The obese, people with AIDS encounter coverage gaps

Feb 17 2014

Many plans sold through the health law's marketplaces don't cover weight loss surgery, and none in Louisiana are accepting payments from a federal program intended to help people with HIV/AIDS. The New York Times explores who benefits from the latest employer mandate extension, and Kaiser Health News answers a question about the health law's impact on a person covered by COBRA.

The Associated Press: Health Plans Don't Cover Weight Loss Surgery
Like 78 million other Americans, MaryJane Harrison is obese. And like many critically overweight Americans, Harrison cannot afford to have weight loss surgery because her health insurance doesn't cover it. The financial burden makes it nearly impossible for her to follow the advice of three physicians who have prescribed the stomach-shrinking procedure for Harrison, who is four-feet, 10 inches and weighs 265 pounds (2/14).

Reuters: More Obamacare Insurers In Louisiana Reject AIDS Patients
The only three insurance companies in Louisiana that sell healthcare policies under President Barack Obama's healthcare law throughout the state are rejecting payments from a federal program intended to help low-income HIV patients, advocacy groups said on Thursday. The Louisiana Health Cooperative and Vantage Health Plan, two smaller insurers, made the move following a decision by the state's largest insurer, Blue Cross and Blue Shield of Louisiana, late last year to reject the payments (Begley, 2/13).

The New York Times: Assessing Who Benefits From The Latest Rulings On The Employer Mandate
Even companies that have to abide by the mandate in 2015 -; that is, those with at least 100 employees -; will get some leeway in that first year. The law requires that companies offer insurance to 95 percent of full-time employees in order to avoid paying a penalty, but that requirement will not take effect until 2016. Next year, a company can avoid the penalty simply by offering insurance to 70 percent of full-time employees. (Full-time employees, under the law, are those who work 30 hours a week.) This relief, however, is not quite as generous as it might seem at first glance, because the employer mandate actually contains an additional penalty: companies are also penalized for offering insurance that does not meet new standards set by health law for quality and affordability (Robb Mandelbaum, 2/13).

Kaiser Health News: A Reader Asks: If I Am On COBRA, Do I Have To Buy A New Marketplace Plan?
Kaiser Health News' consumer columnist Michelle Andrews answers this question. Cheaper deals may be available on the state exchanges, but consumers don't have to ditch their COBRA plans.