The Patient Protection and Affordable Care Act of 2010 (PPACA) has helped some Indiana residents obtain desperately needed health coverage while contributing to rapid cost increases.
Witnesses talked about both sides of the PPACA story today during a field hearing in Evansville, Ind., that was organized by the health, employment, labor and pensions subcommittee at the House Education and the Workforce Committee.
George Philip Hoy, a retired minister who is an Evansville resident and the interim pastor at the Zion United Church of Christ in Henderson, Ky., spoke in support of PPACA.
Hoy told the subcommittee that he has 17 grandchildren and will soon have 19.
"Four of our grandchildren have pre-existing health conditions," Hoy testified, according to a written version of his remarks provided by the subcommittee. "I am grateful that our grandchildren will be assured of coverage because of the Affordable Health Care Act."
One PPACA provision requires health plans that offer dependent coverage to provide access to the coverage up to age 26, and Hoy said that provision is already helping his family.
"One of our grandsons, an honors college graduate and one of the four grandchildren with a pre-existing health condition, is still awaiting an opening as a school teacher," Hoy sid. "He is single, living at home, and working as a substitute teacher. Thank God he is covered by his parents' insurance due to the provisions of the Affordable Health Care Act. We also have several nieces and nephews who benefit from the extended coverage for young adults."
Elizabeth Wilson, a Franklin, Ind., resident said she aged out of her mother's insurance when she was 23, while she was in the hospital for acute pancreatitis and her overall health was deteriorating. Her family depended on COBRA benefits extension coverage to keep her insured, and now doctors believe she may develop a condition such as luplus.
"Without the federal dependent coverage extension, and considering the long string of health challenges that I've faced over the past few years, I could have seen dire financial and health outcomes," Wilson said. "I could not have continued to pay the mounting health care bills to the hospital, my primary care physician, or the various specialists that I had been seeing for the past few years if I were not able to reenroll in my mother's health plan in January 2011 because of the Affordable Care Act."
Robyn Crosson, chief deputy commissioner at the Indiana Department of Insurance, said the Indiana department has joined in the fight to repeal PPACA and has seen the law lead to problems.
Indiana, for example, already was requiring carriers to provide access to dependent coverage up to age 24 when PPACA extended access to age 26, Crosson said.
"While the intent was positive, it has led to a situation where certain employers, who budgeted for covering dependents for a lesser amount of time, now have to react to the change," Crosson said. "Insurers and employers with self-funded insurance have generally reacted by increasing premiums to cover the extra years of cost."
Another well-intended PPACA provision now prohibits insurers from excluding benefits or limiting coverage based on a preexisting condition for an individual under the age of 19.
"One of the consequences experienced in Indiana as a result of this legislation was that carriers stopped writing child-only policies," Crosson said. "Carriers claimed that the law led to adverse selection."
The Indiaa department created enrollment regulations designed to reduce the risk of antiselection, but only one commercial company now appears to offer child-only policies in Indiana, Crosson said.
Still another well-intentioned PPACA provision has created a federally funded health insurance pool for residents with high-risk health problems, but, because people must be without any kind of health insurance program for 6 months to qualify for the federal risk pool, most Indiana residents must enroll in the state risk pool, which has no waiting period, instead of the federal pool, and enrolling in the state pools makes them ineligible for the federal pool, Crosson said.