POINT OF VIEW

It worked for me

October 5, 2011 

— While Republicans rant and rave about the evils of "Obamacare," many individuals are already benefiting from the reforms. I'm one of them.

I've been branded with the scarlet letter "P" for pre-existing condition, denied coverage for years. Thanks to a new program called the Pre-existing Condition Insurance Plan (PCIP), I'm now a card-carrying member of the insured.

The PCIP is part of the Affordable Care Act, which Congress passed in March 2010. It's essentially a bridge plan, available until 2014, when all Americans will be covered under state-based insurance pools called exchanges.

While there's not enough funding to cover all of the 5 million to 7 million uninsured Americans living with pre-existing conditions, there's enough to make a dent. Congress appropriated $5 billion to fund the program, projecting an enrollment of 375,000. Thus far, only slightly more than 30,000 have signed up.

One reason for the modest enrollment is lack of information. Many eligible candidates simply don't realize they're eligible. While the eligibility criteria vary slightly from state to state, there are three main requirements: you must be a U.S. citizen or legal resident, you must have been without health coverage for the last six months and you must have a pre-existing condition or have been denied coverage because of your health condition.

Every state offers a PCIP. North Carolina's is called Inclusive Health, and there are two plans available. Both the federal and state options apply to North Carolina residents who have been denied coverage because of a pre-existing condition. The federal option also requires that the individual has been uninsured for the previous six months. Both plans offer an affordable premium rate.

I shudder to imagine where I would be without Inclusive Health. In November 2007, I was diagnosed with atrioventricular nodal reentrant tachycardia (AVNRT). AVNRT is a fairly common heart arrhythmia characterized by episodes of racing heart. Essentially, there was an extra node in my heart, which caused a short-circuiting of the electrical pathways, thus triggering an abnormally rapid heartbeat.

The good news: AVNRT is treatable through medication and curable through a simple surgical procedure called cardiac catheter ablation. The bad news: I was uninsured, and essentially uninsurable, after suffering an illness in 2005. No insurance company would touch me.

Over the next few years, my AVNRT worsened. The once infrequent episodes became a weekly, sometimes daily, occurrence. I applied for insurance with one of North Carolina's major providers. Two years had passed since my last rejection.

I checked the mailbox every day, like a high school senior anxiously awaiting that college acceptance letter. When the thin white envelope arrived, I knew without even opening that it was the usual denial: "We regret to inform you..."

Not to be deterred, I began looking into overseas option, researching cardiologists in England and India. The irony was that I live less than 10 miles from Duke University Hospital, where a world-renowned cardiologist specializes in cardiac catheter ablations. I was so close to a cure, but without insurance to offset the costs of a several-thousand dollar operation, so far. Then I found out about North Carolina's PCIP, Inclusive Health. I filled out the online application. Five days later, I got the call.

"Your application has been accepted."

I immediately scheduled an appointment with the cardiologist at Duke. A month later, I was waking up from surgery, cured. By 2014, no American will be denied health insurance because of a pre-existing condition. Until then, PCIP plans like Inclusive Health offer affordable options to thousands of Americans who bear the scarlet letter "P."

Jill Hudgins is a free-lance writer and tutor.

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