Health Insurance

[2B]

Martha has some excellent points.   

In my state - Washington - we are able to move from our employeer's plan to an individual plan without underwriting (filling out "the questionaire" which would automatically kick me into the state risk pool).   But once you get the individual plan, you are stuck with it.  If you decide for any reason it's not working for you - tough luck!    I'm going to have some serious research to do before I FIRE.  Making this decision scares the crap out of me, when I think about how high the stakes are. 

Maybe I should move back "home." Unless I missed something, Texas doesn't keep the insurance companies from demanding the forms be filled. That throws lots of people into the high risk pool.

When Bush was governor of Texas he signed the bill that rearranged the private insurance industry to conform to federal mandates. Although the governor is "weak" by the Texas constitution, he didn't do anything to keep the best deal possible go the insurance companies.

A few questions -- Can someone sign up for health insurance in one state and be a resident of another? If someone becomes a resident of a state, can they later move and keep their original state's insurance?

I'm getting close to ER but the medical insurance issue is becoming a bigger part of the equation.

 

[Sheryl]

Here is where I found info on WA:

http://tinyurl.com/ne2ee


I didn't realize how lucky I am to live in this state. I would "flunk" the questionnaire, no doubt about it. Following quote is what I am relying on, but the 90 day limit worries me, based on the time frames others have quoted on this thread.

You will not have to complete the Health Screen Questionnaire if you:

Have exhausted your COBRA coverage — if application is made within 90 days of exhausting COBRA coverage. (You may apply for the new plan up to 90 days before your COBRA coverage will terminate.)

 

[haha]

Here is where I found info on WA:
Following quote is what I am relying on, but the 90 day limit worries me, based on the time frames others have quoted on this thread.

You will not have to complete the Health Screen Questionnaire if you:

Have exhausted your COBRA coverage — if application is made within 90 days of exhausting COBRA coverage. (You may apply for the new plan up to 90 days before your COBRA coverage will terminate.)

I went through this procedure about one year ago. It was quick and painless. Since they are not underwriting you, I was told and it turned out to be true that it usually took less than one month to get coverage.

I took Regence Blue-Shield. I also worked through a broker, which I think has some advantages, and costs nothing.

Ha

 

[2B]

I went through this procedure about one year ago. It was quick and painless. Since they are not underwriting you, I was told and it turned out to be true that it usually took less than one month to get coverage.

I took Regence Blue-Shield. I also worked through a broker, which I think has some advantages, and costs nothing.

Ha

I went on the website but it didn't do much for linking costs and application procedure. What type of money are you paying and for what coverage? The Texas high risk pool is about $7,000 per year with a $5,000 deductible -- per person.

Texas doesn't care if you are HIPPA.

 

[Sheryl]

I went through a pretty detailed analysis of the various high-risk offerings available in WA. There is much variation, depending on type of plan (PPO or HMO), specific situation (how long in the plan, how long prior coverage was, etc.) and deductible.

I assumed I would spend the entire deducible, and analyzed the cost based on monthly payments plus annual deductible. I concluded I would be paying between $5,700 a year for a PPO plan with $2,500 deductible and $7,050 for a "regular" plan with a $1,500 deductible.

A "regular" plan with a $500 deductible cost over $9,000. I couldn't see any point in buying the low deductible plan, when it costs so much more.

When the time comes I'll look closer at the PPO option, but having established relationships with several specialists, I doubt I will do it, if it means I have to start all over with new providers. I also have to look at prescription coverage closer at that time.

I have a nifty spreadsheet if anyone in WA wants it.

 

[2B]

Sheryl,

I think Washington has a winner for me. If your numbers are with the deductible it's well below what I would pay. I could move in with my sister in Belllingham and be a done deal. How does the coverage transfer out of state. I intend to be the proverbial rolling stone.

2B

 

[Martha]

Texas doesn't care if you are HIPPA.

I believe that the Texas risk pool recently changed its rules so that if you can get insurance from a carrier, even if it is incredibly expensive, you can't get in the pool unless you are HIPAA eligible.  Also, I believe that there is a pre-existing condition waiting period unless you are HIPAA eligibile.

 

[Martha]

 

.

A few questions -- Can someone sign up for health insurance in one state and be a resident of another?  If someone becomes a resident of a state, can they later move and keep their original state's insurance?

I'm getting close to ER but the medical insurance issue is becoming a bigger part of the equation.

Not yet.  There has been some talk in Congress about allowing insurance companies sell across state lines products not approved by the customer's state of residence.  The lastest attempt to do this died in commitee this year. States do not like the idea because consumer protections of their states will be lost.


Some people travel a lot.  We plan to keep Minnesota our state of residence.  So long as we do that we can be covered by the Minnesota risk pool.   Fortunately, the Minnesota pool insurance provider covers you when you happen to be out of state.  Not all polices do that: HMOs by way of example.  IIRC, Wisconsin's risk pool only will cover you for emergencies when you are out of state.  Other companies will cover a smaller percentage of the cost of care.  Many plans are  prefered provider 80/20 plans and if you are out of network, maybe you will only get 60% of the charges the insurer would have approved.  This number may be a lot smaller than actual charges.

 

[lets-retire]

And where does it say in the Constitution that we all should have medical insurance, anyway? And by the same token where does it say in the Constitution that we all shouldn't be able to have it? (They never answer that question?)

Since the Constittuion gives the federal government power, if it doesn't give it the power to provide something then the government technicallly can't do it. The closest thing the Constitiution states about providing health insurance is "promoting the general welfare" of the state. I know promoting something and providing something are two very different things. Unfortunately the courts seem to beleive providing and promoting are the same.

So to answer your question, strictly speaking the Constituion does not forbid the people from having universal health care, but it does not grant the federal government the power provide it.

 

[KB]

2B

If you have a policy with Blue Cross/Blue Shield, they have coverage through a program called BlueCard. It can be used by travelers or people living in a different state from where their coverage resides (Home plan).

It offers the subscriber the negotiated rate of a preferred provider (assuming they choose a preferred BC/BS provider) when obtaining services out of their normal coverage area. It is beneficial for both the subscriber and the Plan and is mandated as being a BC/BS plan.

 

[Martha]

Since the Constittuion gives the federal government power, if it doesn't give it the power to provide something then the government technicallly can't do it.  The closest thing the Constitiution states about providing health insurance is "promoting the general welfare" of the state.  I know promoting something and providing something are two very different things.  Unfortunately the courts seem to beleive providing and promoting are the same.

So to answer your question, strictly speaking the Constituion does not forbid the people from having universal health care, but it does not grant the federal government the power provide it. 

The 10th amendment to the Constitution provides that powers not specifically granted to the federal government are reserved for the states or the people.  So, when the federal goverment seeks to establish a new program it must find a basis for the program in the Constitution. 
There are two possibilites.  One is the commerce clause which gives the federal government the power to regulate commerce among the states.  The other is what you mentioned, the broad power to levy taxes and expend funds to provide for the general welfare.  I believe it was this provision which authorized social security, which was held supported by constitutional authority by the Supreme Court at the time Roosevelt was President.  If social security (and medicare) is constitutional, I have no question that a national health insurance program would be constitutional.

 

[bookman51]

Well,  the issue just become temporarily moot for the time being.  I accepted a one-year job and came out of my four-month retirement. My wife will be on the insurance of my employer since there are no excemptions for pre-existing conditions.  However, in another year or two, I will be back looking for insurance.  Her conditions are all pretty minor, and perhaps in the meantime we can get a better description of them so they do not look so bad on paper when we appy again.  

The idea of insurance is to share the risk.  My wife and I have been pretty healthy and paying into insurance for 35 years.  Seems now is the time to get the benefits of sharing that risk, but not seem to work that way.   Used to work in a welfare office many many years ago.  I saw a fair number of both working class and middle class folks reduced to poverty because of health care costs.  If you think it cannot happen to you, think again.  Even if you have Medicare coverage, just look at what it does not cover regarding both certain conditions and long term care.  

 

[lets-retire]

Martha--I think I wasn't clear.  I have no doubt the courts will find universal health care Constitutional, but I think it's because they are reading provide when what is written is promote.

Bookman--Congrats kind of.  Your health care issue is resolved, but your w@rking again.

 

[Martha]

Martha--I think I wasn't clear.  I have no doubt the courts will find universal health care Constitutional, but I think it's because they are reading provide when what is written is promote.

Bookman--Congrats kind of.  Your health care issue is resolved, but your w@rking again.

The specific language reads in article I, section 8:
The Congress shall have Power to lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States.

It is the preamble which talks about promoting the general welfare as one of the reasons to have a constitution.


I understood where you are coming from.  There has been a tension in constitional interpretation since it was drafted.  The draftsmen even argued about it.

Bookman, good luck on insurance for your wife when you job ends. 

 

[greg]

Since the Constittuion gives the federal government power, if it doesn't give it the power to provide something then the government technicallly can't do it. The closest thing the Constitiution states about providing health insurance is "promoting the general welfare" of the state. I know promoting something and providing something are two very different things. Unfortunately the courts seem to beleive providing and promoting are the same.

So to answer your question, strictly speaking the Constituion does not forbid the people from having universal health care, but it does not grant the federal government the power provide it.

I'll stick my nose in a bit: It seems to me that "promoting the general welfare" might/could allow for universal healthcare. If part of the general welfare is having healthy folks/citizens, then it is easier to see the thinking: providing universal healthcare promotes the general welfare. I believe this is how we've always operated in this country,e.g. provide the interstate highway system to promote the general welfare. Ahhh . . . but the tensions.

 

[razztazz]

I'll stick my nose in a bit: It seems to me that "promoting the general welfare" might/could allow for universal healthcare. If part of the general welfare is having healthy folks/citizens, then it is easier to see the thinking: providing universal healthcare promotes the general welfare. I believe this is how we've always operated in this country,e.g. provide the interstate highway system to promote the general welfare. Ahhh . . . but the tensions

Not only that but the 10th amendment basically is the right to call an audible. The Federal Gov cannot, and certainly ought not, just pop off and do-dis and do-dat. Yeah, there is that restriction on how it's supposed to go. If I were president or a Senator I would approach every problem with What would happen if we did nothing? and take it from there. But that does not mean we ought to do nothing.
But of course in the end The People maintain the right to have done whatever it is they wish done.

Means and methods are also thiers. And charging The People's perfectly legitmate instrument, The Government, with the responsibility to "Get it done" is not in violation of anything. To maintain otherwise would be a violation of history and the Will of The People.

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

Some will make all kinds of silly arguments of an administrative or grammatical nature suggesting that it says "The People" and "The States" and therefor the Federal Gov is somehow not allowed to do certain things and they should be laughed at. The Gov is the people. And as some are given to saying: The Constitution is not a suicide pact" It is there to permit the People to get things not prevent them. Only those with an agenda or insidious ulterior motive would wpuld suggets otherwise.

 

[bookman51]

The specific language reads in article I, section 8:
The Congress shall have Power to lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States.

It is the preamble which talks about promoting the general welfare as one of the reasons to have a constitution.


I understood where you are coming from.  There has been a tension in constitional interpretation since it was drafted.  The draftsmen even argued about it.

Bookman, good luck on insurance for your wife when you job ends. 

Thanks on the good luck.  I will need it.  

Regarding the Constitutional issue and universal health insurance, that is a red herring.  Enough said.

 

 

[Martha]

Yes, sorry Bookman, we kept falling off track on your insurance questions, and dropping into politics.

 

[greg]

razztazz:

I certainly wasn't looking for an argument, and I'm about as far from a Constitution expert as can be. (I've reformed. Wahoo! and unclemick have won me over to a 'sweetie." ) But I do think that all constitutions are simply flow charts, diagrams as such, for consiousness. What I mean is, for example, something is planned or decided or noticed and the Constitution simply tells it, the human consciousness, where to go for a fix: the Senate, Congress, Supreme Court, or, maybe back to the state. Something has to be there to make sure that particlars can be generalized ("provide":"promote") or the reverse. Enough said!

 

[Scrooge]

The 10th amendment to the Constitution provides that powers not specifically granted to the federal government are reserved for the states or the people.  So, when the federal goverment seeks to establish a new program it must find a basis for the program in the Constitution. 

There are two possibilites.  One is the commerce clause which gives the federal government the power to regulate commerce among the states.  The other is what you mentioned, the broad power to levy taxes and expend funds to provide for the general welfare.  I believe it was this provision which authorized social security, which was held supported by constitutional authority by the Supreme Court at the time Roosevelt was President.  If social security (and medicare) is constitutional, I have no question that a national health insurance program would be constitutional.

Sure, the clash between the Supreme Court and the FDR administration in the 1930s resulted in a significantly more expansive interpretation of the commerse clause and a much larger role for the federal government in the economic sphere. However, although there is currently no substantial faction within the Supreme Court that would advocate returning to the pre-New Deal interpretation, the Supremes have been generally more willing to listen to state rights arguments in the last 10-15 years. In other words, it's my considered opinion that the answer to the question is "Who knows?" 

 

[Nords]

I certainly wasn't looking for an argument, and I'm about as far from a Constitution expert as can be. But I do think that all constitutions are simply flow charts, diagrams as such, for consiousness.  What I mean is, for example, something is planned or decided or noticed and the Constitution simply tells it, the human consciousness, where to go for a fix:  the Senate, Congress, Supreme Court, or, maybe back to the state.  Something has to be there to make sure that particlars can be generalized ("provide":"promote") or the reverse.  Enough said!

Ruh-roh-- do I sense another Hamilton-Jefferson cage match coming up at the house of Martha & Greg?

"You constructionist!"

"Interpretationist!!"

 

[bookman51]

Even Jefferson found a way to justify the Louisana purchase. Universal health insurance is much more a matter of finances, philosophical differences, and will than a Constitutional issue. I start this post, got my questions answered, not time to end it before it turns into something entirely different than I intended.

 

[Scrooge]

Ruh-roh-- do I sense another Hamilton-Jefferson cage match coming up at the house of Martha & Greg? 

As long as it doesn't turn into a Hamilton-Burr match

 

[Sheryl]

Sheryl,

I think Washington has a winner for me.  If your numbers are with the deductible it's well below what I would pay.  I could move in with my sister in Belllingham and be a done deal.  How does the coverage transfer out of state.  I intend to be the proverbial rolling stone.

2B

That, I don't know. I advise you to do your own research before you move. <-- Martha-like disclaimer.