Answer: Before the Affordable Care Act, insurance options were scarce for Wisconsinites with disabilities. Social Security Disability beneficiaries have a two-year wait period before they are eligible for Medicare, and many people with severe and permanent disabilities did not qualify for Wisconsin Medicaid because they did not have a child under 18 in their home.
If they didn’t have work-based insurance, people with disabilities had few realistic options for individual coverage. Individual insurance plans in Wisconsin could deny people based on pre-existing conditions or charge astronomical rates, and having a disability was almost always grounds for denial or outrageously high premiums and deductibles. The High Insurance Risk Sharing Plan (HIRSP) had a six-month pre-existing condition waiting period and was often far too expensive for people to afford. People who had worked hard all their lives but could no longer work due to their disability couldn’t afford COBRA coverage even if it was offered to them.
In short, people with disabilities who were applying for Social Security or were waiting for Medicare to start often had no options for insurance. Without insurance, many people with disabilities ended up going to the emergency room, and many went without the care they desperately needed.
Thanks to the Affordable Care Act, people with disabilities can get covered and won’t be denied for pre-existing conditions or be charged more because of their illnesses. Costs will be lowered, too. The average Social Security Disability benefit is only 120% of the Federal Poverty Level, so most people with disabilities will be eligible for tax credits and subsidies on the Affordable Care Act marketplace to ensure they can access coverage.
—Kevin Kane, lead organizer, Citizen Action of Wisconsin
The Shepherd Express and Citizen Action of Wisconsin will answer questions about the Affordable Care Act during its implementation. Got a question? Email firstname.lastname@example.org.