Woman News

Reform Promises to Lower Bills for Chronic Illness

Women with chronic illnesses such as rheumatoid arthritis and MS often have trouble affording the care they need, even when they have health insurance. Advocates hope a variety of health-reform provisions will bring relief. Page 2 of 2Other Advocacy Groups Want Reform Like the American Diabetes Association and the National Multiple Sclerosis Society, the American College of Rheumatology, an organization of 7,000 specialists in arthritis care and research based in Atlanta, is also championing provisions in the final bill that will make it easier for low-income people to obtain insurance. "Women are four times more likely to develop rheumatoid arthritis than are men," said Dr. Karen Kolba, a rheumatologist in Santa Maria, Calif. "Losing a job and going through a divorce can mean a loss of insurance, which is dangerous for women with rheumatoid arthritis because they often have difficulty qualifying for individual insurance or paying the premiums. As a result, they are often diagnosed late, so that they can"t take advantage of the drugs that can control rheumatoid arthritis in its earliest phase and ensure that they will have fewer complications later." As one way to lower costs, The American College of Rheumatology is urging Congress to stop insurance companies from charging significantly higher co-pays for new "biologic" medications. These drugs, containing genetically-engineered proteins derived from human genes, can help inhibit the inflammation that is a major problem for those with rheumatoid arthritis. Traditionally, individuals and families paid reasonable co-pays under a three-tier pricing system: $15 for a generic medication, $20 for a brand name and $30 for a medication not on the list the plan covers. Tier Four Being Introduced "Now the insurance companies are instituting a tier four, which requires patients to pay 20 to 30 percent of co-pays for biological drugs that can be effective in patients who have not responded to other medications," said Kolba. "Although the biologics can make a big difference for those who are desperate for help, the patient can end up spending $1,500 to $2,000 a month in co-pays, which is prohibitively expensive for most patients." Over the past decade, health insurance premiums have increased 119 percent nationally, while wages adjusted for inflation have remained flat. Both the House and the Senate would provide subsides to individuals making up to about $43,000 a year or a family of four earning $88,000. The House bill"s subsidies are more generous. Both bills establish insurance exchanges that will increase access to health insurance and give applicants more details about the types of coverage. The House bill calls for a national exchange while the Senate bill includes state exchanges. "The exchanges and other reforms are long overdue improvements in our broken health care system," said Huntley of the American Diabetes Association. "Passing a bill that will give people with chronic conditions access to the tools necessary to manage and prevent their diseases is a historic achievement." Sharon Johnson is a New York City-based freelance writer. For more information: National Multiple Sclerosis Society http://www.NationalMSsociety.org American Diabetes Association http://www.diabeates.org American College of Rheumatology http://www.rheumatology.org * First * Previous *1 *2

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