For People with Diabetes — New Report On Your Health Insurance Problems
Researchers at Georgetown University Health Policy Institute, working in partnership with the American Diabetes Association (ADA), just completed a report on health insurance problems of people with diabetes. “Falling Through the Cracks: Stories of How Health Insurance Can Fail People with Diabetes,” reviews the experiences of 851 people who called the national call center for help with their health insurance problems. Only 1 in 5 callers could be helped.
Case studies from the report are described along with national survey research findings that indicate people with chronic conditions are disadvantaged in health insurance in the U.S. Specifically, people in poor health who lose health insurance tend to be uninsured longer compared to healthy people; and medical debt and medical bankruptcy increasingly are problems of the insured.
Stories of real people in the report add important detail to what is already known. Problems studied were resolved when people could find health coverage that was simultaneously available, affordable and adequate. For most, however, health insurance and other safety net protections — such as COBRA and high-risk pools — often met only one or two of these three requirements, and so did not help. In particular:
- Individual health insurance — 395 people needed coverage in this market but only 15 could buy policies
- COBRA – 377 people lost or were losing job based coverage but only 31 took COBRA
- HIPAA — 87 people were HIPAA eligible but only 11 bought HIPAA coverage
- High-risk pools — 344 people needed coverage and lived in high-risk pool states but only 7 enrolled
The report identified features of health insurance coverage that make it harder for people with diabetes to get and keep coverage during insurance transitions. Barriers to finding new coverage included:
- medical underwriting in individual insurance,
- lack of COBRA premium subsidies for people who lose jobs,
- insurance premium surcharges based on health status, and
- pre-existing condition exclusion periods in high-risk pools.
In addition, people whose health insurance was not changing also had problems — most often they were under-insured. When insurance did not cover test strips or prescription drugs, or when it imposed high-deductibles and other cost sharing, people had trouble getting care necessary to manage their diabetes. Medical and financial consequences of these problems could be severe. In a number of cases, people developed preventable complications requiring hospitalization and/or amassed medical debts they could not afford to pay. The report concluded that the perspective of people with diabetes — or other serious, chronic health conditions — provide an important lens through which to evaluate health insurance. Proposals to change the coverage system need to be considered in light of their impact on sick people.
Click here to read the 
full report (PDF format, 53 pages, 430 KB) or the executive summary (PDF format, 8 pages, 48 KB).
The press briefing releasing this report can be viewed (with transcript available) at www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=1357
This project was supported by grants from the W.K. Kellogg Foundation, the Robert Wood Johnson Foundation, the Commonwealth Fund, and the American Diabetes Association.
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August 16th, 2007 at 8:04 pm
Laid off in April ‘07 at the age of 60. On COBRA for health insurance because I have diabetes (need some kind of insurance for medication). COBRA is r-e-a-l-l-y expensive for a person that is on unemployment.
Something must be done about health care, age discrimination, etc. I really don’t want to name everything that is wrong with this world, because you already know. Of course there are no jobs in Michigan and thank God I don’t own a home.
Worrying about everyting will give a person a heart attack!!!
JRose
MI
October 24th, 2007 at 10:23 am
I am in the exact same situation. After 8 years with a company, due to my health, I could no longer stay. I am 60 and on a cobra plan. I pay $472 a month, that I can not afford and another $125 a month for medication co-pays. Strips for testing and needles are not covered. That is another $150 per month. I am single and very stressed. In CA (where I once lived) they had a state run program. You applied for inssurance on a list and the State had a list of all insurance companies. When each name came to the top of a list, they were matched and the person seeking insurance was allowed to receive insurance without exsisting heath problems or a health check. The insurance company could only charge the fee of a healthy applicant. Now that I live in another state, that is not the case. Why can this not be in every state. We have a nation full of diabetics. Even younger children are becoming type two diabetics. Please place this in your newletter to help others. What happened to strength in numbers.
pg
mo
December 13th, 2007 at 10:42 pm
Land of Opportunity!!!!!!!!!!!! now that is a statement.
I have a diabetic son who is 20 and of course he was on my insurance, but as you are ALL aware it is time for him to make his own way. i have tried to find insurance to keep him covered that i can continue to pay for but it is like everything else, you can not survive in America UNLESS you have money, and a lot of it.
I am livid at the American health care system and the Goverment, we can Pore Billions of dollars per day into war in IRAQ and re build cities for other nations as good will gestures that we can not afford, I pay ALL off my taxes and support charitable needs if possible, i have also served my country in time of need, but we can not afford to care and provide for our own people. what do i say TO MY SON, I am sorry that you where born or contracted diabetes but i can not afford to pay for your care this month.
what sort of future does my son have in this land of OPPORTUNITY….I SAY HE HAS NO CHANCE !!!!!!!!!
I write this segment not just for ME but for the other fathers and mothers , grandmothers and ,grandfathers who are experiencing the AMERICAN DREAM as we are.
I prey to god that they will find a cure to this horrific disease NOT just for ME but for all the suffering family,s that are having to endure the same pain as i am …..and i prey that the U.S Goverment does not block or vito any course to help this stricken nations sufferers.
thank you for your time
JOHN ASTON______ Concerned CITIZEN
May 25th, 2008 at 8:14 pm
I have had a kidney transplant 7 1/2 yrs. ago & I lost my health insurance this past Sept. of last yr. & the LAND OF OPPERTUNITY has not allowed me to get the Health insurance I so desperately need. I am also a servere anemic & everyone flatlines me. By the way I am NOT on disability and am unable to work. So can you see how frusturated I am. As for for the politicians I am independent, I have always figured may the best liar win. They do absolutly nothing for me– they never have that is quite obvious. People talk about discrimination or minority, all I can say is good luck to me. By the way the company I was involved with was my own blood & they felt that I know longer needed health insurance that I offered to pay for & they new that I was unable to get insurance. Great Family uh.
December 12th, 2008 at 6:03 pm
My husband worked for a Ford Dealership. The dealership was bought back by Ford (yes, Ford has money) and the company was dissolved because the company was dissolved that means no COBRA. COBRA is expensive…don’t get me wrong. I went to seek medical insurance and picked the HIPPA box (I thought it would be a fall back…just in case…after all I am cancer survivor (7 years) and my 10 year old had epilepsy (outgrew it last year) and I have diabetes (controlled no meds). I filled out the form and they require that you provide either a credit card or a checking account. I did and did not hear back for several weeks then $1,869.10 was taken out of my account! The insurance company never provided notice…this was 3x the originial quote…who can afford to be sick! BAIL ME OUT…I contribute more than the banks and auto dealerships and I can balance a bank account!
December 30th, 2008 at 2:46 am
I have a sister who has diabeties along with a list of other illnesses like congestive heart failure and highblood pressure. She is not elgible for medicare, disability or any state aid. The private insurance companies will carry her but at a very hefty price try $1200 a month with her in very poor health and her age which is 64 and her husband 67 and retired and not in the best of health himself, how would they pay for this. You either make to much money or not enough money, you cant win for losing. I know there are many people and families like my sister. I just lost my mom almost a year ago and I faced somewhat similar issues not being able to get things she was entitled to durable medical equipment,home health services she needed to live a decent life. Because I was her caregiver and along with my other siblings we tried to get her the proper care but it felt like at time that they were saying to me She is 87 and she has lived a long time and she had outlived her usefullness. Your feel like oh my god I am sick and there going to say oh just put them out to pastre. Its a shame when those who helped make this country with their back breaking sweat need help and they cant get it. Its a shame when you take billions of dollars to fight wars and make deals to help other countries and you cant even take care of your own. You are letting your ederly and sick die because they cant afford their medicines and there is no money or programs to help unless you are 200% below the proverty level, which is barley living and then you still might not qualify for some programs. The only way you can get some help is if you have little something sell it so you can be become income elgible like Sell you life insurance policy, that were all told you should have so if a love one dies you will have some money to burie them and have a little extra to help with that decreased income, figure that one out. I am just so sadden and I dont know what to do, not just for my sister but to all who face what she does and the love ones who are helpless to help them. You maybe able to give a few dollars here and there to help but that really wont solve the issue because they still may not have enough to pay for all the meds they need.
shirely j. a concern sister
March 21st, 2009 at 10:27 am
Hi, I lost my health insurance in the summer of 2008. I now have not seen a doctor for over a year. I presently have no medication or insulin for my diabetes. I can not afford to pay to see a doctor nor can I pay for my insulin which without it I some time have readings of over 500 because my body does not produce insulin for me. I have a disease that if taken care of I could live a long time. But I will die from this disease because I have no money to get the insulin I so badly need. Every where I look for insurance I can’t afford it, or pre existing conditions apply.
Please can some one help me,
Robin
March 25th, 2009 at 4:14 pm
I am also just numb about the lack of government and the American Health Insurance system affordable coverage for people diagnosed with Juvenile Diabetes. I am frustrated, angry and frightened for ALL of us! I feel sorry for the government officials and insurance agents that deny people coverage on a daily basis. I pray that they themselves or their loved ones never have to experience a medical challenge in their life time! I am not sure how they sleep at night…i know that i couldn’t. My heart is very heavy for us as a responsible and caring community. I work full time, pay taxes and have always paid for a medical insurance. People in our country are rewarded more for not working and/or contributing responsibly to society!….How can that be?????????