Passage of House Health Reform Potential Impact for Women with Ovarian Cancer

With the passage of the Affordable Health Care for America Act (H.R. 3962) in the House of Representatives this past weekend, women with ovarian cancer and their families may be wondering how this bill will affect their health care coverage. Listed below are some major provisions of the bill. The House bill is not the final Health Reform bill – we will not know what final provisions will be enacted until a joint bill is passed by both Houses.

Most Americans will be required to have insurance
•The bill will require all individuals to have health insurance and will levy a penalty on those without coverage, starting in 2013. Exceptions will be granted for religious or financial reasons.
•Health Insurance Exchanges will be organized. Individuals who do not already receive health insurance through their employer may purchase health insurance through Health Insurance Exchanges. These exchanges will offer insurance plans that include a minimum benefits package and comply with other cost and quality standards.
Benefits
•Requires coverage for individuals with pre-existing conditions. Additionally, no insurers will be allowed to put annual policy limits or lifetime policy limits into effect or cancel a policy when individuals file expensive claims.
•Insurance Companies prohibited from charging women more based on gender. A practice known as gender rating, where women are often forced to pay higher premiums for the same coverage men receive will be eliminated.
•Eliminates Cost-Sharing for preventive services in Medicare and Medicaid including mammograms and Pap tests.
•Provides wellness grants for small employers to implement a qualified wellness program.
Coverage
•Employers will have to offer coverage to employees and pay for a majority of the premium costs.
•A national “Health Insurance Exchange” will be created for individuals who do not already receive health insurance through their employer. Additionally, states that comply with federal standards will be eligible to run their own health insurance exchanges. Within the exchanges, insurance plans provided by private companies will be available for purchase, as well as a competing government-run health insurance plan.
•Individuals who currently are uninsured, have expensive coverage through an individual plan, or who work for small businesses may seek a health insurance plan through the Exchange over the next few years.
•Individuals and families can purchase insurance on the exchange if they are not covered by employer-sponsored insurance or if they do not have other federal insurance including Medicare, Medicaid, TRICARE or Veteran Affairs (VA) coverage.
•If a person is a full-time employee receiving coverage through their work, they will not be able to shop for insurance through the Exchange unless their employee-provided coverage accounts for more than 12% of their income. By 2015, the Secretary of Health will determine whether employees of large businesses may enter the Exchange.
Cost
•Low and middle-income individuals will receive a federal subsidy to enable them to afford their purchase of health insurance. Financial assistance to pay for health insurance will be provided to families with incomes up to 400 percent of the Federal Poverty Level. For example, assistance will be provided to a family of four with an income below $88,200. (Visit the Federal Poverty Guidelines to see more).
•The bill places caps on out-of-pocket spending. Individuals will have annual out-of-pocket spending limits of $5,000 per year, and families will have annual out-of-pocket spending limits of $10,000 per year. Lower-income individuals and families with incomes below 350 percent of the Federal Poverty Level will have lower out-of-pocket limits.
•Small businesses will receive a tax credit to assist them in offering health insurance to their employees.
Changes to Existing Programs
•Medicare Part D Gap will be reduced and eventually eliminated. There will be a $500 reduction in the coverage gap (also known as the Medicare Part D “doughnut hole”). By 2019, the “doughnut hole” will be completely eliminated.
•Provides a discount on brand name drugs purchased through Medicare.
•COBRA coverage may be retained until the exchange is established.
•Provides numerous incentives for coordination of care, enactment of alternative medical liability laws, administrative simplicity and use of comparative effectiveness determinations.
What’s next?
Health care reform is far from over. First, the Senate must pass either this bill or its own bill. Next, a Conference Committee must be formed to combine the House and Senate bills. Then that combined bill must be voted on by both the House and Senate. Once passed, the bill will be signed by the President. Many do not expect the President to sign a health reform bill until February, 2010.

Article courtsey of the Ovarian National Alliance.

Take Charge!

What I have realized through this experience is that we as women need to take charge of our own health care. Just because a physician tells you, does not mean you should accept it as gospel if you still feel like something is wrong. We as women know our bodies and must trust our own instincts when we think something is wrong. Get a second, third fourth or even a fifth opinion. Also ask as many questions as you need and if you are not comfortable with the answers find a new doctor. We should also share information, sharing information on ovarian cancer helps raise awareness, and will help you or someone you know get a much earlier diagnosis. Early diagnosis makes a huge difference. Again, I want to encourage all women to take charge of your health, for we know our bodies best!

This is God’s day. My faith gives me power. My prayers and all those that are praying for me give me strength. Amen

The 411 on the seasonal flu and H1N1

What Ovarian Cancer Survivors Need To Know
Together with the White House, the Ovarian Cancer National Alliance participated in a discussion about the flu, both seasonal and the H1N1 viruses. The discussion was led by cancer and vaccine experts at the Center for Disease Control and Prevention (CDC).
Women with ovarian cancer have a higher chance of having complications from the flu virus. As a result, the Ovarian Cancer National Alliance advises you to read the information provided below and consult your doctor about what actions you should take to protect yourself.

Prevention

How can I protect myself from getting the flu?
Experts suggest vaccination. In addition, you should wash your hands frequently and avoid touching your face.

Why are there two vaccines this year?
There are two vaccines for two different types of flus this year. One is the seasonal flu, the other is H1N1 (commonly referred to as “swine flu”). Both vaccines are made through the same process, and should have the same efficacy against the viruses. As in previous years, anyone allergic to eggs should not receive the shot form of the vaccine.

If I am an ovarian cancer survivor, can I get the nasal spray/mist? Should my family members that I am in close contact with get the nasal spray/mist?
People with compromised immune systems, including people in treatment or with a history of cancer should not get the nasal spray. The nasal spray vaccine contains weakened live viruses. These people should only get the shot, which contains dead viruses.

Individuals who do not have compromised immune systems, including caregivers of those with cancer, may opt to have the nasal spray vaccine. The nasal spray/mist has only been approved for use in people 2-49 years of age who are not pregnant and do not have compromised immune systems.

If I am an ovarian cancer survivor and am not in treatment, should I get a flu vaccine?
Medical experts recommend that if you have a history of cancer you should receive both the seasonal flu shot and the H1N1 shot (not the nasal spray/mist). People with a history of cancer are at high risk of complications from the flu.

If I am in treatment for ovarian cancer, should I get the flu vaccine?
If you are in treatment for cancer, medical experts recommend that you receive both the seasonal flu shot and the H1N1 shot (not the nasal spray/mist). Dr. Bill Atkinson, vaccine expert at the Center for Disease Control and Prevention (CDC), recommends that if you receive your vaccination while receiving chemotherapy, you should confer with your doctor about getting re-vaccinated following treatment. There is no evidence that the flu shot will affect the efficacy of chemotherapy.

How do I get the vaccines?
Call your doctor to see what s/he can offer. The H1N1 vaccine is being distributed to states through the federal government, which purchased the vaccine. The seasonal flu vaccine is likely available at your doctor’s office, but may be found in retail stores such as pharmacies and grocery stores. The H1N1 vaccine is paid for by the federal government, but your provider may charge an administrative fee. If your provider does not offer the H1N1 vaccine, call your State Department of Health.

After I get vaccinated, what should I do?
1) Create a written record of your cancer and the treatment you are receiving and keep this information with you at all times.
2) Create a legible list of your medications and the time of day they are taken.
3) Keep your doctor’s name, contact information, and office address with you at all times.
4) Continue taking prescribed medications even if you are sick with the flu unless your doctor says otherwise.
5) Be alert to changes in your breathing and contact your doctor immediately if you notice changes.

The Flu

What are the symptoms of the flu?
Seasonal flu symptoms may include fever, coughing, sore throat, runny or stuffy nose, headaches, body aches, chills and fatigue. In the case of the H1N1 flu, symptoms may also include vomiting and diarrhea. If you get these symptoms and have a condition that would put you at increased risk of complications, such as ovarian cancer, call your health care provider.

Additionally, see your doctor immediately if you experience dizziness, confusion, severe/persistent vomiting, rapid breathing, shortness of breath, difficulty breathing or flu like symptoms that get better and then worse – this may indicate a secondary infection.

If your child has a bluish skin color, is not drinking fluids, lethargic, irritable, and/or has a rash, consult your doctor.

If I get the flu, what type of treatment can I get?
If you are diagnosed with ovarian cancer, you can receive anti-viral treatments, such as Tami flu and Rolenza. Please see your doctor for treatment options, as not everyone will need or be eligible for treatment.

If I get the flu, what should I do?
Call your doctor to see what s/he recommends in terms of treatment. It is also advised that you stay home as to not spread the flu virus and infect others. If you must go out, consider a face mask.

If I am in treatment and I think I have the flu, what should I do?
Call your doctor immediately. Your doctor will likely recommend anti-viral treatment, and the flu may affect your ability to receive chemotherapy on schedule.

This article was taken from the November 2009 Ovarian Cancer National Alliance nwsletter.