The bill does not protect people with pre-existing conditions

Lyric

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Wed Dec-16-09 07:36 PM
Original message

The bill does not protect people with pre-existing conditions

At least not unless they're (a) rich, (b) one of the rare handful whose condition is dirt-cheap to treat, or (c) already have extremely good insurance that's kept the bills all paid, plus enough private resources to cover their own share.

Why? It's because of credit.

The bill prevents insurance companies from discriminating against people who have pre-existing conditions, but I searched the text myself, and it does NOT prevent insurance companies from discriminating against people who have credit problems.

For instance: a fictional woman named Jacqueline has severe diabetes. She is completely uninsurable right now, even though she works a good job as a copy editor for a newspaper. She also has poor credit thanks to decades of medical bills piling up that she simply could not pay, as well as other defaults and delinquencies related to missed work/paychecks. All of these credit problems exist for her BECAUSE she has diabetes.

Under the proposed bill as it stands, a health insurance company could not deny her coverage because she has diabetes. However, they CAN pull her credit report, take note of the outstanding medical bills, and deduce that she HAS a pre-existing condition. They can then deny her insurance based on her poor credit score, and accomplish EXACTLY the same end as before the proposed reforms. The only difference would be that the excuse stamped on the rejected application would read "Poor Credit Risk" as opposed to "Pre-Existing Condition."

Now consider this: what do many, many people with pre-existing conditions have in common? Credit problems due to medical debt. So if YOU were an insurance company and you wanted to screen out expensive high-risk patients without blatantly violating the rules, how would you do it? Well, you'd screen them out anyway and reject all of the ones who don't meet your credit standards--a.k.a., the people with medical and other debt related to their pre-existing conditions. VIOLA! The most important aspect of the reform bill is thus completely nullified.

Of course a very wealthy person with diabetes might be helped to save some pocket money; their credit score would be fine because they'd been able to keep up with their bills out-of-pocket. The handful of people who already HAVE really good insurance and really good jobs would also be helped at least for a while, so long as their credit score stays good. But the non-millionaires WILL get screwed eventually. It's only a matter of time before financial hardship comes knocking for all non-rich people, and when it does and they miss a premium or two, the health insurance company suddenly has a valid reason to cut them off and never take them back, thanks to their reduced credit-worthiness.

As if the complete nullification of the pre-existing conditions protection wasn't bad enough, it could potentially get worse. Unless and until someone in Washington wakes up and sees this enormous loophole, there also won't be an exception to the mandate for people like Jacqueline, people who would be glad to buy insurance except nobody will SELL it to them thanks to their credit problems. If there's no exception made for situations like that, then people could be further penalized for their illness-related financial problems.

Simply banning insurance companies from considering medical debt when deciding whether or not to approve an application won't work either, because the repercussions of a medical crisis go FAR beyond just the hospital bills. There are missed mortgage payments, credit card payments, utility bill payments, car loan payments, ALL of which are caused by missing work time when ill/hospitalized, and are JUST as damaging to a credit report as medical debt, if not more so.

The only way to be sure that average people with pre-existing conditions are protected is to insert language that specifically BANS the insurance companies from using credit scores as an excuse to deny insurance. I've been doing some reading on this subject recently, and it seems that while auto and home insurance companies have been using credit report data for a long time, health insurance companies have only recently begun to do so because health insurance is an inherently different risk pool with its own unique set of ratios and complications. However, this practice is becoming more and more popular in our modern society, where your credit score basically determines your value as a human being.

Congress needs to address this problem NOW. Otherwise, we risk millions of extremely angry people who THOUGHT they'd finally be able to get health insurance, and instead got another round of denials with a mandated tax penalty on top, just to add insult to injury.

This is a serious problem and we need to be yelling about this. I urge you to contact your Senators and Congresspeople ASAP--feel free to use my own words if you don't have the time to compose your own.