Friday, August 01, 2014

Thanks to Obamacare .............

We rail against Obamacare, and with good reason. Spending TRILLIONS of dollars (including
$1 billion+ on a website that STILL doesn't work) to provide health insurance to a relatively few people is foolish. Providing coverage to the uninsurable via a risk pool makes much more sense than the system we have now.

That being said, let's look at Chloe Jones' situation.

Chloe is 14 years old and has CF (cystic fibrosis). Treatment can easily run $300k per year for a new drug (Kalydeco).

Kalydeco received FDA approval in 2012 when used to treat a rare form of CF that affects roughly 1,200 individuals.

Chloe is one of three plaintiffs who filed suit in Arkansas federal court last month. Along with the other plaintiffs, Chloe believes the state is denying them their civil right to treatment under the state-run Medicaid program.
The program, which covers most health care expenses for over 70 million low income people nationwide, has denied the plaintiffs’ coverage for the drug Kalydeco because of its cost.
Arkansas (where Chloe lives) has denied payment for the medication under their Medicaid program. States have limited resources and lack the ability to legally print their own money like D.C. does. Just like most individuals, states must make tough financial decisions.
I can certainly empathize with Chloe and her family, but Medicaid is not their only option.
Obamacare took away, and then restored the child only health insurance policies. If Medicaid won't cover Kalydeco, find a child only health insurance plan that will.
At least one carrier (Humana) will cover the drug as a tier 4 or 5 drug (depending on the plan chosen). 
Chloe and her parents would be better served by playing the system as it exists rather than trying to change it.
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