Politicians, bureaucrats and insurance company executives make decisions about life-saving medical care for people with disabilities every day. When those decisions are based on financial considerations, such as the size of profit made by the company providing the care, Olmstead fails and people may die.
Fourteen year old Mycal Johnston drowned from the fluid in his lungs on July 12, 2009. He had been discharged on June 24 from Oahu’s Kapiolani Children’s Hospital, with a prescription to fill at home for the one drug specialists had found that could control this life-threatening symptom of Mycal’s cystic fibrosis. Wellcare was receiving more than $15,000 dollars a month from the state of Hawaii to provide Mycal with his Medicaid services, but by refusing to provide him with a primary care physician the company was able to deny filling the prescription until Mycal died.
More of Mycal’s story is told on Disability Mom’s blog.
In May 2010, a Honolulu man may have attempted suicide when he was shot by an off-duty FBI agent. Research showed that he had been off his medications since January, not purposefully, but because Wellcare refused to provide him with a primary care physician who could authorize the prescriptions.
Erik Sorensen died because he turned 21. The monthly payment Wellcare was receiving from the state of Hawaii went from almost $12,000 a month to less than $6,000, while his scheduled nursing and personal care assistants were costing Wellcare over $10,000. They slashed his services to fit his budget, and Erik later stated in a deposition filed in Hawaii District Court that he felt strongly that Wellcare was threatening to institutionalize him if he did not accept the reduction in services.
If Erik had been institutionalized, Wellcare would have gone back to receiving more than $10,000 a month for his care.
More about his story is written here.
Worse yet is the plight of hundreds of thousands of people with disabilities who are on waiting lists for Medicaid services. Federal law prohibits Medicaid-eligible children under the age of 21 from being placed on any kind of waiting list for servces, but there is anecdotal evidence that many states disregard this right.
Individuals who did not make it into Medicaid before they turned 21 can then sit on waiting lists for services for up to thirty years.
Olmstead has failed them as well.