Two men with serious health conditions. Only one was protected by ACA

As Republicans contemplate “repeal and replace” legislation, they will probably allow insurers to reinstate the annual and lifetime coverage caps. These once applied to 105 million Americans and are now banned under the Affordable Care Act.

Did you ever wonder what would happen to taxpayers, patients, and families when these caps are hit? I certainly do.

Rocky Clark was a Chicagoland football star paralyzed on the gridiron. Carlo Trovato was diagnosed with leukemia and had a $1 million-cap insurance policy from his employer. Both men suffered devastating illness or injury. Only one was protected by the ACA, and that made all the difference.

More here.

Author: Harold Pollack

Harold Pollack is Helen Ross Professor of Social Service Administration at the University of Chicago. He has served on three expert committees of the National Academies of Science. His recent research appears in such journals as Addiction, Journal of the American Medical Association, and American Journal of Public Health. He writes regularly on HIV prevention, crime and drug policy, health reform, and disability policy for American Prospect,, and other news outlets. His essay, "Lessons from an Emergency Room Nightmare" was selected for the collection The Best American Medical Writing, 2009. He recently participated, with zero critical acclaim, in the University of Chicago's annual Latke-Hamentaschen debate.

4 thoughts on “Two men with serious health conditions. Only one was protected by ACA”

  1. Why would somebody ever have accepted a medical insurance policy with a lifetime cap? Didn't he know that cancer, heart disease, lung disease, and a dozen other equally terrible conditions could outspend his maximum within a few years? Why didn't he negotiate a better contract? ::snark off::

    Harold, in present circumstances we may be pissing in the wind. But hey, I gotta piss anyway, and I can't think of anything better to piss on, so keep after it, friend, and I will too.

    1. If it's an employer-provided plan, you either take it or don't. And, in most cases pre-ACA, individual plans also had lifetime caps. So in general, either you had insurance with a lifetime cap or you didn't have insurance.

      1. Don, are you saying you don't believe in the unfettered marketplace to solve all problems?

        I think you overlooked the end of my first paragraph.

        1. Yeah, I missed the ::snark off:: I'm assuming the "unfettered marketplace" is also snark.

          But I bet a lot of people actually believe what you said is reasonable.

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