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.
Theoretically, this should induce inflation, but we are not seeing anything like what the theorists would have predicted.
Because it’s spread out throughout the world. When they see the U.S. print money, they print money and benefit their cronies as well. When you consider that, it can be predicted it will take longer.
If that is ever stopped purposefully, the economy will see a renaissance not seen in decades.
Well, it's not an "entitlement", that would be MediCaid, which is medical-welfare. But rather, a High Risk Pool Association is a insurance-like financial structure, that can be completely sustained by private funding once established by the state. HRP patients should be paying a premium just like anyone else.
Done properly, it's not even expensive, however, just like an insurer, a lot of money will flow through it.
The reality is, that there will be relatively few patients in the HRP at a time.
Actually it IS a "conservative act" in that it's in the best interest of the insured community AND the carriers, by keeping premiums/claims low, and enrollment high. Most of the HRP states were Red states.
Of course everything I said above could be all mucked up since it is now in the hands of Congress, but MS, NH and many other states managed to get it right.
Who has a problem with that?
Pretty inflammatory statement. Care to explain?
If they can't write a small check and get a large one in return, it's 'unfair'...and 'greedy'...and 'not who we are.'
Or something.
Back before insurance got "fixed" that was a high deductible plan with an ISA kicker.
Great deal for you.
Yeah....what you said.
Unless there is a compelling societal argument, I would agree. I can agree with compelling drivers to carry liability insurance. Medical insurance, I'm not so sure.
Allow me to reiterate: I don't support mandatory medical insurance coverage.
Was this information passed out to our wonderful, honest and non-partisan Press so they could inform the Public?
Did the Republicans hold a News Conference sharing this information point by point to refute the Propaganda being spewed by the Democrat Party?
Just askin’...
Why? It was decided that for society as a whole, it is better for everyone to have to pay a little bit more for auto insurance than to have someone suffer a catastrophic loss due to an uninsured driver.
We know what actual catastrophic care insurance costs...$50-100/month.
Unfortunately, except for a few religious groups, those have been made illegal.
Bookmark
Say you lose your job and your insurance and you continue coverage under COBRA and a year later, you get a new job that offers insurance. Because you have maintained coverage, the new ins. can't deny you because of a pre-existing condiition.
Say you lose your job and your insurance and you do not continue under COBRA. A year later, you get a new job and new insurance. Because you went a year without coverage, there was a penalty period of up to 6 months in which the new insurance would not cover the pre-existing condition. Once that period expired, the new insurance would then start covering the condition.
Depending on how long you were without insurance, the maximum penalty period was a year before the new insurance would start covering.
Am I wrong in the above?
And just how is private funding going to sustain it? It didn't sustain the pools that existed before Obamacare, what will change now?
Done properly, it's not even expensive, however, just like an insurer, a lot of money will flow through it.
Please describe how a proper pool is done?
The reality is, that there will be relatively few patients in the HRP at a time.
But those that are there will cost a lot. Far more than can be funded by premiums alone.
First, this guy's a broker. He sells a PRODUCT and he has to MARKET his product. Using language like "robbing Peter to pay Paul" leads one to believe that by tossing anyone with a pre-existing condition out of the so-called "healthy" pools will dramatically reduce premiums for those healthy folks.
It won't.
I know two actuarial accountants and a number of health care administrators at Blue Cross/Blue Shield of Illinois and also HCSC (Health Care Services Corporation) the holding company for Blue Cross/Blue Shield.
Here's what they all tell me: Pre-Existing conditions aren't an issue for BC/BS.
Why?
Let's assume that the "4% of American's have pre-existing conditions" argument is true.
That means 96% of American's covered by private insurance are "suffering" some form of financial penalty for those that have a pre-existing condition today.
Also not true.
According to the folks I talk to who do the accounting for and manage healthcare plans pre-existing conditions affect premiums for everyone else by pennies to a few bucks per month per policy holder.
What really affects the cost of health care?
Uninsured. No surprise. Those who have no coverage and show up in emergency rooms - the most expensive place to receive health care.
Government regulation. Again, no surprise.
Defensive medicine. Really? Who'd have thunk it! Doctors who have to order every test under the sun to avoid a lawsuit.
Litigation. Here's a shocker, people sue for everything these days! (Article here on FR with a woman in Massachusetts suing Trump for loss of happiness...)
Malpractice Insurance. As a result of all the litigation, malpractice insurance experiences double-digit increases every year for almost every doctor in the country.
And then finally what no one seems to talk about: insurance write-downs which cause doctors, hospitals, etc.. to come back after you and I for the "uncovered" items healthcare insurance mysteriously doesn't pay for.
Are the "chronically ill" or those with pre-existing conditions really the ones driving up the premiums for the "healthy" folks?
Nope. They're not. And when those of you who are complaining the loudest don't see the YUUUUGE drops in your monthly premiums under TrumpCare you're being led to believe are there when everyone who has a pre-existing condition is kicked out of your insurance pool I have just three words for ya:
Told ya so.
Mark this post. It'll be true should TrumpCare ever come to pass.
It's not hard to read the bill and understand it. It's not that long.
Having said that, he's a SALESMAN. He sells a product. He wants you to believe that the product he'll sell should Trumpcare ever come to pass will be the cheapest and best.
Typical salesman, IMO.
By the way he used talking points. I heard the exact same talking points repeatedly on talk radio here in the Chicago market over the weekend, notably on WGN and on WLS.
I doubt he actually "read" the bill, more than likely he based his write-up on the talking points. The same talking points Reince Priebus used on Fox News Sunday yesterday, BTW.
I think they call that the Bronze plan. The cheapest Bronze plan in our community has ~$7K deductible.
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