Are we allowed to talk about it yet?

[MichaelB]

Regarding pre-existing conditions, the language in the bill allows insurers to impose underwriting conditions if there is a lapse in continuous coverage.

It also allows states to redefine what essential health benefits must be covered by insurers, and which are not.

It also establishes a separate, high risk pool, defines 8 conditions that automatically qualify, and delegate to the state the authority to add to that list. There is no language in the bill that requires the high risk pool to provide coverage for essential health benefits removed from the mandatory list.

Based on the language, it is reasonable to assume that under this bill, it is possible to have a condition that is not covered by insurance. That is a legitimate concern, IMHO.

 

[pb4uski]

Regarding pre-existing conditions, the language in the bill allows insurers to impose underwriting conditions if there is a lapse in continuous coverage.

It also allows states to redefine what essential health benefits must be covered by insurers, and which are not.

It also establishes a separate, high risk pool, defines 8 conditions that automatically qualify, and delegate to the state the authority to add to that list. There is no language in the bill that requires the high risk pool to provide coverage for essential health benefits removed from the mandatory list.

Based on the language, it is reasonable to assume that under this bill, it is possible to have a condition that is not covered by insurance. That is a legitimate concern, IMHO.

So if no lapse in coverage then pre-existing conditions are covered? That makes a lot of sense to me... it would be a bigger stick to prevent people from cherry-picking and applying for insurance only when they get sick than the mandate and related penalties were.

What they are doing is effectively punting the medical underwriting/pre-existing conditions and essential health benefits issues to the states... so governors and state legislatures will bear the political cost of "taking away" coverage for pre-existing conditions... quite clever actually.

 

[MichaelB]

So if no lapse in coverage then pre-existing conditions are covered? That makes a lot of sense to me... it would be a bigger stick to prevent people from cherry-picking and applying for insurance only when they get sick than the mandate and related penalties were.

I wouldn't say exactly that. One may have a preexisting condition and lose coverage due to a redefinition of EHB. The lapse in coverage allows the insurer to underwrite. That's all it says. To discourage people from jumping in and out, there is a fine for dropping coverage, and a reduced opportunity for enrollment.

We are really getting ahead of ourselves with this discussion, because how it is implemented is just as important, and many of these details are only known then.

 

[daylatedollarshort]

As long as you have had coverage (and weren't we ALL supposed to be covered under ACA?), you are OK.

With subsidies being reduced for many under the current house plan, especially older Americans, and median household income in the U.S. around $50K, many households simply can't afford $1 - $2K or more a month to keep continuous health insurance premiums alone, especially during times of unemployment or disability.

 

[Just_Steve]

What they are doing is effectively punting the medical underwriting/pre-existing conditions and essential health benefits issues to the states... so governors and state legislatures will bear the political cost of "taking away" coverage for pre-existing conditions... quite clever actually.

What they are doing is effectively PUTTING the medical underwriting/pre-existing conditions and essential health benefits issues to the states where it belongs.

 

[Texas Proud]

You might look into the benefits available to members of any professional organizations to which you belong. This sometimes can include group health insurance.

https://www.thebalance.com/membership-organizations-and-health-insurance-2645660

From what I gather, there still are credits to be able to buy insurance... if they continue to make you buy through the exchange to get those credits then any of the outside options are not a good choice for many...

Now, if the credits are like other refundable credits and you just buy anywhere then some of these might be an option...

 

[Fedup]

It is too late.

You can try to bury your head in a sand but uncertainty in insurance market is already driving expected 2018 price increases up as compared to relatively "modest" hikes in 2017.

Papajones, this is a polite forum. It's considered rude to send people a nasty message just because you don't agree with them. Maybe I should report you to the moderator. Spreading mis information is not allowed. Maybe you are the one whose head is bury in the sand.

 

[W2R]

Papajones, this is a polite forum. It's considered rude to send people a nasty message just because you don't agree with them. Spreading mis information is not allowed. Maybe you are the one whose head is bury in the sand.

Notice his status in the past few minutes has changed to "Gone Traveling". I can assure you that he won't be sending any more nasty messages.

 

[LARS]

So if no lapse in coverage then pre-existing conditions are covered? That makes a lot of sense to me... it would be a bigger stick to prevent people from cherry-picking and applying for insurance only when they get sick than the mandate and related penalties were.

As I have thought about it that is my impression of the reason for introducing PE conditions. It is a way to "coerce" rather than "mandate" all have insurance. [mod edit]

Whether it will work as intended, and not spin out of control causing many to be swept up in PE conditions, is anyone's guess.

 

[Quantum Sufficit]

That is because we are being screwed. As an ex physician who got out at 49 these insurance companies are crying crocodile tears while they laugh all the way to the bank. The only way to fix this is FREE MARKET health care coops etc for all but high dollar catastrophic dx with docs charging AND COMPETING for business.

 

[samclem]

I wouldn't say exactly that. One may have a preexisting condition and lose coverage due to a redefinition of EHB.

Yes, I see your point. OTOH, it's no different than if an individual had a health problem from the start that was not covered as an EHB.

To discourage people from jumping in and out, there is a fine for dropping coverage . . .

It's a provision that the insurance company may increase premiums by up to 30% for one year when the person decides to jump back in, right? (but no [-]fine/[/-]tax from the IRS every year, like we have at present).

 

[hesperus]

As I am doing, call your senator and congressperson, let them know how you feel about this latest bill.

 

[broadway]

As I am doing, call your senator and congressperson, let them know how you feel about this latest bill.

My Congressperson voted the way I wanted, but unfortunately, I have no control over the others.

 

[Packman]

While it is a bit comforting to say that we should wait to see what the Senate does, few of us got to (or are heading to) ER without a lot a good solid pre-planning. I believe I will be able to figure out a solution to all of this health insurance mess no matter what Congress does. However, it's all about planning and having the time to do so. Living in AZ, where my wife and I experienced a 170% premium increase, with basically no notice, I am concerned that one option for us will be to move to another state, or perhaps country. That doesn't happen in a few months. So at least I hope our lawmakers have the common sense and decency to make changes slowly and make sure the HI ship doesn't tip over while it's making the U-turn.

 

[Ronstar]

Health care and health insurance are important issues to early retirees. The moderator team finds that this thread has run its course - AHCA has passed in the House and now is in the Senate's court.

A lot could change in the Senate. Continuing to discuss the details of the House bill at this point is speculation given the anticipated changes..

It would make sense to discuss the issue again after the Senate has made their changes.

Thanks for the discussion.

Ronstar on behalf of the ER.org moderator team.