Student Who Battled Insurance Company Over Cancer Coverage Dies
In 2011, Guha was diagnosed with Stage IV colon cancer and immediately began to undergo treatment. Unfortunately, his health insurance, which he purchased through his university, placed a $300,000 lifetime cap on his policy. When he reached that limit, Guha found himself caught in a life-or-death battle with Aetna -- and in a desperate struggle to raise the money he needed for treatment.
Through "Poopstrong," Guha told about his fight with Aetna. The story, which highlighted some of the flaws of the public health system, quickly drew attention. Eventually, following a face-to-face Twitter exchange, the company's CEO, Mark T. Bertolini, agreed to cover the student's bills. Within months, Guha's health had improved enough for him to go off chemotherapy. Last fall, however, his cancer returned and his health quickly deteriorated.
On January 1, 2014, Obamacare's spending cap and pre-existing conditions provisions will be enacted, effectively making it illegal for companies like Aetna to refuse coverage to patients like Guha.
Below is a reprint of our original story on Arijit Guha.
There's nothing new about using social media to battle big businesses: For years, the media has trumpeted stories of angry customers who voiced their gripes on social networks, often with great results. Recently, however, an Arizona cancer patient went to unusual lengths in his social media campaign, using Twitter and Facebook to engage the CEO of one of America's biggest insurance companies in a dialog about America's health care system -- and his own troubles within it.
In the end, he emerged victorious: His insurance company, which had previously denied him coverage for his expensive treatments, agreed to pay the bills.
In February 2011, Arijit Guha, a 30-year-old graduate student at Arizona State University, returned from a trip to India with a recurring pain in his abdomen. Convinced that he had picked up "a stomach bug," he went to the hospital, where he underwent extensive tests. The ultimate diagnosis: Stage IV colon cancer, which had spread to his gall bladder, lymph nodes and abdominal lining.
A Brief Respite
Luckily, Guha was insured: When he enrolled at Arizona State, he signed up for the university's health insurance program, which was underwritten by Aetna (AET) -- in fact, he paid extra to sign his wife up for coverage, too. But less than a year into his battle with cancer, Aetna let him know that he was going to have to face his health problems alone: His insurance policy had a lifetime cap of $300,000. Between his chemotherapy and operations to remove part of his colon, his gallbladder and his abdominal lining, Guha quickly reached that limit.
Guha was ineligible for Medicaid, and could only sign up for federal programs for the uninsured if he had been without insurance for six months. Faced with the loss of benefits and a potentially devastating six-month lapse in coverage, Guha went to the Internet. He launched Poop Strong, a website where he blogged about his situation, solicited donations, and sold stickers, T-shirts and bracelets. Between the revenue from his site and negotiations with his health care providers, he was able to continue receiving chemotherapy. In the process, he accumulated an estimated $100,000 in medical bills.
While the $300,000 cap on Arizona State's student insurance plan seems low, it is comparable or better than the plans offered by most universities. Fortunately, the problems Guha faced will soon be consigned to the medical waste bin of history: The Patient Protection and Affordable Care Act -- aka Obamacare -- will eliminate both spending caps and denial of coverage for pre-existing conditions on Jan. 1, 2014.
Taking It to Twitter
Early last week, Guha took his problem to Twitter, commenting on an Aetna report that its fourth quarter profits were up 73%. This generated an automatic response from the insurance company, which told him that "We care about our members. We want you to be empowered to be healthy and make informed decisions." Guha quickly answered: "That's so sweet you want me to be empowered. Does @mtbert [Aetna CEO Mark T. Bertolini] care to empower me by paying my $118k and counting in bills?"
Things progressed from there.
Before long, several of Guha's friends joined in the conversation, and representatives from Aetna called the graduate student to discuss his health problems. Soon thereafter, the company victoriously tweeted to Guha's supporters that "We connected with @Poop_Strong and will continue to support him through the start of the new plan year."
But Guha quickly burst their bubble, responding, "The thing is, I've needed you for the last 6 mos. Not for 'support' and to 'discuss concerns' but to pay my bills."
Talking to the Big Boss
By the end of the day, Bertolini had become involved, directly answering Guha's comments and those of his friends. Rather than defusing the situation, his tweets escalated it, with the CEO asking why Guha chose to buy such a limited insurance plan and Guha asking why Aetna chose to sell it. Before long, Bertolini, Guha and Guha's supporters were in a heated discussion about national health care, Bertolini's salary, Aetna's benefits, and Guta's predicament.
The next day, Bertolini and Aetna worked out a deal with Arizona State to cover Guta's bills. The graduate student tweeted "Congrats, Twitter hordes! @Aetna just agreed to cover the full extent of my bills. Every last penny. Thanks, @mtbert, for listening."
"I am glad we connected today and got this issue solved." Bertolini responded. "I appreciate the dialog no matter how pointed. I've got it and own it!...This chapter is another step in the journey. The system is broken, and I am committed to fixing it."
As for Guha, he can now use his Poop Strong profits to help others. As he tweeted after Bertolini's announcement, "Since I don't need the money to cover my bills (thanks again, @mtbert!), all the money we've raised will now go to charity...I hope the Wellness Community, @AZCancerCenter, and @CCAlliance won't mind getting some big checks from all the money I've raised."
Bruce Watson is a senior features writer for DailyFinance. You can reach him by e-mail at firstname.lastname@example.org, or follow him on Twitter at @bruce1971.