Mike DucheineUSA. Sobbing inconsolably, 40-year-old Gerry Conze of Brooklyn, NY, remembers his mother who died more than five years ago. She was 63 and had just suffered a stroke. “The insurance refused to cover the expenses for her treatment,” he said, pausing at almost every word. “The hospital was doing the bare minimum to keep her alive, waiting to find out who was going to pay for the expenses. I couldn’t. In the end, she didn’t make it.”
Mr. Conze’s situation was one of several dozen such cases at Kings County Hospital in Brooklyn, NY. In fact, over the past years, the decision of healthcare providers not to insure individuals with pre-existing conditions has created a river of human casualties flowing over its banks. “On the [hospital] floor where my mom was, two, three people died every day because insurance would not pay for their treatments,” Mr. Conze recalls.
A 2009 study conducted by the American Journal of Public Health puts the number of casualties due to pre-existing conditions at 45,000 deaths per year. This number rises even higher when factoring in the uninsured who have succumbed to poor health, without the opportunity to seek treatment.
The casualties continue to climb as insurance providers have mastered the art of denying coverage to more and more applicants. According to a congressional investigation conducted by the Committee of Energy and Commerce in 2010, more than half a million applicants were denied coverage by the four largest health insurance providers in the nation (Aetna, Humana, UnitedHealth Group and WellPoint) from 2007 to 2009. That’s one out of seven applicants who could not obtain coverage because of pre-existing conditions, an increase of 49 percent in the two-year period. During the same time frame, the insurance providers rejected 212,800 claims for individuals who were already insured, based on their previous medical conditions.
Insurance companies denied coverage to 172,400 people in 2007 and 221,400 people in 2008. By 2009, the number of individuals denied coverage rose to 257,100. Between 2007 and 2009, the number of people denied coverage for pre-existing conditions increased 49%. During the same period, applications for insurance coverage at the four companies increased by only 16%. | Committee on Energy and Commerce, 2010.
Such practices were initially said to end with the passage of the Patient Protection and Affordable Care Act (PPACA, also known as Obamacare) on March 23, 2010. Residents in all states are temporarily protected under the Act, but ultimately, less than half the country may actually benefit.
26 leaning Republican states have opted out of Obamacare and even some conservative leaning Democrat states are threatening to make the transition difficult. The fast approaching January 1, 2014 deadline, which will require all insurers to comply with Obamacare, is likely to change the landscape for patients with pre-existing conditions who live in one of the states opposed to the Act.
Anxiety is high among these individuals. “It feels like we’ve been given a death sentence,” says Mrs. Greene, whose 49-year-old husband was diagnosed with Kaposi Sarcoma, an AIDS-related form of cancer, in 2009. Together, they live in Green Bay, Wisconsin, one of the states that do not favor PPACA. “I don’t know how much time I have left,” says Mr. Greene. “The governor vows to get rid of Obamacare. As soon as he does, the insurance will stop paying for my treatment.” Already in 2009, Mr. Greene’s insurance company declared his cancer a pre-existing condition.
It’s a refrain that’s heard everywhere, across the country. The effects of the insurers’ callous decisions have yet to subside, as hundreds of thousands of individuals who were at one time or another denied coverage are now fighting for their lives. It’s too late for some, unsuccessful mostly for others. With more states opposing Obamacare than those that have embraced it, mountains of human casualties, due to pre-existing conditions, will continue to grow.