Uninsured medical expenses and the Affordable Care Act

The implementation of the Affordable Care Act (ACA) may lead to a significant spike in the number of Americans covered by health insurance. However, even for patients who have insurance, a health crisis can still often become a financial crisis. This can include members of your own family as well as your friends, neighbors, and co-workers. According to the chief professional officer of the United Way of the Titusville Region, as many as one in three bankruptcies in the U.S. is now a result of uninsured medical expenses.[i] Very often, this situation affects people who need a transplant or are living with a catastrophic injury or illness and who are unable to cover unexpected out-of-pocket expenses related to their medical care.

The Congressional Budget Office projects that health insurance marketplaces created by the ACA will cover seven percent of the U.S. population, or 30 million people.[ii]There are a few aspects of the law that will have an important impact on the people we serve here at HelpHOPELive. For example, under the ACA, lifetime limits, or “caps,” on spending for essential medical services are lifted.[iii] Individual states will continue to debate an optional expansion of Medicaid through the ACA, with implications for patients who would benefit from eligibility criteria based solely on income instead of factors including age, ability to work and family status.[iv] Our home state of Pennsylvania is trying to opt out of Medicaid expansion under the ACA, instead proposing “Healthy Pennsylvania,” which would extend health insurance to as many as 500,000 residents.[v] Some states are taking advantage of ACA funding for a program aimed at removing existing barriers to providing long-term care at home, an option the disability community has pushed for that could help more people to live with greater independence.[vi]

In spite of these changes, medical expenses can still add up quickly. Even with high-end insurance coverage, there can be significant long-term out-of-pocket expenses related to transplants or the treatment of many catastrophic injuries or illnesses. What many people don’t realize is how severe these financial challenges can be. It’s a major and ongoing problem affecting thousands of families in our country.

Consider just a few examples. Yearly costs for a C-6 quadriplegic can range up to $111,000. Transplant patients regularly have to cover $600-$1,000 per month in out-of-pocket medication co-pay expenses. Many patients who are dealing with paralysis after a catastrophic injury need to make renovations to their homes or find new transportation options. They may be unable to continue working. Others may need help with travel to specialized treatment centers or even relocation for an extended period of time.

While uncovered and often long-term medical expenses can be overwhelming, for many there is a network of support right in their community that is anxious to help. Funds raised through HelpHOPELive community campaigns support the specific financial needs of each patient. We use a highly personalized approach, working closely with each patient and their family and friends to identify a fundraising plan of action that fits their unique needs. By supporting the work of HelpHOPELive, you can make a difference in the lives of thousands of people who need a transplant or are affected by a catastrophic injury or illness every year.

[i] The Titusville Herald. “Health care law guidance available through United Way.” December 18, 2013. http://www.titusvilleherald.com/articles/2013/12/18/news/doc52b10f9a3fafd567411005.txt.

[ii] Kliff, Sarah. “Don’t believe the hype: Health insurers think Obamacare is going to be fine.” Washington Post. January 15, 2014. http://www.washingtonpost.com/blogs/wonkblog/wp/2014/01/15/dont-believe-the-hype-health-insurers-think-obamacare-is-going-to-be-fine/?wprss=rss_ezra-klein&clsrd.

[iii] Guss, Stewart. “How Does Obamacare Affect My Personal Injury Accident Claim in Texas?” November 17, 2013. http://attorneyguss.com/how-does-obamacare-affect-my-houston-personal-injury-accident-attorney-claim-texas/.

[iv] Stewart, Kristen. “Teen battling cancer awaits Utah Medicaid expansion.” The Salt Lake Tribune. January 15, 2014. http://www.sltrib.com/sltrib/news/57394474-78/medicaid-expansion-federal-health.html.csp.

[v] Calandra, Robert. “Questions persist about Corbett’s health-care plan.” The Philadelphia Inquirer. January 12, 2014. http://articles.philly.com/2014-01-12/news/46116378_1_medicaid-program-medicaid-recipients-healthy-pennsylvania.

[vi] Vestal, Christine. “ACA Spurs State Shift in Long-Term Care.” Stateline: The Daily News Service of the Pew Charitable Trusts. January 17, 2014.http://www.pewstates.org/projects/stateline/headlines/aca-spurs-state-shift-in-long-term-care-85899534029.

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