Compelled to revisit the subject of the Affordable Care Act (ACA) – The Marketplace Exchanges – & Yes the “ACA” IS the same as”Obamacare” — a slang name mostly from those who are against it — but it has “stuck” and continues to cause confusion.

Above are my ‘famous hands’ that appeared in a Cleveland “Plain Dealer” news article dated Saturday, September 10, 2011 ( updated the next day)
by reporter Sarah Jane Tribble.
Me & my spotlighted worried face
This image has an empty alt attribute; its file name is blue-flower-graphic-for-use-on-cemetery-blog.png

The title of this blog post could easily serve as an introduction to a subject that I felt I had studied and explored in 2010, 2011 and 2012; and then left behind in my rearview mirror by 2013. That is because in 2013 I thankfully (yes thankfully!) turned age 65; and I didn’t have to worry about being rejected for health insurance like I was during the time I was ages 62 to 64.

Imagine going from being age 64 where no private health plan would accept you – branding you as being an uninsurable person. However, when you turn one year older, turning age 65, and with with your same health issues,you then qualify for Medicare where you won’t be rejected?! This is our 20th and 21st Century America! Yes, I totally rejoiced reaching 65 when I no longer worried about being turned down for health insurance. No longer did I have to be fearful that I wouldn’t have to pay more for premiums even if I was accepted; which of course I wasn’t. This was true because I had pre-existing health conditions – none of which were life threatening. I have the rejection letters to prove it!

I learned quickly that when you are rejected by one health insurer, you most likely will be reject by all of them that you apply to that do business in your state.

So, here we are almost another 10 years later and the Affordable Care Act has produced the Marketplace Exchange Plans which varies from state to state. We have to keep in mind that in Ohio, it is a Federally operated plan (not state run), and so a person who wishes to explore more information and perhaps enroll in one of the plans being offered must access that website. That is not to say that there aren’t any resources for information if you have unanswered questions, or wish additional explanations about them.

Here are few links to consider for help.:

HealthCare.gov is the main page for information about the Affordable Care Act – check out the “Connect With Us” section found at the bottom right side.

Find Local Help Link

A PDF listing for 2021 of the insurer slated to offer ACA Marketplace Health Insurance.

Susan G. Komen – Women’s mammograms

The News Room at the Kaiser Family Foundation

Lastly, stay informed with the latest national and state news about the Affordable Care Act (The ACA)

Please consider all there is to lose, for all of us, when you are making your final decision to vote in this upcoming general election. This is true even if you have an employer plan and at present feel secure you’ll be able to keep it. Circumstances out of our control can change the whole picture if we lose our job. There is no “Repeal and Replace” plan coming; only a “Repeal Plan” that would mean you lose the benefits you have provided in the ACA. Please be informed and keep abreast of updates.

Your vote can determine the future of health insurance in America. Throwing what we have away for nothing isn’t a wise choice in my opinion. Thank you.

Let’s keep the word “health” in Pre-Existing HEALTH Conditions!

Let’s think about Pre-existing HEALTH conditions!  Have you noticed lately many in the media and TV say or write:  “pre-existing conditions”?  I guess it is supposed to be silently understood that the word  “health” is implied in that statement; making it less important to actually keep the word “health” whenever references are made to this subject.  Let’s not leave it to individual interpretation if it is there or not; or if it is important to state it or not.

Like what has happened after the PPACA – Patient Protection and Affordable Care Act — the title/name  of  the program started to be more commonly known as the “ACA” — the change was to shorten it and make it easier to remember I suppose. It was also done to counter the fact that Republicans quite sarcastically called this 2010 law “Obamacare” — naming it after President Obama but with a negative stance about it; (which reminds me of a retina specialist I saw back in 2010 when I told him I had no health care insurance, and that I was waiting on the Ohio High Risk Pool to kick in for me to apply a few months later.  At the time, the high risk pools were called “the bridge to 2014” when the Patient Protection and Affordable Care Act plans in the Marketplace Exchanges would be available for everyone (not only children); and the retina specialist said with a smirk “oh you mean Obamacare?” and the tone of his voice told me he thought it was laughable;  and I just answered him “yes”.)

In reality “Obamacare” does not exist as it is not the official name of the Patient Protection and Affordable Care Act.  I feel the words “Patient Protection” are also quite important to keep and repeat because we seem to have lost sight of their being a huge part of the reason the law was enacted.  Protections that include from being denied health insurance altogether due to having pre-existing HEALTH conditions.

No one in Congress, nor the President or anyone in his administration, nor anyone sitting on the Supreme Court bench; nor their families, are having to go without health insurance due to having pre-existing health conditions.  So, it is not fair or just that any American citizen should have to be without health insurance due to having pre-existing health conditions in our  21st Century America.  I have the rejection letters from 2010 from four different health insurance companies to prove that it did happen before the Patient Protection and Affordable Care became law.

Furthermore, a person didn’t need to have a major life-threatening illness to be rejected for health insurance coverage either.  So, why are we shortening “pre-existing health conditions” to only “pre-existing conditions”?  Is it like we shortened the PPACA to ACA to make it easier to remember?  Or perhaps to take the main focus off of the meaning of the word “health“?  Only saying or writing “Pre-Existing Conditions”, unintentionally or otherwise, leaves out the important word “HEALTH“!

Health conditions that exist when a person tries to enroll in health insurance plans are what these insurance companies haven’t forgotten about, and certainly won’t if they are once again allowed to reject people for obtaining any health insurance coverage or charge them ridiculously high monthly premiums in order to cover those pre-existing health conditions.  The answers to the questions on the insurer’s enrollment forms are meant to reveal a full range of health conditions and they do.  The health insurance companies take note of them, tally them up, and deem the potential enrollee either acceptable for enrollment; or brand the person as being uninsurable and the rejection letter is generated and sent out.  If a potential enrollee tries to conceal having pre-existing health conditions on their enrollment form, they will be found out and prosecuted for committing fraud.  Disclosure is on the last page of the normally 8 to 12 page enrollment form before the potential enrollee’s signature line.

We are not “making America great again” whatsoever by allowing health insurance companies to go back to the days when having pre-existing health conditions were used as a reason to reject potential enrollees from access to having health insurance and branded them being “uninsurable”.   Now, isn’t that an undeniably deplorable practice on the part of health insurance companies?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sharing a link published online on November 5, 2018 to an abbreviated version of my post here that appears on Cleveland.com. 

“No Quality of Life” — It can Happen to Anyone.

The Title :

“No quality of life:’ Halifax woman with rare disease paying $60,000 for U.S. surgery”

Please read this story if you have read that you have “Tarlov Cysts” on your MRI report, and your back pain is worsening.  You admit that you are noticing such things happening to you such as the fact that you cannot sit for long periods without feeling like you are sitting on a rock.  It hurts to bend down, twist, stretch, or lift even a half-gallon of milk. 

It is not likely you will find ANY doctor in NE Ohio, or indeed in the entire state of Ohio, who will explain to you what it means to have symptomatic Tarlov Cysts.  But, they will tell you that they do not operate on them.  

Please join several Tarlov Cyst Facebook Groups and read the posts and ask questions – and lots of them!  You will receive a more well-rounded education from other members who are willing to share their journey, and who also suffer from this debilitating disease.  

I personally feel that any Tarlov Cysts are like ticking time bombs in our bodies even if they do not initially present with pain.  Having one fall or being in one auto accident can change it all for a person. 

Please be your own advocate no matter where you live.  The doctors may turn away from you, but those who are also suffering from this horrid chronic pain disease will not.

It is Important to be Informed about Possible Changes for Health Insurance in 2017

“Your Health Care in 2017:  What You Must Know” an in-depth article that appears in “Parade Magazine”dated December 28, 2016, written by Frank Lalli, provides a detailed account of important points regarding the health insurance industry — before and currently under the Affordable Care Act — including Medicare and Medicaid, and the important changes that could lie ahead in 2017.  

This well-researched article offers a great start for a reader to become informed on this subject which affects all Americans in one regard or another.  

Kasich urged to fight Obamacare repeal | The Columbus Dispatch

Warning that nearly 1 million Ohioans could lose health coverage, advocates for the poor and disabled urged Gov. John Kasich to oppose a plan by congressional Republicans and President-elect Donald Trump to repeal Obamacare unless they have a replacement.

Source: Kasich urged to fight Obamacare repeal | The Columbus Dispatch

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My thoughts:

I received a memo from my congressman, David Joyce, yesterday.  Look to what Paul Ryan is pushing; something entitled “A Better Way”

http://abetterway.speaker.gov/?page=health-care

Now, HSAs, health savings accounts, are not going to be helpful for those who have low incomes or little to no incomes. 

Also, currently mammograms, colonoscopies, and prostate screenings are fully covered under insurance plans; I don’t believe that benefit will continue under their “Better Way” plan.

Also, subsidies that are currently in place; I didn’t see that in their plan. 

There are reports of going back to the state run high risk pools where historically there have not been subsidies.

Ohio never could set up their own high risk pool. Check out the reports on that from 2005 when Ann Womer Benjamin was the Director of the Dept. of Insurance and it was discussed where it was stated in a September 26, 2005 report:

“State Sen. Lynn Wachtmann the goal is not to deal with the “masses of uninsured.”

http://www.insurancejournal.com/news/midwest/2005/09/26/60166.htm

There is more to consider beyond the guarantee that a person cannot be rejected for getting health insurance due to having pre-existing health conditions.  What about their monthly premiums?  Will their pre-existing conditions work against them to determine what those monthly premiums will be? 

And, then there are the lifetime caps that insurance plans had in place before the ACA was implemented that were eliminated under the ACA.

Folks need to look at all of the individual benefits currently in place in the ACA (AKA Obamacare — yes they are the same — amazingly some folks still think they are not the same!) and then compare to the provisions stated by Republicans and what they are proposing for their replacement plans.  If you don’t see them mentioned, you can’t be sure that they will be part of their plan.  

Those who depend on ACA plans, and it can be anyone who has a low paying job with no employer-sponsored health insurance, need to understand what the changes mean for them.

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For health and dental insurance help in Ohio, please visit:

“Universal Health Care Action Network of Ohio”

http://uhcanohio.org/

Being called “Deplorable” or “Irredeemable” is one thing –But being deemed to be Uninsurable, that is quite another

During the U.S. Presidential election we just experienced, we read and heard the words “deplorable” and “irredeemable” that were used to try to put certain people who supported a certain candidate into a separate category.    

However, there is another word that comes to mind that we haven’t heard or read about in a while that held a category all of its own that no one would want to be included in if they could help it — “Uninsurable” — meaning not eligible to be insured.  

For reasons such as having sinusitis, consulting for a surgery they did not have, or taking an expensive medication, in other words for having non-life threatening health conditions, people were being denied enrollment in health insurance plans in the private market.  They were left with no choice but to become uninsured.

The reason for putting the term “uninsurable” out to pasture, sort to speak, is that the Affordable Care Act (originally named the Patient Protection and Affordable Care Act  which was signed into law on March 23, 2010, and was fully implemented on January 1, 2014 when the marketplace exchanges began) made being an uninsurable person obsolete.  

Healthcare.gov  is in place and offers health insurance plan choices so people no longer have to face being an  Uninsurable Person — a truly deplorable category that was a reality for some people who had pre-existing health conditions that precluded their obtaining any health insurance in the private market.

On the news tonight it was reported that over 20 million people are now enrolled in “Obamacare”  — yes “Obamacare” is the Affordable Care Act!  Believe it or not there are some people who still do not understand that they really are one in the same. 

So, please, lets close out 2016 by not being deplorable!  Lets not stand in the way of those who would become uninsurable otherwise without the ACA being in effect in 2017 and beyond.  

Surely in 21st Century America it shouldn’t have to be that if you lose your job, you could lose your health insurance if you are deemed to be an uninsurable person.

 

 

Tarlov Cyst Disease – Not so Rare After All

Untold numbers of people take opioid medications to control pain, real chronic pain. Yes, it does exist in so many forms. Why else would we call these drugs “Painkillers”?

Chronic physical pain can come from many sources and last a lifetime.

Citing one disease that can cause chronic pain for those who live in the shadows with it — Tarlov Cyst Disease that is symptomatic with pain.  It is a largely misunderstood disease, but one that is progressive and affects in a symptomatic form for so many who are struggling to find relief from pain that it causes unless or until doctors can get a better handle on how to successfully treat this disease that is often referred to in MRI reports as “incidental findings” and left at that for the patient to figure out on their own.

Doctors either tell the patient “they don’t cause pain” or “they rarely cause pain.” In order to determine if they cause pain, the patient can be told that nerve blocks have to be performed to determine if the Tarlov cysts are the reason for their pain. The problem is that “needles in the spine” often worsens a patients pain based on reports from so many who are members in several Tarlov Cyst Facebook Groups in America and in other countries.  They have joined these support groups to learn more about what they are living with and where they can go for meaningful help.

The Tarlov Cyst Facebook Pages have been of great help to me for learning what others are experiencing with this disease and the few, very few, doctors who have operated on Tarlov Cysts to not only bring relief from pain for a symptomatic patient, but just as importantly, to stop the erosive progression of the disease.

I would like to share a link to a foundation that is bringing greater awareness to Tarlov Cyst Disease. I have no connection to this foundation.  I do have Tarlov Cyst Disease, and it is symptomatic with me. 

Thank you. 

http://tarlovcystfoundation.org/about_us0.aspx

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Facebook Groups for Tarlov Cysts:

Tarlov Cyst Disease

Tarlov Cyst Disease Awareness

Life Before and After Tarlov Cyst Surgery

Tarlov Cysters

Tarlov Cyst Support

NE Ohio Tarlov Cyst Family

Tarlov Cyst Disease Education and Awareness Page

Tarlov Cyst Society of Canada Page

Websites:

National Institute of Neurological Disorders and Stroke

Wikipedia – Tarlov Cyst

Tarlov Cyst Disease Foundation

National Organization for Rare Disorders (NORD) – Tarlov Cysts

Rare Diseases – Tarlov Cysts

Yahoo Results for “Tarlov Images”

The Energy and Commerce Committee 21st Century Cures