If you know people who are uninsured because of a pre-existing condition, getting health coverage under the Pre-Existing Condition Insurance Plan (PCIP) is now a lot easier and more affordable.
On May 31st the Department of Health and Human Services announced new eligibility standards and lower premiums in some states that will now make this program, created by the Affordable Care Act, available to many more Americans.
These changes include:
Reduced Premiums: Premium prices were reduced up to 40% in some states effective July 1, 2011. Please visit www.pcip.gov and go to "State Plans" and click on your state of residence to see the current rates.
Simplifying Eligibility: Starting July 1, 2011, people applying for coverage in the federally-administered PCIP can demonstrate eligibility for PCIP simply by providing a letter from a doctor, physician assistant, or nurse practitioner dated within the past 12 months stating s/he has or, at any time in the past, had a medical condition, disability, or illness. This option became available to children under age 19 in February, and we are extending this pathway to all applicants regardless of age. In addition, a person applying for coverage must be a U.S. citizen or reside in the U.S. legally and have been without health coverage for at least 6 months.
Basics: The program provides comprehensive coverage at the same price that healthy people pay and is already changing—and saving—lives. Enrollees receive primary and specialty care, hospital care, prescription drugs, home health and hospice care, skilled nursing care, preventive health and maternity care.
To qualify for this program, a person applying for coverage must be: a U.S. citizen or residing here legally; have been without health coverage for at least 6 months before applying; and have a pre-existing condition or have been denied health coverage because of a health condition. Eligibility is not based on income and enrollees are not charged a higher premium because of a medical condition.
If you know someone who you think might qualify for this program—available until 2014—please tell them to go to www.pcip.gov for more information or call a toll-free line at: 1-866-717-5826 (TTY 1-866-561-1604). The Call Center is open from 8 AM to 11 PM Eastern Time.
Thank you for helping us extend the reach and impact of this important health coverage option for the uninsured.
When she was a young resident at New York City's Harlem Hospital in the 1980s at the height of the AIDS epidemic, Dr. L. Jeannine Bookhardt-Murray (pictured right) longed to know and remember her patients, many of whom died not long after they entered the hospital.
"I was a young doctor. You finish medical school with the idea that you are going to go out and save the world and suddenly you find yourself in a situation where there is absolutely nothing you can do except the best you can do. I used to feel a little hopeless, a little helpless," said Bookhardt-Murray.
She began writing intimate details about her patients on index cards in an effort to get to know them better:
"What helped me through it was just to get to know my patients. Even though I knew most of them would die I would find time to sit with them and talk with them and really understand who that person was. During those years I would keep little 3x5 cards. I'd write every patient down and everything I learned about that patient on there because I never, ever wanted to forget what that experience was like."
Twenty-five years later, those days are over. As the Medical Director at Harlem United, a wholistic healthcare center that teaches prevention and provides treatment to those with HIV/AIDS, Bookhardt-Murray has a long-term relationship with many of her patients because of antiretroviral medications that reduce the amount of HIV virus in people's bodies, allowing them to lead a normal life.
"We know now that people will live a normal life span. They won't die from AIDS if they are taking their medications. They will die from the other things we all die from, but they won't die from AIDS," she said.
Despite the progress in medications, the HIV/AIDS rate among African Americans is higher than ever.
Blacks make up only 13 percent of the population but accounted for almost almost half, or 46 percent, of the people living with the disease. In 2006, black men made up two-thirds of all new infections among blacks and the new infection rate for black women was 15 times higher than that of white women.
In many ways, said Bookhardt-Murray, the high rates of infection may be related to the stigma that still exists in the black community. It's a stigma that hasn't lessened since those difficult days at Harlem Hospital.
In the National HIV/AIDS Strategy released by the Obama Administration this summer, addressing the stigma associated with HIV was one of the main policy recommendations.
According to the report:
The stigma associated with HIV remains extremely high and fear of discrimination causes some Americans to avoid learning their HIV status, disclosing their status, or accessing medical care.7 Data indicate that HIV disproportionately affects the most vulnerable in our society-those Americans who have less access to prevention and treatment services and, as a result, often have poorer health out- comes. Further, in some heavily affected communities, HIV may not be viewed as a primary concern, such as in communities experiencing problems with crime, unemployment, lack of housing, and other pressing issues.
It's what Bookhardt-Murray witnessed in the African-American community.
"During those days I took care of ministers from churches in Harlem -- many of them married. It's like everybody was dying from AIDS: Ministers, choir directors, drug addicts prostitutes, judges, doctors...a couple of my colleagues," said Bookhardt-Murray. "If there was a stigma, and there was a stigma, it's what I call a false stigma because this is a disease for our people that has always impacted every single level of society and it still does. It's just so highly stigmatized that no one talks about it."
There are stigmas in the black community surrounding all sorts of issues, such as diabetes, cancer and mental illness.
"It's just cultural in African-American communities. We don't talk about what we have. That great stigma has just carried over to HIV and AIDS, which has the worst stigma of all. The stigma is so bad that now even today when someone dies of AIDS, the family would rather say they died of cancer," said Bookhardt-Murray. "Some have taken it back to slavery times when there was a lot of stigma around things. We weren't supposed to talk about anything. We were supposed to be secretive about many things. We just don't talk about these bad things, but they are happening all around us."
And that is endangering a new generation.
"Our transmission rates in the African-American communities have not decreased that much and some of that may be from complacency. People think, 'Well, if I get the infection, I'll just take medications.' I'll talk to young people and they say, 'Well, everyone around me has HIV so what's the big deal? I'll just take the medications,'" said Bookhardt-Murray.
"But it's not that simple. When we are doing prevention work, I always tell people the pills are one thing but the pills don't treat the mental anguish that comes along with having an HIV infection. The great sense of guilt and depression and dejection and isolation, that overwhelming sense. The pills don't treat that. That becomes now the hardest thing for us to treat in people who are doing fine on the medication. We really need to pay attention to the mental affects of the disease."
Part of that effort is doing a better job of teaching young people about the consequences of their actions.
"People need to take great responsibility for their bodies and the situations they put themselves into. They need to relly think about the consequences of their actions. Everything we do has a consequence. If I go out and cross the street, it has a consequence. If I cross while the light is red, I might get hit by a car, right, so I wait until it's green. If it's green and I cross, I might still get hit by a car, but it's less likely," said Bookhardt-Murray. "They are experimenting with sex at very young ages these days, and they don't understand the consequences. We've got to help them try."
Beyond that, Bookhardt-Murray says she wants the disease to go away for good and she is optimistic about that happening:
"I want to see a cure during my lifetime. Two things I've hoped to see during my lifetime: An African-Americn president and a cure for AIDS. I never thought I would see it in the order I've seen it. I always thought a cure from AIDS would come first. I'm still waiting and I am convinced I will see a cure during my lifetime," said Bookhardt-Murray.
"I just can't tell you how sick of death I am. The whole illness and all of the issues that come with HIV and AIDS; I want them to stop."
Maria Davis (pictured) was diagnosed with HIV in 1995 and AIDS in 1998. She has since become an outspoken advocate for the disease. She is a peer counselor at Harlem United, a wholistic care center for people with HIV and AIDS.
Despite having neuropathy, a condition caused by her HIV medications that has damaged the nerves in her legs and leaves them feeling numb, Davis, 51, has raised money for Harlem United by completing the New York City Marathon twice.
So when she met an elderly gentlemen during this year's marathon, talk quickly turned to her HIV status.
"It was like HIV 101. I'm used to questions being a peer educator," Davis said.
Davis thought she had made a new friend who she was educating until he questioned how she became infected:
"So you were a hooker, right?" the man asked at Mile 3.
Davis was so shocked that she almost fell out. She's a promoter who was infected via a heterosexual relationship. She only found out her status when she tried to purchase life insurance.
"Oh, so you must have used IV drugs. You were a junkie?" the man said.
Davis said that despite all of the public education about HIV/AIDS, she still sees the bias out there.
"When I tell people I'm living with AIDS, they get a little standoffish....The stigma is still incredible, because people still ask me whether they can get HIV from the toilet seat. I'm like, No. 'You can't get it if I drink behind you?' No. It's bodily fluids. It's not saliva. It's not holding someone's hands," said Davis.
But Davis says she tries to be understanding because she once held misconceptions about the disease:
"When the insurance people said to me you have to take an HIV test, I was like, Absolutely, of course, because back then we thought it was only a gay white man's disease, and we were wrong," Davis said.
And that's what helped inspire her to become a peer educator. Davis said there's a need to make more of a personal connection to those with HIV/AIDS and those most at risk. Too often, she said, educators hand out a condom and a booklet about the disease and call that "outreach."
World AIDS Day 2010
"You can put a book in front of a person but whatever they are going through with their life, your point of reference is not everyone else's point of reference.... It depends on what a person has going on in their life. Are they homeless? Are they in a domestic violence situation? Are they abusive to themselves? Do they not love themselves?" said Davis.
"You have to know people's stories. That's what I think we have to do more of in this community: Know a person's story. Not just put a condom in their hand or a booklet in their hand and say, 'Here is the information.' Find out why they are not taking that information and what can we do to help them understand how important they are as human beings."
It was a lack of love for herself that led to her contracting HIV from a heterosexual relationship, Davis said.
"I didn't love myself, although I showed myself as a strong African-American sister who had it going on, inside I was in turmoil," she said.
Understanding why she contracted HIV led her to want to help others:
"What really inspired me to be a peer educator was seeing so many people still getting infected. Not dying, but still getting infected in the African-American and Latino community. I said what can I do to put me out there even more. I felt I needed to be right in the community, on the ground with the folks that I see walking up and down the street every day," Davis said.
That desire led her to Harlem United, where she is a peer educator and runs marathaons to raise money for the organization. On the marathon path, Davis said she learned about bravery from some of the other participants.
"I saw a man on crutches and he didn't have a body, only a torso. I saw a gentleman on one foot pushing toward the finish line ... people in a wheelchair. I was like, Do I want to give up? No, because if he can do it, I can do it. I have feet. Yeah they are a little numb, but they are still feet," Davis said.
Davis finished the marathon in 7 hours and 46 minutes. A healthy person can walk the 26-mile route in about 7 hours.
"I'm with the average people," Davis said.
Her run-in with the man who thought the only way she could have possibly have gotten AIDS, was from being a drug-using hooker inspired her even more:
"The one thing I would like to happen is that everybody stop looking at each other from the outside.... We are all human beings. When we decide to start accepting each other as human beings and not looking at each other for whatever we might be going through, this will be a better world," Davis said.
"We have to learn how to suffer with each other, not look at someone and say, 'I feel sorry for you,' or, 'I'm in a better place than you,' but suffer with them like Jesus Christ did. He suffered with people. To me that's when the numbers will go down, because then people will start feeling better about themselves. They will learn love starts from the inside, not the outside."
When Roger Chapman (far right) was first diagnosed with what is now known as HIV/AIDS, doctors still thought it was a gay men's disease.
Thirty years ago, it was identified as GRIDS or gay-related immune deficiency, because clusters of homosexual men were the first to be identified in this country with the symptoms.
When Chapman, 58, discovered the news 31 years ago, he thought he wasn't going to live long; his prognosis was "death likely within a year."
"In the beginning, it was kind of hard because I didn't want to believe it. I used to get dressed every night and wait for the undertaker to come get me so he would find me nicely dressed," Chapman said.
Today, Chapman has overcome the feelings of inadequacy and self-hate that he felt. He is a leader and client representative on the executive board at Harlem United, a holistic health care center for people with HIV/AIDS in Harlem.
As a gay man and former IV drug user, Chapman said he had to make a decision:
"It came a point where I had to realize that either I'm going to live or I'm going to die. What's been happening to most of us who have HIV, especially for as long as I have had it, and for those who have AIDS, we start doing self-stigmatization.
"We start internalizing those things people say, 'Oh, you are a drug addict, a homosexual, a street worker,'" Chapman said. "We keep hearing those things and a lot of people take it in and that's how we lost a lot of our brothers and sisters. They started believing and they gave up. They gave up."
Chapman didn't want that to happen to him. After seeing the disease take so many of his friends and volunteering in AIDS wards, where he saw so many people suffering and dying, he made the decision to help others.
Today, as World AIDS Day approaches, men remain at the highest risk for contracting the disease. Men accounted for 74 percent of HIV diagnosis in 2008. Half of the men diagnosed with the disease in 2008 think they were exposed through male-to-male sexual contact.
"I learned that I don't have to die," Chapman said. "I had some stuff that I could share."