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.