you can't deny that it's providing critical assistance to your fellow Americans. At the very least, before anybody thinks about repealing or defunding it, how about we figure out how to preserve the parts of it that are really good, that are helping people receive the care they so desperately need. Jennifer

Finally Friday Edition

The end of the health reform anniversary week, and the day before our big fundraiser , here's the news:

As pressure to deal with the deficit mounts, Dems weigh whether to tackle Social Security. This is sort of interesting because Social Security is paid for out of its own fund and has absolutely nothing to do with the deficit. If they were looking at Medicare and Medicaid, although I'd be really nervous, I'd understand it. But Social Security? Makes no sense. Meanwhile, though, the Dems and advocates try to come up with a response to the GOP's huge Medicaid cuts, bracing for some cuts, but hoping they will be far smaller than the GOP proposal.

The GOP are also preparing to ratchet up the heat if another short-term budget deal is needed in the absence of an agreement by April 8, when the current funding runs out. They want to tack on defunding of the programs they don't like -- health reform being number one. This may be needed to satisfy the Tea Party conservatives and get enough votes in the House. But this sort of deal has already been rejected in the Senate, and the President will never sign it. Are we heading towards gridlock and a shut down? Everybody hopes not, but there's no clear path to compromise.

Indeed, Senate Dems plan to use health reform to help them in 2012. They are banking on polls that show most Americans don't want full repeal or defunding. They are betting that GOP candidates are going to have to keep promising repeal or defunding to hold onto the hard right, and this will alienate moderates. I guess we'll find out!

Amidst all the budget cutting, Lance Armstrong heads to DC to push for more cancer funding. He says cancer is not a political issue. Health care shouldn't be, either.

The Government Accountability Office says if you're denied coverage of a prescribed treatment, file an appeal. 39-59 percent of appeals are successful. Our rate is about 85%. And if you need to dispute a medical bill, here's some important info that will help you negotiate a good resolution.

This is a really important story. A child has a life-threatening peanut allergy, so her parents go to the school and ask for accommodations -- the other kids have to wash their hands and faces when they come to school and after they eat, and rinse out their mouths as well, to avoid contaminating the child with the allergy. The other parents raise a huge fuss, suggesting that the allergic child be home-schooled. The school finally caves and eliminates the requirement that the kids have to rinse their mouths. WHAT ARE THESE PARENTS THINKING? You should have to home-school your child because she has a disability? The truth is I've heard this many times before. We have sick kids quarantined in their homes for no other reason than they're sick and the school won't figure out a way to meet their special needs. This is TOTALLY against the law, but it happens every day.

In what has to be a disastrous move, Michigan cuts unemployment benefits and other states consider doing the same. In Michigan, it was part of a compromise to preserve the 20 weeks of federal unemployment by reducing future aid for the unemployed.

The marvelous Dr. Pauline Chen explains why it's safe to have residents in the operating room when you go under the knife.

Americans are into sleep deprivation, called "sleep machismo." I sort of get that. And sleep-deprived people eat more calories a day -- in search of the sugar rush.

And that's it for this morning. Have a great day! Jennifer

Thursday, March 24, 2011

More Health Reform Victories

All week, in recognition of the anniversary of health reform, we have been posting stories of health reform successes. Here are two more:

Melanie lives in New York. She has dilated cardiomyopathy, which has caused congestive heart failure. She received an artificial heart called a VLAD, but she needed a heart transplant.

The heart transplant would cost nearly $1 million. However, her insurance had a lifetime limit of $200,000. Melanie was distraught, not knowing what to do.

Because of the Affordable Care Act, though, Melanie’s lifetime limit would be eliminated at the start of the next plan year, which was only about a month and a half away.

Melanie’s heart belongs to the Affordable Care Act.


Naima called from Reno, Nevada. Her four year old daughter was born with jejuna atresia and had half of her small and large intestines removed. As a result, she has a feeding tube and never will be able to eat solid foods.

Naima called because she has tried to get Medicaid, but was turned down because Naima’s husband works and makes too much money to qualify. However, neither he nor Naima had insurance through work to which they could add their daughter.

So Naima had decided that she would fundraise to help pay for her daughter’s health care, including the feeding formula she needs to survive. I explained, to Naima’s disappointment, that non-profits cannot fundraise on behalf of an individual person, so we could not help in that respect.

However, I had another idea. What about the new Pre-Existing Condition Insurance Plan? For less than $300 per month, Naima’s daughter would be covered, and the benefits under the plan covered the majority of her daughter’s needs.

Naima was thrilled – another beneficiary of the Affordable Care Act.