Thursday, April 21, 2011

Del Castillo says health plans gaining greater control over future of SB 1274


Insurance company meddling in Hawaii state law has worsened, according to patient rights attorney Rafael del Castillo. Castillo says he is "concerned because Sen. Roz Baker is doing the drafting and I believe she will enlist the assistance of the health plans lawyer, Ellen Carson, as she did once before on SB1274. Carson is going to see to it that our consumer protections are repealed. The health plans are ADAMANT that we shall lose those protections and rights."

We need to ask ourselves who benefits if SB 1274 is passed. The obvious answer is all the health insurers in Hawaii who provide Medicaid coverage to 264,000 people.

But who has the most to gain from the passage of SB 1274? The answer to that is the two for-profit companies that between them gobble up almost seventy percent of the state's Medicaid budget.

Passage of SB 1274 will allow Evercare (UnitedHealth Group) and Ohana (Wellcare) unfettered permission to make life and death medical decisions based on profit margin rather than medical need. The current "retroactive" clause in the bill will save UnitedHealth up to $500,000 by dismissing all the currently pending review cases. Speaking to the media on behalf of the bill, UnitedHealth attorney Dianne Brookins openly admitted these legal costs "just adds to the cost of healthcare."

Companies like UnitedHealth and Wellcare keep shareholders happy by keeping something called the MLR, or Medical Loss Ratio, as low as possible. When the government is paying them a guaranteed monthly fee for every Medicaid or Medicare enrollee, the MLR is kept low by not spending as much of that fee as possible. Across the country, over 13.5 million people are having their Medicaid decisions made by for-profit health insurers.

This video has been released by the opponents of SB 1274, to show the human toll when for-profit health insurers have life and death power over the families of Hawaii's disabled population.

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I'm the mom of a child with disabilities. Hannah's first neurologist said she might never develop beyond the level of a 2 month old infant, and there wasn't anything I could do about it. The brain damage was just too severe. Nine years later, she walks, uses a touchscreen computer and I've just been shown she can learn to construct sentences and do simple math with the right piece of technology. Along the way, I discovered I needed to teach myself what Hannah's rights to services really were. Learning about early intervention services led to reading about IDEA and then to EPSDT. I've been waiting for the Obama administration to realize the power and potential of EPSDT for the medical rights - including the right to stay at home with their families - of children with disabilities. The health reform people talk about long term care, and the disability people talk about education and employment, but nobody is talking about EPSDT. So I am.