Background and Fact Sheet on the President’s Event today on the Affordable Care Act and The New Patients’ Bill of Rights

.  Her first health insurance company would not take her back.  This situation was very stressful as she was quite ill at the time.  Katie and her husband called the Montana State Insurance Commissioner’s office, and they intervened for them.  Through a state-backed program, Katie is now covered.  Under the Affordable Care Act, rescissions are prohibited by all insurance companies, effective for plan years beginning on or after September 23, 2010.

Katie shared her story when she introduced the President at a health reform town hall in Bozeman, Montana on August 14, 2009. 

Laura Klitzka (Green Bay, Wisconsin)
Laura is a 35-year old, married mother of two with metastatic breast cancer.  She was first diagnosed in January 2008 and has since undergone eight rounds of chemotherapy, a double mastectomy, and 33 rounds of radiation, only for the cancer to return and spread to her bones.  Laura’s cancer is untreatable in the long term.  Laura has insurance coverage under her husband’s employer, but the plan has a lifetime benefits limit of $1 million, and Laura and her husband worry that they will reach this limit because of her expensive treatments.  Laura is receiving $1,050 a month in Social Security Disability Insurance after she was laid off from her job during her treatment.  Laura estimates her family has at least $12,000 in unpaid medical bills, and they are struggling to get by.  Laura says she doesn’t want to lose their house over her illness, and while she knows she will not be able to see her children grow up, she wants to be sure the time she has left with them is quality and not spent worrying about health care bills.  Under the Affordable Care Act, all insurance companies are prohibited from imposing lifetime benefit limits, effective for health plan years beginning on or after September 23, 2010.

Laura shared her story when she introduced the President at a health reform town hall in Green Bay, Wisconsin on June 11, 2009.  She also sat in the First Lady’s box at the President’s Address to a Joint Session of Congress in September 2009.  Video of Laura’s story is available HERE.

Jennifer Restemayer (Bismarck, North Dakota)
Jennifer’s 9-year old daughter, Allison, was diagnosed seven years ago with a rare Genetic Disorder called Mucopolysaccharidosis type 1 (MPS 1), which causes severe mental delay, enlargement of organs, and eventual death if left untreated.  She takes an Enzyme Replacement Therapy which is very expensive, but slows the natural progression of her disorder.  Allison’s father’s health insurance policy has a $2 million lifetime maximum. After a major spinal surgery and an increasing dosage requirement for her daughter, Jennifer fears that Allison will soon reach $2 million of her lifetime max.  Under the Affordable Care Act, Allison and her family will no longer need to worry about hitting a lifetime benefit limit because all insurance companies are prohibited from imposing lifetime benefit limits, effective for health plan years beginning on or after September 23, 2010.

Amy Wilhite (Marblehead, Ohio)
In March 2007, doctors diagnosed Amy Wilhite’s daughter, Taylor, with Acute Myeloid Leukemia (AML), a fast-growing cancer of the blood and bone marrow. Taylor received three rounds of chemotherapy and a bone marrow transplant. The cancer treatment produced multiple side effects: problems with her heart and hip, short-term memory loss, steroid-induced diabetes, and a compromised immune system. Taylor’s father’s insurance plan has a $1 million lifetime limit. As Taylor approached the limit, her parents requested a $500,000 extension and it was granted.  Although Taylor is in remission, she will need follow-up visits with her oncologist, check-ups with her endocrinologist, and multiple major surgeries on her hip.  Amy, Taylor’s mom, said they have been picking and choosing which tests and follow-ups to go through with, because they don’t want to exceed the cap. Under the Affordable Care Act, all insurance companies are prohibited from imposing lifetime benefit limits, effective for health plan years beginning on or after September 23, 2010.  The Wilhite family can now follow doctor’s orders without having to worry about hitting a limit.

Nathan Wilkes (Englewood, Colorado)
Nathan’s son, Thomas, was born with hemophilia in 2003.  At the time, he and his family had high quality insurance through the high tech telecommunications company that he helped found, but when the insurance company saw Nathan’s claims (ranging from a few thousand dollars to $750,000 a year for his son), they started to increase the premiums for all the employees and their families.  The company tried to find other coverage, but no other insurance company would take them with Thomas on the policy.  When his son Thomas neared the $1 million cap on his policy, Nathan searched for another option.  A social worker suggested that Nathan and his wife get divorced so that she could go on Medicaid.  Nathan found a way to get his son into the state’s high risk pool, but it too had a $1 million cap.  Nathan paid premiums to both his company and the high-risk insurance pool.  By this time, he was paying about $25,000 out of pocket a year and still getting huge bills and threats from collection agencies.  Finally, Nathan decided to form his own small business so that he could have more control over the plan selection.  Nathan faces increasing premiums and a $6 million lifetime cap, which he fears will be exceeded because of his son’s continuing need for care.  Under the Affordable Care Act, all insurance companies are prohibited from imposing lifetime benefit limits, effective for health plan years beginning on or after September 23, 2010.

Nathan shared his story when he introduced the President at a health reform town hall in Grand Junction, Colorado on August 5, 2009.  He also sat in the First Lady’s box at the President’s Address to a Joint Session of Congress in September 2009.  Video of Nathan’s story is available HERE.

MEETING PARTICIPANTS

Kathleen Sebelius, Secretary Health and Human Services
Hilda Solis, Secretary of Labor
Nancy-Ann DeParle, Counselor to the President and Director of the Office of Health Reform
Stephanie Cutter, Assistant to the President for Special Projects
Valerie Jarrett, Senior Advisor and Assistant to the President
Jay Angoff, Director of the Office of Consumer Information and Insurance Oversight, HHS
Phyllis Borzi, Assistant Secretary of Labor, Employee Benefits Security Administration
John O’Brien, Director, Planning and Policy Analysis, Office of Personnel Management
Mark Iwry, Senior Advisor to the Secretary of the Treasury, Deputy Assistant Secretary for Retirement and Health Policy
Scott P. Serota, President and CEO, Blue Cross Blue Shield Association
Daniel J. Loepp, President and CEO, Blue Cross Blue Shield of Michigan
David H. Klein, President and CEO, Excellus Blue Cross Blue Shield
Bruce Bodaken, Chairman, President, and CEO of Blue Shield of California
Tom Bowser, President and CEO of Blue Cross Blue Shield of Kansas City
Vicky B. Greg, President and CEO of Blue Cross Blue Shield of Tennessee
Patricia Hemingway Hall, President and CEO, Health Care Services Corporation
Joel Ario, Pennsylvania Insurance Commissioner
Mila Kofman, Maine Superintendent of Insurance
Jane L. Cline, West Virginia Insurance Commissioner
Kim Holland, Oklahoma Insurance Commissioner
Sandy Praeger, Kansas Commissioner of Insurance
Susan E. Voss, Iowa Insurance Commissioner
Mike Kreidler, Washington Insurance Commissioner
Karen Ignani, President and CEO, America’s Health Insurance Plans
Ronald A. Williams, Chairman and CEO, Aetna, Inc.
Angela F. Braly, Chair, President and CEO, WellPoint, Inc.
James Roosevelt, Jr., President and CEO, Tufts Health Plan
George C. Halvorsen, Chairman and CEO, Kaiser Permanente
David M. Cordani, President and CEO, CIGNA Corporation
Michael B. McCallister, President and CEO, Humana, Inc.

ELECTED OFFICIALS EXPECTED TO ATTEND

Senator Richard Durbin, D-IL
Senator Kent Conrad, D-ND
Representative Rob Andrews, D-NJ
Representative Donna Christensen, D-VI
Representative Kathy Dahlkemper, D-PA
Representative John Dingell, D-MI
Representative Frank Pallone, D-NJ
Representative Jan Schakowsky, D-IL
Representative Carol Shea-Porter, D-NH
Representative Betty Sutton, D-OH
Governor Jim Doyle, Wisconsin
Texas State Rep. Garnett Coleman
Linda Langston, Iowa County Executive
Kevin Lembo, Connecticut Office of the Healthcare Advocate
Joel Ario, Pennsylvania Insurance Commissioner
Mila Kofman, Maine Superintendent of Insurance
Jane L. Cline, West Virginia Insurance Commissioner
Kim Holland, Oklahoma Insurance Commissioner
Sandy Praeger, Kansas Commissioner of Insurance
Susan E. Voss, Iowa Insurance Commissioner