Posted on 05/07/2017 1:33:44 PM PDT by taildragger
Posted by May 6, 2017 Action, Protecting America - Protecting our Freedom, Something YOU can do
Let me begin this post by saying I am a licensed Independent health insurance broker with 10 years of experience mostly in the Medicare, Group & Individual insurance markets. I represent my CLIENTS and myself, not one particular company or lobbying organization. My goal is to have happy customers and to be able to make a living with products that are valuable and affordable to people so they will want them.
The House GOP congress recently passed a bill to repeal and replace Obamacare this past week. It is called the AHCA or “American Health Care Act”. Partisan politics has once again reared its ugly head and the Democrats are using scare tactics and outright lies (much like they did to pass Obamacare) to try and dissuade people from supporting this bill. Much has been made about “Pre-Existing Conditions” and how this bill would supposedly not protect those consumers. This is an outright LIE. I will explain what Pre Existing condition really means, who it applies to and what options are available pre Obamacare, during Obamacare and if this bill passes the senate, post Obamacare under this new bill.
What are “Pre Existing Conditions” and who does this apply to?
The Democrats with their overtly theatrical rhetoric would have you think that Pre Existing Conditions applies to everyone with a hangnail and that those mean Republicans will have every person in the country re-evaluated for hangnails and thrown off their current insurance plan if a hangnail is found. This is of course not true.
First of all, Pre-Existing conditions don’t even apply to about 85% of consumers. If you are one of the following, then the new law will NOT affect you AT ALL:
Thats the majority of people in the country. So the majority of people in the country will NOT be affected by the Repeal & Replace of Obamacare’s Pre Existing Conditions law.
So that begs the question. Who will be affected by these changes and how?
People who will be affected by the Pre Existing Conditions changes
The people that will be affected by these changes are people who:
This would be people who are under 65, not veterans and not disabled and they allow their current insurance to expire and then do not get new coverage within 63 days.
What happens to these people if they allow their insurance to expire and don’t new coverage in 63 days?
So whats next for these people? Do they get sent to Mars? Do we let them die in the streets? Of course not.
These people will be eligible for High Risk Pool Insurance through their state, backed the federal government. If they wait more than 63 days to get coverage and are denied new coverage due to a Pre existing condition they will get a letter telling them how to apply for the high risk pool plan to get guaranteed insurance. So alas, they will NOT be left out in the cold to die like the Democrats would like you to believe. Will they pay more for this coverage had they not waited? They might, depending on their states rules. Some states have subsidies based upon income to help people afford the high risk pool plan premiums. They might also have broader access to doctors and hospitals then if they were stuck in their old HMO so there could be a silver lining there as well. High risk pool plans were largely successful Pre Obamacare. The problem was there were only 33 states that offered them so 17 states did not have this option before. All 50 states will have this option under the Republican plan.
What is a Pre Existing Condition?
So what is a Pre Existing condition anyways? Its definitely not a hang nail. Its not even high cholesterol. The only Pre existing conditions underwriters take into account when deciding the issue coverage or not are conditions like Diabetes or Cancer for example. Some companies will insure conditions like Epilepsy, others won’t. Some companies will issue a policy covering everything except the Pre existing condition or some companies may have a waiting period for the Pre existing condition to be covered. In any case, there will always be the high risk pool plan options if people get denied. Nobody will ever be left in the cold. Also its important to remember that people with Diabetes and Cancer and other serious conditions cannot be denied coverage if they already have insurance. They cannot be kicked off their current plans and they cannot be denied by an insurance company if they do not allow their current plan to lapse more than 63 days without a new plan. Also remember this NEVER applies to folks on Medicare, Medicaid or Tri Care or with VA benefits or anyone obtaining insurance through their employer. Pre Existing conditions never apply to those people.
What other changes are in this law? Will it help or hurt anyone?
Now that we have covered Pre Existing Conditions, what else is in this bill and how will it affect people?
Conclusion
In conclusion this bill stops robbing Peter to pay Paul. It is much more fair in its pricing laws and it ensures every American has access to health insurance without a heavy emphasis on redistributing wealth and rewarding bad behavior. This bill rewards responsible behavior while still protecting our most vulnerable.
Move. It's overrun by liberal moonbats.
That's not GI. You don't want that. However, carriers generally honor each other's pre-x's.
This also keeps my premiums much lower than if I chose a standard HMO option where just about everything is covered (after per-event co-payments).
Funny. I wouldn't have thought that establishing an expensive entitlement like a high-risk pool was a particularly Conservative act.
What?
So the carrier doesn't have to issue you a policy but if they do it can't cost more than the previous carrier charged?
Seriously?
I remember my husband quitting work in Texas to become self employed. I was pregnant at the time and bought Blue Cross and was told that I would be covered at the ‘group rate’ and I was. I had a high risk pregnancy and birth with a child in NICU and 60K in bills and it was all paid for. I remember something similar in PA, but that was a long time ago.
Obama care supporters act as though this is the first time in forever when pre existing conditions were covered. Also, I support states' rights.
That's great. I know the Blues often didn't exclude pregnancy.
I was just a little surprised at your statement since in my experience TX wasn't really a state mandate kind of place.
A lot of people get scared off with out-of-pocket and so prefer the HMO where everything is covered (with a nominal co-payment). However, the monthly premiums are much higher and if not subsidized by an employer, probably unaffordable to many. The HSA/out-of-pocket option is actually cheaper in the long run, especially if something catastrophic happens (because you are 100% covered after the deductible is paid).
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This, I believe, was the point that Rush Limbaugh was trying to make on Thursday that we shouldn't call this insurance. In a sense, our healthcare problem is unsolvable with the idea of insurance as simple risk management. Allowances are going have to be made for those with preexisting conditions, particularly those which are not caused by their behaviors. To some degree, many people are going to pay more than their individual cost to cover the uninsured and the uninsurable.
Great post, thank you.
Many employers offer an HSA in the benefit package as one of the coverage options. So it is possible.
I don't support mandatory insurance coverage.
Not if you don't qualify as insurable.
but if they do it can't cost more than the previous carrier charged?
Well I don't know about that. But they would cover the pre-x if the previous carrier did. (within their designated time frame)
Contribution amounts are limited. And most companies offer HSA for an employee to contribute to, but they do not contribute. Rather than them paying $10k a year into insurance I rarely use, put that money into an HSA.
My retirement medical costs would be well covered by that type of scenario.
Set aside funds when you are healthy to pay for deductibles when you are not. Then the $6,000 and $12,000 annual deductibles are not so scary, and catastrophic insurance becomes more common.
I use a health care ministry to insure our college age daughter. Her school has an affiliated hospital to train nurses and doctors, and campus clinics are basically free.
So she will likely never have a traditional health insurance claim, since all minor bruises and illnesses are very inexpensive. I can cover the deductible for a major event like an auto accident with savings before filing any sort of claim.
The unACA led to terrible insurance costs and deductibles if you didn't get a subsidy. One plan I saw offered a $12,000 family deductible and paid 70% after that, but cost minimum $1400 per month for a family.
Let's not pretend that the unACA truly helped anyone except:
Those families that could get a federal subsidy,
Insurance companies getting subsidies (at least until the feds stopped paying them),
Politicians that got campaign bribes to keep the system in place.
And Medicaid underpayment.
But that's already the case:
To the former, bad debt and charity care are the biggest cost drivers in provider charges. Of course they pass this on to the carriers and cash customers unless they object. (cost shifting)
Regarding uninsurables, if done properly through a wide-disperal assessment, it should cost each premium very little.
From what I've heard, I believe you're going to see the rollover. Also, I also believe you can currently also use your HSA fund for retirement.
What services did taking away Medicare dollars do to seniors and what will putting dollars back do pursuant to law?
They didn’t. The money taken was just made up by debt. This is part of how the debt doubled under Obama.
I do not know how it will be paid for, or if the U.S. will simply default one way or another.
We have been doing a kind of default with the “quantitative easing”. We have been paying debt by basically printing dollars electronically, as best I can determine.
We owe China hundreds of Billions. They demand payment, we ship them more electrons, totally recyclable, that shows they have been paid.
Theoretically, this should induce inflation, but we are not seeing anything like what the theorists would have predicted.
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