Zip, Nada, Gone!
Just when we were getting our notes together to tell you all about California’s high-risk pool, the Major Risk Medical Insurance Program (or MRMIP), Governor Brown issued the 2017 budget. And guess what? He abolished it! Really? Because as inadequate as MRMIP was, we will surely need it when Obamacare is repealed.
No Plan B
California is facing repeal without a Plan B. A major option for accessing health care that the California pre-existing condition community might have had is now zip, nada, gone! While it’s true that like most high-risk pools, MRMIP had serious deficiencies, but it was still a lifesaver for some of us!
Background
Before Obamacare made medical underwriting illegal, health insurance companies sought to avoid insuring people who needed care.
If a person with a pre-existing condition applied for coverage, the insurer would either completely decline to insure the person, or decline to cover their pre-existing condition, including any additional illness arising from that pre-existing condition. (For example, if you had high blood pressure, and then suffered a stroke, the insurance company might deny coverage for your stroke.)
So California, and many other states, created high-risk insurance pools for the people who couldn’t get conventional health insurance. After Obamacare was passed, many states eliminated their high-risk pools, just like Governor Brown is doing now with California’s MRMIP.
How many Californians are at risk
If Obamacare is repealed, there are over 5.8 million Californians with asthma, high blood pressure, allergies, heart disease, tendonitis, back problems, diabetes, HIV/AIDS, cancer, and more who will go back to being uninsurable. Check out our blog Back to the Bad Old Days to see how many ways you can become “uninsurable!” It’s a real eye-opener.
Even people who have survived a health condition and need on-going treatment are considered to have declinable, pre-existing conditions.
What do people with medical conditions need?
They need good care. Let’s look at one example – a person with cancer. Nearly 40% of Americans will develop cancer at some point in their lives so this could be you. According to the American Cancer Institute, in 2013 over 14,000,000 Americans were living with cancer. And according to the California Department of Public Health, over 1,340,000 Californians are currently living with a medical history that includes cancer.
To stay alive, many people with cancer have to take very expensive medicines for years. They need reliable access to doctors, especially specialists. They can’t afford to miss treatments. And treatment must be affordable or else they can’t get it.
Do high-risk pools meet patients’ needs?
Not very well. All the high-risk pools were designed with the same goal: to limit access to care! Check out our blog on High-Risk Pools, Relics of Our Ugly Past to learn more.
What about California’s high-risk pool?
California’s high-risk pool, the Major Risk Medical Insurance Program, or MRMIP was developed to provide health insurance for “Californians who were unable to obtain coverage in the individual insurance marketplace.” (Check out the 2016 MRMIP Application and Handbook for more information.).
This is a somewhat broader focus than just covering people with pre-existing conditions. Here’s an example:
A small business owner can’t afford to buy health insurance for herself during Open Enrollment (which ends on January 31 each year). In May, she discovers she’s pregnant. She can’t pay out of pocket to deliver her baby. Her income disqualifies her from Medi-Cal. And she can no longer buy health insurance through Covered California because open enrollment is over. If she meets all the other qualifications, MRMIP could be an option for her. But not anymore.
While most states eliminated their high-risk pools soon after Obamacare was implemented, California is only doing so now.
How well did MRMIP work?
Though it saved lives, it also took lives. The waiting list was so long, thousands of Californians died waiting to get on it.
Get the straight scoop on this from our own Terri Carlson, creative genius behind the video “Will Marry for Health Insurance.” Here’s the latest in her video series in which she explains how MRMIP completely failed to help her.
MRMIP – Meager and now MIA
MRMIP only covered up to $75,000 a year in medical costs and had a maximum lifetime benefit of $750,000. People with expensive-to-treat conditions like hemophilia or cancer could blow through those low coverage limits in a heartbeat!
Plus, to even qualify for MRMIP, a person had to be uninsured for six months! Six months without medication? Six months without treatment? We’re talking about people who suffer from medical conditions. And if the program were full, then even after qualifying for coverage, you might have to wait years on a waiting list.
MRMIP was a resource for some people who had nowhere else to turn, but it didn’t hold a candle to Obamacare with its ban on pre-existing condition exclusions and both annual and lifetime limits on care. Now, however, Obamacare is being repealed. And at the same time, MRMIP is being abolished. Wha?
“Earth to Gov. Brown, not now!”
Inexplicably, right when we’re facing repeal, Governor Brown wants to abolish MRMIP!
Has he not been watching the news? What will Californians with pre-existing conditions do?
Now is not the time to abolish this agency.
What to do?
It’s hard to know what to do. Critical programs that people depend on for their health care are being defunded and attacked by the GOP Congress, including Obamacare, Medicare, Medi-Cal and Children’s Health Insurance Program (CHIP). This impacts state programs, like MRMIP, as well.
Are they perfect programs, meaning comprehensive, sustainable and fair to all? No, they reinforce the inherent inequality in American health care. These programs are somewhat like Band-Aids stuck over the gaping inadequacies of a “non-system.”
So are they worth preserving? As Bernie Sanders put it so clearly at a rally the other day in Michigan, the answer is definitely YES.
Today we must fight to preserve the existing programs millions of Americans depend on, and tomorrow we must fight to win Improved, Expanded Medicare for All.
If you want California to lead the nation with our own Medicare for All system, take action! Join us on Twitter and Facebook, and
Sign our Open Letter to Governor Brown and Our Legislative Leaders!
Dear Governor Brown, Senate President Pro Tem DeLeón and Assembly Speaker Rendon:
California families depend on Medicare, Medi-Cal and Obamacare for our very lives.
Protect these programs, but more.
Give us healthcare that covers everybody for everything for life!