The LA Times wasn’t kidding when it reported that California high-risk pool for the medically uninsurable is “unavailable, ineffective or unaffordable for many.” I looked into this program — dubbed the Major Risk Medical Insurance Program (MRMIP) — because it’s pretty much my only option for insurance after having been turned down by Kaiser, Anthem Blue Cross, and Pacificare due to “pre-existing conditions.”

The one good thing about the MRMIP: The people working at the call center are very knowledgeable and helpful — which basically was very helpful in letting me figure out how bad the situation is. The problems with MRMIP:

1. MRMIP has a long waitlist. As of now, it’s 3 months long, according to the woman at the call center I spoke with. Why? The state isn’t funding the program like it’s supposed to.

Basically, I’m supposed to pay for 2/3 of the cost of my insurance, with the state making up for the last third. But, as the LA Times reports: “Lawmakers have kept annual financing at or below $40 million a year, requiring the pool’s administrators to cap its enrollment. As a result, for much of Schwarzenegger’s tenure, the pool has had a waiting list of hundreds of people.”

This waitlist exists despite the fact that the number of people already on MRMIP isn’t large at all. “The program now covers about 13,000 Californians — about 2% of the medically uninsurable,” reports the LA Times.

Luckily, I can still ride out my former USC health insurance coverage (Anthem Blue Cross) for a few more months. I’ve been complaining about the cost of this insurance — $400 a month — but now it seems like a bargain because –

2. MRMIP is expensive. Like really, really expensive. The application online has the 2008 rates, but since, due to the waitlist, I wouldn’t be enrolled until 2009, I asked the woman if the rates would change — and indeed, they will be going up!

In LA County, MRMIP applicants have 3 options, Anthem Blue Cross PPO, Blue Shield HMO, and Kaiser Permanente SoCal. Since I already have Anthem, I wanted to keep that so I could keep seeing the same docs. However, that privilege would cost me $538.20 a month in 2009! ($476.25 in 2008) That’s $6458.40 a year!

The cheapest option is Kaiser, which would cost $294.55 a month ($274.78 in 2008). This looks like the option I’m going to have to choose simply due to financial reasons. I really don’t want to switch to Kaiser, because its facilities are often not the easiest places to get to via alternative transportation. Diane, a fellow de-car’d woman, advised me against Kaiser because with them, even filling a prescription becomes a big ordeal, requiring multiple bus transfers and waiting around in less-than pleasant areas (i.e. that skeezy area right under the 10 freeway on La Brea).

Yet Kaiser looks like the best option. After paying my $294.78 a month, I’ll still need to meet a $500 deductible for anything beyond routine preventive care services — which generally require $20 copays. I didn’t even ask about Blue Shield’s 2009 rates, which are the highest of the three, at $527.10 a month for 2008.

These costs are crazy, but MRMIP has an even crazier problem —

3. MRMIP has an exclusion / waiting period. Got a pre-existing condition? Well then don’t enroll in Anthem’s PPO because the first 3 months “no benefits or services related to a pre-existing conditions are covered.” But get this! The very next sentence describing this exclusion period reads thusly: “However, subscriber contributions are paid during this period.” Yep — you’d still have to hand over a check for $538.20 each month to Anthem, but you won’t be able to get any help for the very health issues that made you seek out health insurance in the first place!

The Blue Cross HMO and Kaiser policies have a slightly better deal. Instead of an “exclusion period,” there’s a 3-month “waiting period” — during which you’re technically enrolled in MRMIP but aren’t allowed to actually get health care (”No benefits or services are provided to subscribers and enrolled dependents during this period”). Fortunately(?), you also don’t have to start paying the monthly fee until month 4.

The exclusion / waiting period is waived for people who’ve been on the MRMIP wait list for 180+ days — or for people who, like me, who were previously insured by another program — so long as we get our MRMIP application in within 63 days since that previous insurance ended (This, BTW, is the reason why I’m scared of a lapse in coverage; lapses make it more difficult to get health insurance in the future).

Right after this post I’ll get to work on my MRMIP application, unless anyone has a better suggestion. One main thing I’ve learned through all this: Schwarzenegger sucks. Not only did he veto universal health care for Californians TWICE, he also recently vetoed a bill to expand the pool for MRMIP, according to the LA Times.

How fast do you think Obama will be able to get his health care policy in place? It’s not what I’d consider universal health care, but it certainly sounds better than what we’ve got now –

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For those who don’t have school or employer-sponsored health insurance — AND have been turned down by the “free market” — AND remain ineligible for health insurance programs aimed at the young(er), the old((er), the disabled, or pregnant –

I looked into what’s available for us in terms of “regular” health insurance (meaning plans beyond catastrophic insurance, or simple prescription med discounts and the like). This is what I’ve found so far:

>> Health insurance via organizations you’re involved with, like your local chamber of commerce, alma mater, or freelancers’ union. Roz Cummins — frequent contributor to Grist — gets her insurance through her local chamber of commerce, and encouraged me to do the same. Unfortunately, Santa Monica Chamber of Commerce doesn’t offer a health insurance option — and is against universal health care to boot. I also discovered that my alma mater, USC, only offers its alumni catastrophic insurance. And freelancers unions with local chapters — while able to procure discounts for those who’re accepted by insurers — can’t help out those who’ve been rejected in the private health insurance market.

>> Health Insurance Portability and Accountability Act. If you’ve been covered under employer-based health insurance for 18+ months, AND exhausted your COBRA coverage, you can get HIPAA coverage — as long as you don’t qualify for Medicare, Medi-Cal, and/or do not have other health insurance coverage. Unfortunately, since I got my last health insurance via my school, not an employer, I’m not eligible for HIPAA.

>> Major Risk Medical Insurance Program (MRMIP). This program guarantees coverage for Californians who’ve been turned down (or have good reason to believe they’ll be turned down) for medical insurance due to “pre-existing conditions” — and aren’t eligible for Medicare or COBRA. I’m applying for this.

The bad news is that a recent LA Times article found that “Rising premiums and limited subsidies have made the Major Risk Medical Insurance Program either unaffordable, unavailable or ineffective for many of those who most need health insurance.”

Still, I’m totally applying for MRMIP, and will let you know what happens from here. If you’ve tried applying for MRMIP in the past, please share your story in the comments.

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Need another reason NOT to vote for McCain? His health insurance plan would force more people out of employer-sponsored health insurance to the individual market — in the guise of giving you “choice.” And guess what: Women are forced to pay significantly more for health insurance for men, even for policies that exclude maternity services.

Of course, for those of you who — like me — don’t have employer sponsored insurance anyway, there’s no choice but to try and find an option in the individual health insurance market. Most of you’ll want to buy individual health insurance, warts and all.

However, if — like me — you’ve been turned down by a bunch of health care companies and can’t get individual health insurance. So here’s what I’m up to now.

First, I checked out the California Department of Insurance site, which has put together a short guide for insurance seekers. Unfortunately, most of the info had little to do with me, but I’ll list those here for those who might be helped by it:

>> Family Medical Leave Act, for those working at companies with 50+ employees

>> COBRA, for those who used to have employer-sponsored health insurance and want to extend that after leaving the company

>> Access for Infants and Mothers, for pregnant women and their newborn children

>> CalWORKS, for families with minor children

>> Healthy Families, for children and teens

>> Medi-Cal, for those 21 or younger or 65 and older — or adults taking care of people that fit those age constraints — as well as those who are pregnant, disabled, refugees, or living in a nursing home.

>> Medicare and Medigap, for older or disabled people

While I didn’t qualify for any of the above, I did find some programs I might be able to take advantage of. That’s what my next health care post’ll be about.

Update: Here’s Part II — in which I find a health insurance program that might actually have to accept me!

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How I’m voting for the environment in the Nov. 4, 2008 election.

As of now, I plan to vote no on Prop 3. Rest assured that it’s not because I hate kids with leukemia. And rest assured that if you make a compelling argument in the comments, I’ll reconsider my position.

Prop 3’s a heart-tugging initiative. Basically, it’d authorize almost $1 billion in bonds to fund hospitals that treat kids with serious illnesses like leukemia, cancer, and sickle cell anemia.

The reason I’m voting no? Four years ago, Cali voters supported a similar bill that authorized $750 million in bonds. Even the LA Times, which is for Prop 3, notes that $350 million of this money still remains unspent.

We vote on propositions like every 6 months. I suggest that the private hospitals, which are the ones that’ll be getting about 80% of this money, use up what they’ve already got from taxpayers first before asking for $1 billion more.

After all, many of us — especially myself, who can’t get health insurance in the private market — are unhappy with the health care system at the moment — especially the private sector. This is why the Green Party opposes Prop 3.

Basically, I’d like to wait to see what happens with our health care system after Obama becomes president. After that, I feel both I and other voters will be better able to decide what initiatives to dedicate taxpayer money towards.

And the hospitals asking for the money still have $350 million left to play with until that happens.

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How I’m voting for the environment in the Nov. 4, 2008 election.

I voted for Julia Brownley in the primaries, and I’m voting for the California League of Conservation Voters-endorsed candidate again. I voted for Julia in 2006 too.

While Senate Bill 840, the California Universal Health Care Act that would’ve given full, universal healthcare for ALL Californians, got vetoed by Schwarzenegger AGAIN, I’m proud to say my Cali Assembly member had signed on as a co-author of the bill. I trust that she’ll pick up the fight again in Feb. 2009, when the bill comes up again.

Vote Julia Brownley for Cali Assembly, 41st District.

Image via juliabrownley.com

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Now that I’ve been turned down by Anthem Blue Cross, Pacificare, and Kaiser for health insurance, I’m getting pretty stressed out — especially after watching Critical Condition. Thanks to reader M, I learned PBS’s Critical Condition, a docu film about health care (or the lack thereof) in the US, is available for free viewing online until Nov. 11.

Critical Condition follows 4 people who either don’t have health insurance, or lose health insurance because they have to stop working due to medical issues. The sad thing is that, due to financial reasons, many of these people had cut corners — i.e. skimping on meds they need and not getting preventive care — to then develop life threatening health problems that they can’t pay to get taken care of.

One guy with serious back pain, for example, keeps taking more and more over the counter pain meds — until he finally has to go to the ER due to ulcers caused by those meds. A woman in pain delays going to the doc because of the expense — to find out that her financial worries delayed her diagnosis until she had stage 3 cancer. Because these people without insurance are under financial constraints, they end up playing Russian roulette with their lives. In fact, 2 of the 4 people featured in the docu are now already dead.

The film’s full of scary facts about the medically uninsured. Uninsured patients charged 2.5 times what insured people are charged for the same treatments and procedures, for ex. A doc talks about how in the US, we ration care for people without health insurance. And about the back pain dude who finally gets the surgery to help him live something closer to a normal life, several doctors attest to the fact that the dude should’ve gotten help A LOT earlier than he did, and that had the dude not been part of a docu that brought him attention, he likely would never have gotten the help he needed.

To be clear, I still do have health insurance at the moment — I’ve opted to extend my student health insurance for $400 a month — but that option ends in a few months from now. So now I’m going to look into how to get nontraditional insurance. Some of you readers have kindly weighed in with advice and options; I’ll look into and evaluate those in coming posts.

In the meantime, watch Critical Condition, and sign up for updates from OneCareNow, the nonprofit that’s fighting to get universal health care for all Californians.

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How I’m voting for the environment in the Nov. 4, 2008 election.

I’m pissed that this proposition’s even on the ballot, because it’s already been voted down TWICE by Californians, in the form of Prop 85 and 73. I phonebanked and everything — and now we have to fight it AGAIN!

Prop 4 would basically force girls under 18 — some of whom come from physically and sexually abusive families — to get permission for an abortion from a family member. Most girls consult with their parents about their reproductive choices already, so this prop would basically hurt only the girls who come from the worst family situations where such open communication isn’t possible!

The revisions in Prop 4 from the previous prop allows a girl to talk to another family member instead of a parent — but only if she can convince a doc that “she fears physical, sexual, or severe emotional abuse” by her parent AND that “her fear’s based on a pattern of such abuse.” Of course, if the girl has no other family members, she’s shit out of luck here.

Another revision allows judges to waive this notice requirement — but only if the girl can convince the judge she’s “sufficiently mature and well-informed” or “that notification would not be in the minor’s best interest.” Basically, this prop would put the fate of a beleagured teenager at the mercy and whim of doctors and judges who barely know the girl or her parents and family members.

Vote no on Prop 4.

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>> I’ll be watching the debate tonight at V Lounge, 2020 Wilshire Blvd., Santa Monica, avec mes amis. Everyone’s welcome, so long as you have at least $10 ($25’s “recommended”) to contribute towards the Obama-Biden campaign.

>> Prefer to stay in front of the computer? Hulu’s gonna livestream the debate. (via Lifehacker)

>> At CJR, Trudy Lieberman’s put together a dozen tough questions on health care she’d like the candidates to answer tonight. Just reading the list’s pretty illuminating about the many holes in both candidates’ health care platforms. Earlier: What US healthcare will look like: Obama vs. McCain

>> Unrelatedly: My tweeting’s mentioned in CNET’s “Tracking ‘green’ news as it grows, with Twitter” — an article about the green web and tweeting written by Elsa, my fave San Francisco shopping buddy.

Photo by Barent Roth

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Thanks to our fucked up health care system, we need a new D.A.R.E. campaign of sorts: Don’t do prescription drugs — even when it’s prescribed to you cuz you need it!

Why? According to Business Week, “That prescription you just picked up at the drugstore could hurt your chances of getting health insurance.”

Basically, insurance companies are looking up people’s prescription drug records — then using that as a reason for denying them health insurance. And while an increasing number of people are taking anti-depressants, “drugs for depression and other mental health conditions are often red flags to insurers.”

I actually already knew this, because when Pacificare turned me down for health insurance, I got a letter saying this decision may or may not have been based on the info about my prescription drug history obtained from MedPoint, a company that collects this sort of data.

No, Pacificare’s decision didn’t have to do so much with my drug history. Still — While I tend to agree that anti-depressants are often over-prescribed, I don’t think that even people who take anti-depressants unnecessarily should be given such a harsh penalty for their actions — considering, after all, these actions were doctor-sanctioned.

As an FYI to anyone who’s been denied health insurance — and BTW, according to Business Week, about 30% of people who apply for individual insurance “are deemed uninsurable because of their histories, according to industry veterans” — I was able to get my prescription med history from MedPoint FREE by requesting it.

MedPoint and IntelliScript are the 2 big companies that compile prescription drug history info. If either of them provided info to a health insurance company you applied to for coverage, AND you were turned down, you should be able to get your med info free — at least in California.

Image via dare.com

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Update on my health insurance situation: Anthem Blue Cross and Pacificare have turned me down; Kaiser’s taking its sweet time coming down with a decision. In the meantime, I’m still paying $400 a month to continue my old USC health insurance — but even that’ll end in less than 5 months.

Think it’s strange that a physically healthy, relatively young, working girl like me can’t get health insurance — at any price? So you know, 80 percent of those without health insurance work. That’s one of the important facts in the new documentary Critical Condition, which aired on PBS this week. Trudy Lieberman provides a review of the film, which I’d totally watch if PBS streamed it online –

Even those with insurance sometimes can’t get coverage for the very medical conditions they need the insurance for in the first place. Glenn Hall pays $8400 a year for a Blue Cross Blue Shield policy — but still isn’t covered for the very things he gets sick for. Why not? Glenn had a kidney stone once — so his insurance company slapped an exclusion on diseases of the kidney and urinary tract. Now Glenn pays for full coverage though he doesn’t get it — and can’t change insurers due to pre-existing conditions.

Such exclusions are the gaps in medical coverage new Cali bills are trying to close up. 10 bills that seek to expand what insurers must pay for await Schwarzenegger’s signature. Read the article to find out how Schwarzenegger “must balance improved coverage with the risk of driving costs so high that people can’t afford it.”

Of course, for the second time, Schwarzenegger just vetoed Senate Bill 840 (PDF), Senator Kuehl’s California Universal Health Care Act — which promised full, universal healthcare for ALL Californians. Nonprofit OneCareNow, which has been pushing for SB 840, says “we’ll be back” come February 2009 — but the veto’s a bitter disappointment indeed.

And unfortunately, while McCain’s health care proposals are horrendous, Obama’s isn’t all that much better — mainly because it’s very short on specifics.

My next health care post’ll have more cheerful info ’bout what we can do ’bout all this. Promise.

Update, 10/19/08: Kaiser’s officially turned me down too.

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