The ACA may have saved Raymond Owens’s life. Raymond and his wife Adele have owned a flooring contracting business for 25 years and their three children are the focus of their life. Their quest for a better life for their family became more difficult when Adele was laid off from Home Depot two years ago. They managed to keep their insurance by paying for COBRA until their eligibility ran out. They couldn’t afford to pay $1,600 a month for insurance on the individual market and hoped that Adele would soon find a job that came with coverage. “We didn’t want anything for free,” Adele said. “We just wanted insurance we could afford.”
Unfortunately, after six “nerve-wracking” months without coverage, their worst fears came true – Raymond was diagnosed with merkel cell carcinoma, a very aggressive and fast-moving skin cancer. They found surgeons at Memorial Sloan-Kettering Cancer Center in New York City who could treat him, but the hospital wanted the Owenses to pay $65,000 first.
What would you do if you were Raymond? Buying insurance on the individual market wouldn’t have helped him. Unlike many states, New York has consumer protections that ensure that he could have purchased insurance – guaranteed issue (an insurer has to sell insurance to anyone who applies, regardless of health conditions) and community rating (an insurer has to charge everyone the same premium, regardless of factors like illness). But Raymond’s treatment for cancer – a pre-existing condition – would not have been covered by insurance purchased on the individual market for twelve months. During the month that he spent looking for a way to pay for surgery, three more tumors grew. He couldn’t afford to wait.
Luckily, the ACA provided a solution. The NY Bridge Plan, New York’s ACA-funded pre-existing conditions insurance program, covered his treatment from the day his coverage began. And it only cost a fraction of what he would have spent on the individual market. Premiums are $421 a month for residents of downstate counties, and $362 for residents of upstate counties. So far, 2,600 New Yorkers have found coverage through the Bridge Plan. You can find more information and an application form here.
Raymond’s surgery was affordable with the new coverage, and he is now cancer-free. He and Adele can now focus on his health, rebuilding their business, and spending time with their kids.
On Thursday, September 16 from 10:00AM–2:00PM, West Side Campaign Against Hunger will be available to answer benefit questions related to housing, health care (Medicare, Medicaid & EPIC), Social Security, food stamps and more! No appointments are necessary.
West Side Campaign Against Hunger is located at St. Paul & St. Andrew Church– West 86 Street (corner of West End Ave.) NY, NY 10024
On May 28th, the House of Representatives removed a provision in H.R. 4213 that would have continued until November a provision that allows thousands of unemployed New Yorkers to purchase health insurance through COBRA by providing them with a 65% subsidy for their health insurance premiums.
Just as stunning, while so many states – including New York – are struggling to balance their budgets, the House removed an extension of enhanced “FMAP” funding that supports state Medicaid programs. The results are certain to be significant additional public employee layoffs throughout New York.
HCFANY urges Senators Schumer and Gillibrand to restore vital funding for COBRA health care benefits for the unemployed and FMAP (Medicaid) funding to support our state budget! This is not the time to choke off the economic recovery!
Anti-health reform activists continue to fight reform with misinformation. There’s an email circulating now with a false claim about health care reform and W-2s. It says that consumers will see their taxes go up because of a provision of PPACA, the new federal health reform law.
The email says that consumers will be charged higher income taxes because their W-2s will now show the value of any health insurance benefit they receive from their employer.
Like most myths, this one builds on something true – next year, W-2 forms will show the value of employer-provided health care benefits. But this is actually helpful information; many consumers have no idea what their employer is paying for their coverage.
Then the rumor jumps to a false conclusion. While the value of the health care benefit will be printed on the W-2, it will not be included in a consumer’s calculation of taxable income. As a White House blog post debunking the email said, “you will absolutely not pay taxes on these benefits.”