On this episode of the podcast, Terry and Bob discuss the Employee Retirement Income Security Act of 1974 (ERISA), which protects employer-sponsored insurance plans from state regulations that help patients. They also detail the recently-passed $1.9 trillion stimulus package’s patient-friendly provisions, including Obamacare subsidies for the middle class, increased federal matching for states that expand Medicaid, additional funding for telehealth, and COBRA coverage for employees who have lost their jobs during the pandemic. 

Terry and Bob introduce a new segment called The Last Word, which features Dr. Paul Langley refuting the latest ICER reports. In the inaugural segment, Dr. Langley explains how ICER’s recent review on medications treating high cholesterol is flawed. Namely, it ignores the scientific method and neglects the voice of patients and caregivers. It’s a complete scam, he argues. Read more at AccessandAffordability.org

Terry interviews Glenn Kantor, founding partner of the law firm Kantor & Kantor, about what patients should know about ERISA and how it affects their disability claims. He explains how insurers hide behind ERISA to avoid paying claims and the many hurdles patients must go through to file a claim successfully. Insurance companies often follow a policy of “deny, deny, deny,” knowing that patients will often simply give up attempting to get their disability claims approved.

His top three tips for disabled people filing claims are:

  1. Tell your employer about your condition.
  2. Be honest with your doctor about the severity of your symptoms.
  3. Consult with an experienced ERISA lawyer before filing a claim.

He calls for ERISA reform to eliminate discretionary review so that disability appeals can be examined by judges on the balance of evidence rather than giving preference to insurers. 

Patient correspondent Kate Pecora interviews Kaitlin Kerr, who explains how patients with disabilities can lose their Social Security Disability Insurance upon entering an interabled marriage. She tells her story of losing her life savings and her house to pay for her medical treatment. She discusses how her disability benefits, which were extremely difficult to get, are threatened by marriage — even common-law marriage. She highlights how the Biden administration is working to eliminate this marriage penalty, and why it must listen to real patient voices in order to make successful reform that doesn’t discriminate against some interabled married couples. 

Listen HERE