Louisiana's largest insurer is engaging in behavior that public health advocates say is designed to protect the insurer's pocketbook against the high cost of providing treatment for HIV/AIDS patients. Reuters has the infuriating details:
Hundreds of people with HIV/AIDS in Louisiana trying to obtain coverage under President Barack Obama's healthcare reform are in danger of being thrown out of the insurance plan they selected in a dispute over federal subsidies and the interpretation of federal rules about preventing Obamacare fraud.In a nutshell, Blue Cross and Blue Shield of Louisiana is hoping that, by denying these patients -- already overburdened by the incredible cost of managing HIV/AIDS treatments -- the right to use Ryan White Act funds to help pay their premiums, they will just go away. While the insurer argues that using these funds to pay for insurance premiums amounts to a kind of 'fraud' on behalf of patients, the reality is that Blue Cross and Blue Shield's behavior flies in the face of federal guidance:Some healthcare advocates see discrimination in the move, but Blue Cross and Blue Shield of Louisiana says it is not trying to keep people with HIV/AIDS from enrolling in one of its policies under the Affordable Care Act, also known as Obamacare.
The state's largest carrier is rejecting checks from a federal program designed to help these patients pay for AIDS drugs and insurance premiums, and has begun notifying customers that their enrollment in its Obamacare plans will be discontinued.
The carrier says it no longer will accept third-party payments, such as those under the 1990 Ryan White Act, which many people with HIV/AIDS use to pay their premiums.
"In no event will coverage be provided to any subscribers, as of March 1, 2014, unless the premiums are paid by the subscriber (or a relative) unless otherwise required by law," Blue Cross Blue Shield of Louisiana spokesman John Maginnis told Reuters.
In September, CMS informed insurers that Ryan White funds "may be used to cover the cost of private health insurance premiums, deductibles, and co-payments" for Obamacare plans.Note that many of these HIV/AIDS patients in Louisiana have no other option but to use third-party funds (i.e. Ryan White) to help pay for health insurance, given Louisiana's barbaric refusal to expand Medicaid. Many of these patients -- unable to work -- make far below the poverty line, thus preventing them from accessing Affordable Care Act subsidies designed for those earning over 100% of poverty.
Health advocates are upset by what they perceive as blatantly discriminatory behavior on behalf of the insurer:
Healthcare advocates are worried that the refusal to accept Ryan White payments is an effort by insurers to keep AIDS patients from enrolling in their plans and last month began pressing the issue, including with the office of Democratic Senator Mary Landrieu.And, surprise, surprise! It looks like these advocates are pretty much spot on:
In an email reviewed by Reuters, a healthcare expert on Landrieu's staff wrote, "BCBS LA told me their decision was not due to the CMS guidance or any confusion (as we thought before) but was in fact due to adverse selection concerns. I have also recently learned North Dakota's BCBS plan has implemented the same policy."Yes, adverse selection! In other words, this mega-sized insurer just doesn't want to have to shell out to take care of people with one of humanity's most expensive diseases: AIDS.Jessica Stone, the Landrieu staff member, declined to elaborate on the email further or to discuss her interactions with Louisiana Blue.
Adverse selection refers to the situation where an insurer attracts patients with chronic conditions and expensive care. Louisiana Blue's action "sure looks to us like discrimination against sick people," said John Peller, vice president for policy at the AIDS Foundation of Chicago.
This is absolutely shameful behavior -- and we, as Kossacks, owe it to our brothers and sisters in Louisiana to push back hard against Blue Cross and Blue Shield's immoral, unethical and cruel behavior.
Imagine having HIV or AIDS, thinking you will finally have high-quality, affordable health coverage, and then having it stolen from you by private health insurance company bureaucrats looking to pinch pennies by, once again, playing fast and loose with the law.
This is why folks hate (err...loathe) private health insurance companies.
One way you can help support these individuals is by tweeting this diary -- the title includes the Twitter handle for Blue Cross and Blue Shield of Louisiana.
We will not back down!