by Andrew Walden

On April 8, officials of the Hawaii Health Connector trumpeted their receipt of a "$128,086,634.00 Level 2 multi-year funded grant from the U.S. Department of Health and Human Services".  Quoted in the Health Connector news release, Senator Brian Schatz said: “we’ve already seen thousands of people across the country receive access to affordable care and preventative services.  This funding is critical for a call center and consumer assistance program that will help Hawaii families make important choices about the care they receive.”

Schatz didn't mention that the $128M was paid for by cutting off funding and closing the Pre-Existing Conditions Insurance Plan (PCIP) program which provided coverage for seriously ill patients who were otherwise denied overage due to 'pre-existing conditions.'

The Hawaii payoff flouted a proposal from House Republican leaders to the Obama administration.  Speaker of the House John Boehner wrote to President Obama March 5:

"to allow PCIP to continue to accept new enrollees, we urge you to support efforts to transfer the funds necessary from other PPACA programs, such as the Prevention and Public Health Fund, the Secretary's transfer authority to assist with state based exchanges, comparative effectiveness planning, or another similar program to PCIP.  As you are aware, on prior occasions you have signed into law legislation that reduced the Prevention and Public Health Fund.  We believe allowing those  with pre-existing conditions access to health insurance is another worthy reason to reprogram these funds.  In fact there are numerous programs within PPACA that receive greater levels of funding than PCIP.  With your support, we could help these Americans get the care they need." 

Just 34 days later, the Hawaii Health Connector received its $128M under, "Secretary's transfer authority to assist with state based exchanges."

On April 15, just seven days after the Hawaii grant was announced, House Republicans followed up by introducing legislation to save PCIP, H.R. 1549, the Helping Sick Americans Now Act.

Testifying before the US House Energy and Commerce Committee April 3, Susan Zurface, who suffers with Chronic Lymphocytic Leukemia, explains,

"Without my newly diagnosed illness, I was unable to find any health insurance coverage that would cost less than $350/month with a $10,000 deductible. It was during that research that I came across, in late February, the Ohio High Risk Pool program, offering medical coverage for $250/month with a $2,500 deductible for people with pre-existing conditions. I contacted the insurance company directly and spoke about the coverage. I printed off the application and sent it to my local oncologist for certification. I received it back and was prepared to mail it in, when I learned that the program was no longer accepting new patients due to lack of funding. My options are limited."

The cut-off was announced with little notice.  The Friday, February 15 Washington Post points out:

Obama administration officials said Friday that the state-based “high-risk pools” set up under the 2010 health-care law will be closed to new applicants as soon as Saturday and no later than March 2, depending on the state....

Among those stunned by Friday’s news was a 61-year-old Virginia woman who is battling stage-four breast cancer. The woman, who asked to be identified by her middle name, Joyce, because she wants to keep her illness private, is self-employed and had bought her own insurance for years.

Late in 2010, however, the insurer that Joyce was using pulled out of Virginia. She was healthy at the time. But when she applied to other companies, she was told that because she had been diagnosed with— and successfully treated for — an earlier breast cancer, she was ineligible for coverage.

Joyce said she was unaware of the high-risk pools at the time and remained ignorant of the option even as she was diagnosed with her current cancer. As the disease has progressed, the cost of her treatment has skyrocketed. The latest expense, a 10-week course of chemotherapy that she expects to total about $30,000, as well as additional tests that could top $8,000, has forced her to dip into her retirement savings.

It is only in the past several weeks that Joyce learned of the high-risk pool, and she was on track to finalize her application Sunday.

On Friday, she scrambled to get it in by the unexpected new deadline. She said the computer system appeared to accept her entries, but she will be on tenterhooks until she finds out for sure.

“I feel like the rug has been pulled out from under me,” Joyce said. “On every level, this is just beyond discouraging.”

According to the Health Connector news release, "This award will fund the customer service call center, consumer assistance program and general maintenance and operations of the Connector through December 2014."

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