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Uninsurable Utahns

I wish there was a way for families who make too much for CHIP and Medicaid, but can’t afford private insurance to get decent coverage.
The Rasmussen Family

Hollee Rasmussen is a young mother of three children who lives in Vernal with her husband where they own a plumbing company. Although Hollee, her husband, and her oldest daughter have insurance, her four-year old twins are left without coverage. The twins are completely healthy other than ordinary childhood illnesses; yet because of a heart condition one twin had at birth (that self healed), insurance companies refuse to insure either twin. Group plans that would offer coverage for Hollee’s family through their business are consistently too expensive.

“My husband is constantly trying to find ways to afford insurance for our family and through his company. He works a lot and tries to help his employees as best he can.” Hollee is constantly worried that her children will contract illnesses or have injuries, especially because she knows that even one incident could devastate her family financially. In the past Hollee and her family have had to make payments on debts they have accrued for medical services to hospitals and clinics. To avoid digging her family deeper into medical debt, Hollee has put off taking her kids to the doctor as long as she can. She tried other means of treating her children, turning to any remedy that was rumored to have worked.

“I waited to take my children to the doctor until they are extremely sick and their illness had progressed to something much worse and harder to treat. I wished there was a way for families who make too much for CHIP and Medicaid, but can’t afford private insurance to get decent health care coverage.

The Patient Protection and Affordable Care Act will help the Rasmussen family in a variety of ways:

Most importantly, starting September 2010, insurers cannot discriminate against children based on pre-existing conditions so Hollee’s twins can no longer be denied coverage.

In June 2010, an interim high-risk pool will provide immediate access to insurance for Utahns who for at least 6 months have not been able to get coverage because of a pre-existing condition. This pool will operate until 2014 when the full health reforms come online.

Lower income Utahns will be eligible for subsidies to help them purchase coverage through the high-risk pool.  This interim high-risk pool has consumer protections to ensure you get quality insurance.  The plan cannot exclude coverage of pre-existing conditions or charge older Utahns more than younger people.

By 2014, insurers cannot discriminate against anyone based on pre-existing condition. Individuals and families will be able to shop for and compare affordable plans on a new online marketplace called an Exchange. Families may receive subsidies to help buy coverage from their state’s health insurance exchange.  If they still cannot afford to buy insurance, they could apply for a hardship waiver and subsidies will be provided to families with incomes of up to 400 percent of the poverty level.

As a small business owner, Hollee’s husband will have access to new tax credits for small employers who contribute at least 50% of their employee’s total premium.  The full 35% credit of an employer contribution will be available to small businesses with fewer than 10 employees averaging less than $25,000 annual wages.  Small employers with fewer than 25 employees and average annual wages of less than $50,000 are eligible for a sliding-scale credit.