Posts Tagged - ‘pre-existing conditions’

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Immediate Family Health Insurance Changes Post-Reform

Tuesday, March 23rd, 2010

(Image: Steve Polyak under CC 3.0)

With the passage of the healthcare reform bill comes many changes to family health insurance policies. Some of them occur immediately.

What significant impact will families feel now?

  • Children can no longer be excluded from health insurance plans due to pre-existing conditions.
  • Adult children can remain on your health insurance policy as a dependent until the age of 26.
  • There are no more lifetime or annual caps on health coverage, either per individual or per family.
  • Free preventative care will be offered with new health plans.
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Reform Would Fund Guaranteed Issue Health Insurance Pools

Wednesday, March 17th, 2010

(Image: brentbat under CC 3.0)

Many supporters of the Obama administration’s healthcare reform believe that it will significantly help uninsured individuals with pre-existing conditions. Most health insurance plans are not willing to accept them. While each state has a high-risk health insurance pool, they are often underfunded and must put a cap on the number of people they accept.

Although guaranteed issue health insurance is already available for that group, some people may be unable to afford it on their incomes. Therefore, the bill currently pending in the Senate would increase access to the states’ high-risk pools, through $5 billion in funding. Premiums are lower, since they are partially subsidized by taxpayers.

Unlike most aspects of the legislation, the boost to the state-wide pools will not take place in 2014. Instead, it is set to become effective immediately!

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Anthem Blue Cross Health Insurance Sued By Consumers

Tuesday, March 2nd, 2010

(Image: umjanedoan under CC 3.0)

The proposed health insurance rate increases by Anthem Blue Cross in California have been extremely controversial nationwide. Now, a consumer protection group has filed a lawsuit against the health insurer.

The group, known as Consumer Watchdog, claims that Anthem and its parent company WellPoint violated state law by leaving members with pre-existing conditions in closed policies–while preventing new members from joining certain health insurance plans. When Anthem then decided to jack up premiums, those people had nowhere to turn.

There is little competition, because people with pre-existing conditions can’t shop around for individual health insurance from other providers. Instead, they must either settle for inferior coverage and higher deductibles or pay more for the same coverage. Anthem Blue Cross’ actions may be considered an anticompetitive practice due to a provision in the California health and safety code, which requires health insurance companies to either expand the risk pool or offer a comparable alternative to closed plans.

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Republicans: Underpants Gnomes in Health Insurance Summit

Friday, February 26th, 2010

(Image: Bill Ward’s Brickpile under CC 3.0)

Yesterday’s marathon bipartisan healthcare reform summit was interesting, but probably made little progress. There were definitely some areas of agreement. Most notably, Democrats and Republicans agreed that nobody should be denied individual health insurance coverage due to a pre-existing condition. They simply have different ways of going about it.

The problem with their differing methods is that Republicans would like to expand coverage without creating a mandate, which they consider to be unfavorable government intervention in private enterprise and consumer choice. In effect, their proposal is similar to the Underpants Gnomes of South Park fame. For those who have not heard of them, they have a business model that goes something like this:

  1. Steal underpants
  2. ????
  3. Profit!

Obviously, their strategy failed. The view presented by the GOP at the summit fell along those lines:

  1. Ban health insurance companies from denying coverage to people with pre-existing conditions
  2. ????
  3. Access to affordable health insurance for all!

Unfortunately, our health insurance industry doesn’t work that way. Health insurers refuse to cover people with pre-existing conditions because they fear that they will file too many claims and be unprofitable customers. In order to maintain profits for their shareholders, they can only accept those consumers if there is a larger pool of policyholders among which the cost of coverage can be spread around. Some younger, healthier people will continue to drop their individual health insurance plans if not encouraged to keep them. Therefore, as nice as it sounds, health insurance providers will not simply allow everyone to buy health insurance if it causes them to lose money.

A health insurance mandate is not an ideal solution, but there are few other options to accomplish the goal of eliminating barriers based on pre-existing conditions. Others include a government-run public option, or even a full scale single-payer system, which the Republican party is even more opposed to.

Admittedly, liberals have also been accused of using similar logic: that increased public spending on health care will eventually reduce the deficit.

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Bad Romance: Woman Will Marry For Health Insurance

Friday, February 19th, 2010

(Image: Will Marry For Health Insurance)

Another sign of the times: a woman named Terri Carlson is willing to marry a man for his health insurance. While there have been some reports of couples marrying sooner than they otherwise would have (or delaying divorce proceedings) in order to get on their spouses’ health insurance plans, this is unusual.

Terri suffers from a rare genetic immune disorder called C-4 complement deficiency. This pre-existing condition makes finding affordable health insurance very difficult. The divorcee and mother has been receiving COBRA health insurance for the past two years through her ex-husband’s job. However, that coverage is set to expire soon. Meanwhile, the expense of treatments and medications mean that even guaranteed issue individual health insurance will be unaffordable. Therefore, she is looking for a man who is willing to marry her and list her on his policy.

She is perfectly honest; it’s not about love. Obviously, someone with comprehensive health insurance will do far better with her than a person with a bare-bones high deductible plan. Needless to say, uninsured guys need not apply.

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