[ColdNoMore]

Originally Posted by charlieo1126@gmail.com

One of the important things in Obama care was not being able to use pre existing conditions , the plan might have had flaws but everyone tried to sabotage it from the start , when it was ruled everyone didn’t have to join it was hurt badly , especially by seniors that had there’s and didn’t care . I had to laugh at the argument that it was unconstitutional to make people join unlike medicare ( sigh )

Well stated.

[Villages Kahuna]

Remember, if POTUS’ lawsuit to eliminate Obamacare is successful, that would eliminate the pre-existing conditions protections that are part of the Act. In that it’s being proven that COVID is leaving survivors of the infection with long term problems, it’s a certainty that insurance companies would claim such and deny coverage for long term treatment.

[Boomer]

Originally Posted by J1ceasar

I think your way over thinking this not to get political but even the guy that it's the president right now has said he refuses to take away the pre-existing condition clause for any health insurance policy so we are protected 100% if you feel so strongly I suggest you start saving for your children and their children into a trust maybe 5 or 10 million dollars will do it. Or start your own insurance company

I think you missed my point or decided to dismiss it or divert the discussion by getting personal. I am not sure why you brought my family into it. I am not talking about my family.

I am talking about the fact that that late last Thursday a brief was filed that threatens the protection of preexisting conditions. The “guy” to whom you refer in your post fully supports that filing. The argument is to completely strike down that which contains the protection of preexisting conditions.

In my opening post here, please notice that I said, “No matter where your loyalties lie, no matter whether you have younger people in your life to love, please pay attention, stay informed — from a variety of sources.”

I am telling you that while the nation is enveloped in chaos, behind the scenes the case to nail the coffin shut on the protection of preexisting conditions is on the march toward the final decision.

When I wrote yesterday’s post, I did it from my own thinking about whether Covid could be termed a pre-existing condition if the protection is struck down.

This morning I did a Google search and found an article in Fortune asking the same question about the threat to preexisting conditions protection.

May I ask that you please do the following so that you can find more current information than what you seem to have:

1. Go to Google.
2. Type in the words ‘preexisting condition’ and ’Covid’ and ‘Fortune.’
3. Just typing those 4 words into Google search will take you to the article in Fortune which will explain some details of what is going on right now that threatens the protection of pre-existing conditions.
4. Go for it. All you will really need to read is the first sentence in the Fortune article.

I graciously and sincerely hope you will take the time to do that little search so that you will have the most recent information. Confining yourself to limited sources of information is not a way to stay truly informed.

I remain,
Cassandra Boomer

PS: Btw, if there is any curiosity about why I sometimes sign off as Cassandra Boomer, it’s a reference to Greek mythology. You can Google the words ‘Cassandra’ and ‘Trojan War’ — and you will quickly find a short explanation. I knew, going in, that my Cassandra shtick would apply here. (sigh)

[Eg_cruz]

Originally Posted by Boomer

It is highly possible, that in the relatively near future, insurance companies -- again -- will be allowed to use pre-existing conditions as their right to deny coverage.

If insurance companies are awarded the unconscionable power to deny coverage for pre-existing conditions, it is not a big leap of the imagination to think that having had Covid 19 could be termed a pre-existing condition.

Why do I think that could happen? — because we do not understand where this virus can take us. But we do know that Covid 19 can sometimes leave very serious, and possibly chronic, health problems in its wake — even after supposed recovery.

I realize that most Villagers are comfortably swaddled in Medicare or good coverage from military retirement or previous employers. But, even so, in this time of overwhelming distraction, it is important to stay informed of what is playing out behind the front-and-center chaos.

Gen X and Millennials and younger boomers who get the virus and recover could find themselves saddled with a pre-existing condition — forever— just for having had the virus — even though nothing else has shown up — yet — after recovery.

Maybe I am overthinking this. Gee, could insurance companies ever even consider reaching into such a pot of gold as Covid recovery as an excuse to deny coverage.

No matter where your loyalties lie, no matter whether you have any younger people in your life to love, please pay attention, stay informed — from a variety of sources.

The ultimate decision to protect or to take away the individual’s right to not be denied health insurance coverage due to a pre-existing condition is in the works — with powerful support to take away that right.

Be careful what you wish (wished?) for.

Cassandra Boomer

That may be true but my insurance went through the roof before the so called Affordable Care Act my premium was $225 with a $1500 deductible. Today it is $600 a month with a $10,000 deductible. This coverage is for one person with no health issues. I have to Pay $100 a month for the AfCA as mandated by the act even though I’m not covered by AFAC. I have coverage outside of it because I couldn’t afford it under the AFCA. But someone has to pay for the subsidizing, again the middle class is.
The long and short of it the act has way to many holes in it and once again the middle class is paying the price. Young people who can get insurance through work have to even if the AFCA would cost a lot less and the retired person worth $3M gets subsidize because they don’t show any income on their tax returns because they’re using their savings so they’re getting their health insurance for less than $100 a month. I work in this field and I see this all the time. So, yes the act needs to change because it’s a hot mess and I am tried of having to pay for it out of my pocket.

[wayneman]

I am in the medical field and have decent ins. We struggle with the ins co every time we need something done. They deny the procedure or make you jump through hoops. Now, the uninsured come into the ER continuously and get every test and scan they want. I see it every day i work. So don’t worry, they can’t refuse you treatment. The people who have ins are paying for the non insured. We should all take the same approach. Everyone should do away with there insurance and just go to the ER. You can set up a payment plan. My plan would be to show good faith and pay $20/ month. The medical system is broken and it needs to be fixed. There is a Reason ins Companies and pharmacy are raking in billions of dollars. Some of you may think this is wrong, but i am telling you it’s getting worse by the day. It’s reality.

[MandoMan]

Originally Posted by Dr Winston O Boogie jr

What's always confused me about this is that insurance is, or has always been a bet. In the case of health insurance, you're betting that you will have medical expenses and the insurance company is betting that you won't. Or at least that your expenses will be less than what they charge you for insurance.

Forcing insurance companies to cover pre-existing conditions is like forcing someone to bet on a losing horse after the race has been run.

I don't see how there is ever going to be a solution to that issue.

The original intent for the Affordable Care Act was that everyone with a job who didn’t get health insurance coverage at work would have to pay every month for insurance coverage, even if they were young and healthy. The first couple years, my sons were only paying about $100 a month for good coverage with a $2,500 deductible. Then that requirement got canceled by Congress, and as a result, there was no way the available policies could remain affordable. Add to that millions of Americans who had never had health insurance and now began using their insurance for endless trips to the doctor that they used to skip. This should have been anticipated, but it wasn’t.

Even today, the Affordable Care Act could once again be affordable if drug prices were controlled, if everyone without insurance were required to pay for it or pay a large yearly fine, as intended, AND if the policies had substantial deductibles. It could also be done if some of the policies were for catastrophic care coverage. Say, a young single guy had to pay $250 a month and was responsible for all normal costs, but if he crashed his motorcycle, everything over $10,000 would be covered.

[arickis]

Just to state the facts. President Trump does not allow any insurance company to deny coverage based on a pre existing condition. He also promised to forbid any insurance company to deny coverage due to pre existing conditions as long as he is president. These are the facts. do not listen to the fake news.

[ColdNoMore]

Originally Posted by arickis

Just to state the facts. President Trump does not allow any insurance company to deny coverage based on a pre existing condition. He also promised to forbid any insurance company to deny coverage due to pre existing conditions as long as he is president. These are the facts. do not listen to the fake news.

Would love to see some legitimate proof...of the "Just to state the facts."

Because as far as I understand, without actual legislation I don't see how anyone..can promise that.

But just for the sake of argument...let's say it's true.

There is a huge difference between "outright forbid/deny" and "obscene premium increases"...when it comes to preexisting conditions.

Given that even the so-called "not-for-profit" health insurance/providers need to at least break even, I can't quite figure out...how they can stay viable.

For those not in a large group plan (where discrimination for preexisting conditions isn't allowed) or those who qualify for Medicare (ditto) and without a mandate for a large group (that would be less likely to make claims) to contribute...how are insurance companies or health care providers supposed to stay solvent?

As for emergency room care, EMTALA (click here) only requires the institution to provide minimum care and to stabilize...an admitted (which a lot don't even allow admittance) patient.

This does not include those with cancer/obesity issues/diabetes/other long term health issues/Etc.

[llmcdaniel]

I wish you were correct, but doctors are seeing lung and kidney conditions developing as a result of Covid. These could definitely be used against people in the future as pre-existing conditions.

[ColdNoMore]

A lot of folks seem to have forgotten, the dramatic and consistent rise in the costs of premiums and treatment that had been going on...long before ACA.

I recall a huge issue in sitting down with unions in the late 90's and early oughts, in renegotiating the Collective Bargaining Agreement (CBA), was their outrage of how much their portion (at that time based solely on a % of the company's total cost)...had risen in recent years.

This was actually their #2 concern, behind wages of course...but well ahead of work rule changes.

[blueash]

Originally Posted by asianthree

Pre exist has never gone away, it’s just worded differently. Usually becomes your deductible, that they don’t pay for

This is not accurate. The insurance carriers are no longer able to ask or collect data on your pre-existing conditions. The deductible is identical for every person who shares a similar policy with no regard to whether they are ill or well. The same is true of the copays required of a policy. This is exactly how Medicare works. All covered persons have the same language in the policy if they get one the same as their neighbor.

This was a major shift in how medical insurance has been sold and is one of the features of the ACA which is now being challenged in the SCOTUS by several states with the support of the administration in office. The brief filed asks that all the provisions of the ACA be declared unconstitutional. This is explicitly stated on page 45 of the brief filed by the administration

Trump Admin Brief California v. Texas | Patient Protection And Affordable Care Act | United States Government

If the administration's view is accepted by the Supreme Court we will be back to insurance companies having the option of charging more for coverage of older people, sick people, women, throwing children off their parents' policy at age 18 or 21 or whatever they select, lifetime limits, and all the other protections that exist now only because of the ACA.

[roscoguy]

Originally Posted by Choro&Swing

The original intent for the Affordable Care Act was that everyone with a job who didn’t get health insurance coverage at work would have to pay every month for insurance coverage, even if they were young and healthy. ... Then that requirement got canceled by Congress, and as a result, there was no way the available policies could remain affordable. Add to that millions of Americans who had never had health insurance and now began using their insurance for endless trips to the doctor that they used to skip. This should have been anticipated, but it wasn’t.

Very true. What had been reported, but is now largely ignored, is that it was the insurance companies that demanded the individual mandate. This only made sense from an insurance standpoint: you can't have only elderly and/or sick in the insurance pool or there wouldn't be enough money to cover costs. ALL insurance works in a similar way. Some members of Congress & Attorneys General worked to have the individual mandate struck down, basically as a backdoor method to bankrupt or invalidate the ACA.

Originally Posted by Choro&Swing

Even today, the Affordable Care Act could once again be affordable if drug prices were controlled, if everyone without insurance were required to pay for it or pay a large yearly fine, as intended, AND if the policies had substantial deductibles.

Also very true. And another proposed part of the ACA that some members of Congress demanded be removed.

Originally Posted by Choro&Swing

It could also be done if some of the policies were for catastrophic care coverage. Say, a young single guy had to pay $250 a month and was responsible for all normal costs, but if he crashed his motorcycle, everything over $10,000 would be covered.

Another possible method would be to introduce some measure of personal accountability into health care: there would be limited or no coverage for many self-induced conditions. You wanna smoke? No problem, just sign this insurance waiver. BMI over 35? Reduce it or sign the waver. Etc, etc. (That might even make a great warning label for tobacco products... "Warning: Use of this product can invalidate your health insurance!")

[blueash]

Originally Posted by arickis
Just to state the facts. President Trump does not allow any insurance company to deny coverage based on a pre existing condition. He also promised to forbid any insurance company to deny coverage due to pre existing conditions as long as he is president. These are the facts. do not listen to the fake news.

Look at the brief submitted by the President. He asks that all the provisions of the ACA be trashed. He does not ask that the pre-existing coverage provision be retained. He did not ask that the requirement that the cost of the coverage not be based on pre-existing conditions. He does not have the authority as he is not an autocrat to order the insurance companies to sell insurance to people with pre-existing conditions. He does not have the authority to tell insurance companies to sell policies at the same price to those who are well and those who are ill or potentially ill. He has supported a bill which specifically deals with pre-existing conditions and which allows the insurance company to charge whatever premium they wish to those who are unwell. The bill also guts the required coverage of the basic insurance. Right now carriers are required to cover medications. Delete that coverage and see what the effect might be on people with diabetes or cancer.

[Luisa]

Don’t be fooled! We have clearly and undeniably been informed this will not happen.

[Neils]

Originally Posted by J1ceasar

If you really want to get into the specifics of why we're so screwed with house insurance then you have to go back to the IRS and the political parties all deciding that the only way it can be deductible if it is paid through your business. Back in the mid-70s we paid $100 per month for pretty good insurance my children were born I paid only $12 for the telephone in the hospital today the average family pays 10 to $15,000 for insurance that does not include a 5 or $10,000 deductible. The second big problem is that are we consider insurance today is actually Health maintenance. In other words we want our insurance to pay for every little pill test and office visit . However true insurance should be for catastrophic events like breaking an arm a heart attack or liver cancer. If you had to pay the first 3 visits a year to your regular doctor and a modicum pause coverage for your Pharmacy say 500 a year then health insurance would be much much cheaper. Lastly one of the big faults have insurance in America is that the federal government cannot negotiate drug prices on behalf of Medicare and Medicaid for all 50 states the same as I do for Tricare and the arm defense cost. If you want to lower drug costs in America a simple off would be that no drugs can be charged more in retail and anywhere else in the world do you know that in Mexico Italy and Africa drug prices or 1/10 of what we pay? That is because the opportunity cost affordability is much less for those countries. Another way to lower Pharmacy drugs would be for the government to buy the patents out for a few million dollars a year for major drugs that treat things like diabetes cholesterol heart attacks and psychological issues Leslie you have hospitals that are non transparent in their pricing which has recently been disallowed whereas next year I believe they will have to actually post their top 100 operations and procedures on the internet as far as cost so you can shop bye-bye cost. This is just my two cents if you have other opinions as to how 2 lower our actual Healthcare cost I'd love to hear them

Require all providers and drugstores to publish their price list. Same charge for everyone regardless of whatever insurance.

Prices would drop immediately. No more insurance sweetheart deals. Same cost for ins or no ins.

No extra cost for anyone