WASHINGTON (AP) — Cancer patient Kathy Watson voted Republican in 2008 and believes the government has no right telling Americans to get health insurance. Nonetheless, she says she’d be dead if it weren’t for the Patient Protection and Affordable Care Act (PPACA).
Now the Florida small businesswoman is worried the Supreme Court will strike down her lifeline. Under PPACA, Watson and nearly 62,000 other “uninsurable” patients are getting coverage through a little-known program for people who have been turned away by insurance companies because of pre-existing medical conditions.
“Without it, I would have been dead on March 2,” Watson said of the Pre-Existing Condition Insurance Plan (PCIP) program. That’s when she was hospitalized for a life-threatening respiratory infection.
It’s not clear how the U.S. Supreme Court will rule on PPACA, but Watson’s case illustrates the potential impact of tying everything in the far-reaching legislation to the fate of one provision, the unprecedented requirement that most Americans carry health insurance.
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PPACA’s opponents say if that insurance mandate is found to be unconstitutional, the rest of the law should also go, since courts should not be picking and choosing policy and drafters failed to include provision declaring that the rest of the law should stay in effect if some parts are thrown out.
The Obama administration defends the insurance requirement but says that, if the court decides to overturn it, most of the rest of PPACA should stay.
States can choose between administering their PCIP programs or letting the federal government provide PCIP services for their residents.
Officials in the 27 states that run their own PCIP programs are trying to make fallback arrangements in case the law is invalidated and coverage suddenly terminates.
“Some of these individuals are critically ill and are being treated for very serious illnesses, whether it be cancer or HIV-AIDS, and we feel a responsibility to them to do what we can to see they don’t lose access,” said Amie Goldman, who oversees PCIP in Wisconsin.
The federal officials who administer the plan in the other 23 states and the District of Columbia remain mum on what might happen there if the law is overturned.
The White House line is that Obama is confident the Supreme Court will uphold PPACA, and that his administration therefore is making no contingency plans for a reversal. None of that sounds reassuring to Watson, who owns a medical transport service in rural north-central Florida.
“It’s scary,” she said. “They need to look at this carefully because it is going to affect a lot of people with a lot of bad conditions who are not going to have any health care coverage.”
Before PCIP, Watson had been uninsured since 2003, originally turned down because of elevated white blood cells. About three years ago, she was diagnosed with a chronic form of non-Hodgkin’s lymphoma, a cancer of the immune system. Unable to afford medications, she relied on the emergency room to treat flare-ups.
She tried applying to a major insurance company for a small business plan for her and her employees, and was quickly rejected. Then she heard about PCIP.
The temporary program is meant to serve as a patch until 2014, when the federal health care law will require insurers to accept all applicants, including cancer patients like Watson, regardless of medical history. The law’s controversial mandate for individuals to carry health insurance is related to that guaranteed acceptance provision. By forcing healthy people to buy insurance, it would help keep premiums in check, provision supporters say.