Momi's pain is so intense from her disease, formally known as adiposis dolorosa, that any delay would be agonizing. "I have lipomas, fatty tumors that grow throughout my body," she says. "They’re attacking through my spine, my internal organs. My nervous system is actually growing through them. You can see them."
She drives monthly to Las Vegas, more than 100 miles north of Fort Mohave, to see her doctor. He wants to install a pain pump for a new medicine from sea snail venom, but it's so expensive she has had to delay the surgery. "My doctor is helping me so much I can’t even begin to tell you," she says, crying. "I pay him what I can pay him."
No one knows how many people might still be clamoring for coverage at the cusp of Christmas. When Massachusetts launched its health insurance exchanges, the big spike in enrollment did not occur when the program began in 2007; it occurred when the financial penalty for not signing up kicked in that December, according to a study by Harvard professor Amitabh Chandra and other researchers.
For the federal law, the comparable time is the close of the enrollment period at the end of March. After that, people without health coverage face tax penalties of $95 or 1 percent of income, whichever is greater, unless they meet the criteria for exemptions. Chandra, however, notes that there are differences from Massachusetts' experience that make it less than a perfect comparison. For one, the Massachusetts penalty was higher than the federal health law's penalty in the first year. On the other side, he noted that more people in the United States are aware of the health law's penalty "because we’ve had a four-year fight about [the law]; nothing like this had happened in Massachusetts."
Laszewski says the political controversy over the rules may have left consumers confused. "Is my policy really canceled? What do all these objections from insurance commissioners really mean? The consumer is left in the lurch trying to figure out what is going on," he says.
Kirsten Sloan, a policy director for the American Cancer Society Cancer Action Network, says that is not the case with those most desperate for medical care. "Many people living with cancers and survivors who have been waiting, they know these deadlines," she said.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.
Wed, Nov 27 2013