Study: 129 million have preexisting conditions

[kpete]

Source: Washington Post

Study: 129 million have preexisting conditions
By Amy Goldstein
Washington Post Staff Writer
Tuesday, January 18, 2011

As many as 129 million Americans under age 65 have medical problems that are red flags for health insurers, according to an analysis that marks the government's first attempt to quantify the number of people at risk of being rejected by insurance companies or paying more for coverage.

The secretary of health and human services is scheduled to release the study on Tuesday, hours before the House plans to begin considering a Republican bill that would repeal the new law to overhaul the health-care system. The report is part of the Obama administration's salesmanship to convince the public of the advantages of the law, which contains insurance protections for people with preexisting medical conditions.

Republicans immediately disparaged the analysis as "public relations." An insurance industry spokesman acknowledged that sick people can have trouble buying insurance on their own but said the analysis overstates the problem.

The study found that one-fifth to one-half of non-elderly people in the United States have ailments that trigger rejection or higher prices in the individual insurance market. They range from cancer to chronic illnesses such as heart disease, asthma and high blood pressure.


Read more: http://www.washingtonpost.com/wp-dyn/content/article/2011/01/17/AR2011011704481.html

[ananda]

1. Boy this country is sick and toxic.

It's endemic, and an epidemic.

[jus_the_facts]

16. life is a sexually transmitted disease...the mortality rate is 100% n/t

[frazzled]

2. It doesn't take much to be red-flagged for a pre-existing condition

People imagine that we're talking about big-time stuff like cancer or a defective heart valve. The reasons I have seen friends and family members turned down for health insurance include: very slightly elevated blood pressure; a bone density test for a 60-year-old woman that wasn't perfect; having been treated for depression once; and ... in one marvelous case: a finger injury.

If you have to get individual insurance for any reason, there is an extremely good chance that (without this new law) you will be turned down if you are over forty or ever had to take a medication --whether for migraines or allergies.

[rfranklin]

4. I believe they could find a pre-existing condition in anyone...

such as being mortal is a pre-existing condition.

[Demeter]

6. Being Born Female Is a Prime Example

because one is predisposed to pregnancy...

[rfranklin]

3. And just like they have no alternative health plan for the uninsured...

other than "get sick and die," they offer no alternative figures on pre-existing conditions and how they will handle that little sticking point.

[StopTheNeoCons]

5. Health insurance companies are setting up the system to do one thing...

..They want to be able to look at your credit report, see how well you are doing, see what your pre-ex conditions are, and then offer ou a premium surcharge to cover everything, and it WILL be the max they can squeeze from you, I guarantee.

[Egnever]

7. It would be great if you would actualy read the bill

Cause what you just described is not possible under HCR

[enlightenment]

14. Technically, yes.

So what they're doing now is jacking up their rates across the board. The law, as amended (42 U.S.C. 300gg-1), stipulates that insurance issuers cannot charge more to person "A" than to person "B" for the same coverage. It does not say how much they can charge, period.

From Sec. 2704 of the Patient Protection, etc, Act:

(3) (A) in section 2702 (42 U.S.C. 300gg-1) (i) by striking the section heading and all that follows through subsection (a); (ii) in subsection (b)(I) by striking health insurance issuer offering health insurance coverage in connection with a group health plan each place that such appears and inserting health insurance issuer offering group or individual health insurance coverage; and (II) in paragraph (2) (A) (aa) by inserting or individual after employer; and (bb) by inserting or individual health coverage, as the case may be before the semicolon; and (iii) in subsection (e)(I) by striking (a) (1) (F) and inserting (a) (6); (ii) by striking 2701 and inserting 2704; and (III) by striking 2721 (A) and inserting 2735 (A) ; and80 (B) by transferring such section (as amended by subparagraph (A)) to appear after section 2705 (A) as added by paragraph (4); and (4) by inserting after the subpart heading (as added by paragraph (1)) the following:

http://www.opencongress.org/bill/111-h3590/text

What follows is a section that allows premiums difference to be based on family/individual coverage; age (not more than 3:1); tobacco use (not more than 1.5:1); and the poorly defined 'rating areas' that each State is supposed to define (if they don't, the Secretary will assign them).

The relevant section of the enormous Title 42 (the section referred to in the part above - essentially they are adding 'individual coverage' after 'group health plan'):

(b) In premium contributions
(1) In general
A group health plan, and a health insurance issuer offering health insurance coverage in connection with a group health plan, may not require any individual (as a condition of enrollment or continued enrollment under the plan) to pay a premium or contribution which is greater than such premium or contribution for a similarly situated individual enrolled in the plan on the basis of any health status-related factor in relation to the individual or to an individual enrolled under the plan as a dependent of the individual.

http://www.law.cornell.edu/uscode/html/uscode42/usc_sec_42_00000300--gg001-.html

So, they are prohibited from charging more, but there is nothing to stop them from raising premiums through the ceiling NOW, before the restrictive portion of the new Act (sec. 2718) kicks in - the one that uses the vaguely defined 20% or 25% over the cost of premiums and 'other non-claims costs'. The premiums that exist today will be grandfathered in group coverage plans, so the provision for grandfathering is established - and those sky-high premiums can (and probably will be) used as a bar to establish rates for individual coverage under the Act.

There really is nothing concrete in the Act to stop the insurance companies from making out like bandits; vague language about what the Secretary will do or what the States will do notwithstanding.

[Egnever]

15. Sorry but you have to ignore the MLR requirements to make that claim

As there are also specific regulations on how much of each dollar must go directly to health care costs. So there absolutely is regulation in the bill that prevents them from just arbitrarily raising rates.

People seem to be looking for ways to create boogymen here.

[enlightenment]

17. Could you please give me the citation (link) for that specific information?

Seriously - I'm not trying to catch you out. I'd like to add those specifics to my file of information on the Act.

[Hoyt]

18. You are exactly right, Egnever.

And since people haven't even read this stuff, and bitched a fit, there is a chance it could be repealed.

The MLR is the key and when the Exchanges are up and running, we can change plans to a lower cost insurer because they can't deny us for pre-existing conditions. Not as good as a public option, but not impotent either.

Of course that's assuming the rethugs aren't successful repealing or mucking up what has been passed by proclaiming that 75% of the population is against so-called Obamacare -- most Republicans just because they could care less and a bunch on the left who aren't looking at the big picture and keep dreaming up new conspiracy theories to condemn what was passed against tough opposition.

A return to the way things were before "Obamacare" will be a major setback that could last decades.

[sarcasmo]

8. Just like Insurance companies here in Michigan can jack you're rate up if you have poor credit

Health insurance companies are preparing to do the same thing.

[Egnever]

10. Sigh READ THE BILL!

No wonder people rail against this bill. Most haven't got a clue what it does. Premiums can not be based on anything but age and even then there is a limit on the premium difference between young and old.

[davidthegnome]

9. Huh

"An insurance industry spokesman acknowledged that sick people can have trouble buying insurance on their own but said the analysis overstates the problem."

Really? Just how is this overstating the problem? Perhaps you'd care to elaborate for the 129 million of us? Including those of us who have no insurance and can't get any? No? Fucking insurance company sycophant.

Fucking assholes.

I didn't like this bill - I didn't support it, but primarily because it did not go far enough, it did not do ENOUGH. That said, what little it does do should be maintained. The fact that this little crony bitch actually has a "statement" in this article is vastly amusing.

Shit.

[bhikkhu]

11. From the CDC: "50% of adults have chronic illness"

http://www.cdc.gov/chronicdisease/overview/index.htm

This from last summer, one sick nation. The basic causes are listed as obesity, poor diet, lack of exercise, smoking cigarettes, and alcohol consumption. I think many people could take that as inspiration to do better, and it helped me to turn things around in my own life at age 43 a couple of years ago. Now: better diet, exercise daily, no cigs, alcohol very rarely, and feeling fine to be one who will support the system by paying in rather than drawing out.

[grilled onions]

12. The More You Need It..The Less You'll Be Able To Get It

Pre existing covers so many things you have to wonder if there is anything they don't consider a PE. On top of that when they find YOU healthy they start digging into the health of your parents,grandparents--it never stops. The odds are no one is this country can get by without a PE if the insurance does it's homework.

[TygrBright]

13. Oh, well, no WONDER it's not a big problem having them denied coverage... there's only a few...

...there's only a few of them, after all. No big deal, really.

:sarcasm:

:eyes:

wearily,
Bright

[Odin2005]

19. We are fucked.

[RedCloud]

20. stick this in the face of all repugs you know. All media should lock on to this.