For thousands of Californians suffering from chronic and persistent illnesses, access to quality, affordable medical care is essential to their overall health.
Yet, these patients have a one-in-four chance of being denied coverage by their insurance provider, according to a recent poll. Even if Congress cannot agree on how to reform our nation’s health care system, California’s political leaders should agree that patients should get the health insurance they bought.
Almost half of all Americans live with a chronic disease that requires ongoing treatment. In 2015, 47 percent of Medi-Cal recipients had high blood pressure, 42 percent had high cholesterol and 26 percent had arthritis.
In a national survey by the Doctor-Patient Rights Project – a coalition of patients, physicians and advocacy groups – 24 percent of patients with chronic illness said they had been denied coverage for treating their conditions. Of these patients, 34 percent said that forced them to skip treatment and 29 percent said their condition worsened as a result.
In general, the chronically ill tend to be poorer and older than other patients, and may also be more likely to face a denial of treatment coverage from their insurers. That makes them more susceptible to negative health effects when they are denied.
Federal and state governments have not conducted much research on treatment denials and their impact on patients’ health. In a 2011 study limited to six states, the federal Government Accountability Office found that the rate of treatment denials varied between 6 percent and 40 percent, depending on the company.
At the very least, the new survey reveals a hidden health care crisis among insured patients, and a serious need for California’s leaders to investigate treatment denials, particularly of the chronically ill.
Patients with chronic conditions who dutifully pay their health insurance premiums should not have to worry that their insurance provider will deny coverage when they need it most.
Seth Ginsberg is president and co-founder of the Global Healthy Living Foundation, a nonprofit based in Upper Nyack, N.Y., and part of the Doctor-Patient Rights Project. He can be contacted at firstname.lastname@example.org.