Healthcare and Labor advocates demand Cigna put Care Over Cost and cover critical treatment

By Tim Rowden
St. Louis / Southern Illinois Labor Tribune, November 21, 2022

Dozens of health care and Labor advocates – including representative from Painters District Council 58 and Operating Engineers Local 148 – jammed the sidewalk surrounding Bemiston Tower in Clayton, Mo., Nov. 11 to launch of Missouri Jobs with Justice’s Care Over Cost initiative connecting health care policy holders stiffed by their insurance companies to demand private insurers provide the coverage they promised.

Bemiston Tower allegedly houses Cigna insurance’s St. Louis office. It’s hard to say for certain, however, as aggrieved policyholders and advocates were prevented from entering the building to deliver more than 3,000 petition signatures demanding they cover Springfield, Mo. resident Mark Hall’s ulcerative colitis medication.

Cigna is not alone among private insurance companies prioritizing profit over coverage for necessary health care expenses.

St. Louis

Andre Smith, a St. Louis resident and student at Rockhurst University, shared his story of facing crippling debt after receiving a surprise $15,000 bill from Blue Cross Blue Shield (BCBS) of Kansas City.

“Health insurance companies rake in billions of dollars of profits off our premiums and then turn around and deny services and medication to their customers” said Smith. “I know as an individual, I am powerless to stop them – BCBS has shown me that by ignoring my pleas.

“When I enrolled at Rockhurst in the fall of 2021, I got access to health insurance with Blue Cross Blue Shield, something I was very thankful for, but also a requirement to attend the institution. I assumed with insurance I could get access to the care that I needed. Isn’t that the entire point? But sadly, at 19 years old, I learned that that is not what health insurance companies do. Instead of helping me when I became sick, I was stuck with an over $15,000 surprise bill I cannot afford just for trying to use the insurance. Fifteen-thousand-dollars for a 19-year-old college student is a life-crippling amount of debt.”

Smith learned about the Care Over Cost campaign of Missouri Jobs with Justice and was on hand Nov. 11 for its launch.

The Jobs with Justice Care Over Cost initiative seeks to connect people like Smith and Hall and build a movement that demands insurance companies prioritize care over profits.

After months of trying to reach BCBS, Smith spoke last month as part of a national Care Over Cost event.

“Right after I spoke, they reached out to me and I am hopeful they will finally agree to cover the services I was provided while I was insured with them.”

Springfield

In Springfield, advocates stood in solidarity with Mark Hall and his wife Callie Gibson as the couple shared just a bit of their healthcare story – and the ongoing struggle of fighting Cigna to simply cover the care Mark needs to manage his chronic illness.

“I was diagnosed with ulcerative colitis when I was 20. Essentially my digestive tract gets inflamed, which causes sores and bleeding from top to bottom,” said Hall. “After months and months of working with my care team, I found a treatment that worked – and worked well for more than a decade – my last colonoscopy indicated I was in remission.

“Last summer, my employer-provided health insurance communicated that my medication was no longer the preferred drug and that I’d be switched. My doctor appealed this decision, but was denied. We began the new drug regimen, and my symptoms returned within four weeks.”

“Mark has been paying into Cigna for more than three years and is being denied the medication that we know works,” said Mark’s wife, Callie Gibson. “We spend MULTIPLE hours on the phone with the hospital and the insurance company EVERY WEEK – which we shouldn’t have to do.

“We’re sharing our story now because this is not how healthcare should work – and not how people should be treated. Cigna made BILLIONS of dollars last year – and this year – in part by making sure people don’t know what their options are, denying care, countering doctors’ orders, all the while we all get sicker, and the bills pile up.”

‘Good health insurance’

“Many of us think we are protected by ‘good health insurance.’ We only learn how companies win and patients lose once we become ill,” said Dr. Judith Dasovich, MD, FACP.

“As Mark Hall’s situation illustrates, private insurance companies are not prioritizing care. What are they prioritizing? Profit. In 2021, Cigna made $5.4 billion in profit. In the first nine months of 2022, they made $5.5 billion, more than all of 2021.”

‘Mad as hell’

“Most doctors I know are like me,” said Dr. Ed Weisbart, a family physician, chair of the Missouri chapter of Physicians for a National Health Program and former Chief Medical Officer for Express Scripts before it was purchased by Cigna. “We love helping our patients, but we are mad as hell that they have to go through this again and again and again.

“Think about it – Mark and his employer are paying Cigna to not give him the medication he needs to be healthy. That may be a great deal for Cigna and its investors, but it’s morally reprehensible, infuriating, and often deadly.”

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