Sen Bill: Preexisting conditions exclusions outlawed for kids immediately, adults in 1/1/2014.

[Pirate Smile]

Stop. Breathe. Read.

by Karoli on January 24, 2010

David Plouffe is back with a big editorial in today’s Washington Post arguing for why Democrats must pass health care reform, and soon. As part of his argument, he enumerates the immediate benefits of passing the bill:

If we do pass it, dozens of protections and benefits take effect this year. Parents won’t have to worry their children will be denied coverage just because they have a preexisting condition.

John Aravosis and others have read this paragraph to mean they’re dumping pre-existing conditions provisions for adults. No. Plouffe was speaking only of the immediate benefits of passing the Senate bill, which does have an exception for children under age 19 that takes effect upon passage. Adult pre-existing conditions exclusions are prohibited for years beginning 1/1/2014.

Let’s all calm down, shall we?

http://www.drumsnwhistles.com/2010/01/24/stop-breathe-read/

Posted in GD. Thought I should post it here too. I wish the adult date was faster - immediately, like kids but killing the bill means there is NO TIME LIMIT for ending the exclusions. I don't see how that is preferable.

If we only use Reconcilliation without passing the Senate Bill, we can't get rid of the exclusion because it is regulatory instead of dealing with the budget.

I would think that after it is passed, it would be easier to pass a bill moving the effective date for adults earlier. It is certainly easier then having nothing in place.

Why is it pushed back? I'm sure it is to avoid the insurance death spiral. If you just pull into the insurance system a lot of sick or expensive people to cover without balancing it with a lot of healthy people also paying monthly premiums then the monthly premiums will have to go way up. More healthy people in the system would drop out because of the expense which means you just continue to get a sicker, more expensive insurance pool leading to more and more expensive insurance premiums. They need both to happen at the same time. I do believe there is some type of insurance all people can buy into right after it would pass but I don't know the details of it.

Yes, it is complicated and messy. We knew that. It's why its never gotten done before.

edit to add - A national high risk pool will be available within 90 days of enactment for people with preexisting conditions. I'm trying to find out more.

[midnight]

1. K&R. I want that discriminatory clause removed. People who are sick or in pain

should not be the ones to wait....

[Pirate Smile]

2. Our options right now are 2014 or never.

[Lorien]

6. And why is that, do you suppose?

[DrToast]

21. That's when the mandates kick in.*

*

[CountAllVotes]

3. by 2014 ...

a lot of these people that have pre-existing conditions and are sick may very well be dead.

How fucking convenient! :mad: :argh:

:kick:

[Pirate Smile]

5. What is your solution which can actually be enacted into law?

[CountAllVotes]

8. why wait until 2014

either do the job right or don't do it at all. This is a half-baked ATTEMPT to get something through that isn't worth a damn thing to those that are in need of care.

How many adult have pre-existing conditions as compared to children with pre-existing conditions? Answer is likely probably 10X as many.

By pulling off this political stunt, nothing is really being accomplished if there will be a bunch of sick people running around that will only get sicker and in the long run the cost will be higher and as I mentioned already, many of these people will be dead, unable to care for their children in many cases.

The answer is to cover everyone, not just children for God's sake! And why is 2014 the magic # here?

I don't get it.

It accomplishes nothing IMO.

:kick:

[mzmolly]

16. All or nothing thinking is not progress.

In 2014 people will greatly appreciate not being denied coverage. It takes time to implement change.

[CountAllVotes]

18. it they can do it for children now

then why make those that need help NOW wait. As I mentioned before, many of these people will be dead in 2014 without medical care.

This is not the kind of "change" I voted for! Would you like it if you had no insurance and had cancer? You cannot wait until 2014!

This is beyond sickening!

:kick:

[Pirate Smile]

19. Here is more about what they do for adults with preexisting conditions between now and 2014:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x7561733

[mzmolly]

20. I defer to the answer from PirateSmile.

:hi:

[secondwind]

34. it isn't cost-effective to glut the plan with a lot of people with pre-existing conditions RIGHT OFF

[Zoeisright]

41. MEDICARE. FOR. ALL.

It's really not that difficult. It just takes a spine.

[Pirate Smile]

9. A national high risk pool will be available within 90 days of enactment for people with preexisting

conditions. I'm trying to find out more.

[backscatter712]

25. Bingo. That's the interim solution designed to provide immediate help. n/t

[lumberjack_jeff]

11. Yes.

Unlike every other realistic suggestion, this bill offers some relief in 2015.

I'd like it to happen now, but it can't.

[Zoeisright]

40. Yep. By then another 180,000 Americans will be dead

because they didn't have health insurance. If this isn't genocide ...

[Lorien]

4. How many adults will die of their pre existing condition prior to 2014? Why the wait?

And what's to be done about excessive deductibles and pricing?

[Pirate Smile]

10. See the edit I added at the end of the OP.

[amborin]

7. re: no exclusions for pre-existing conditions:

the big insurers have loopholes, in any case

they can rescind people's insurance for "fraud," among other reasons....

leaving the policing of HCR up to states is folly

the case of the state of California attests to this:

California is unable to persist in its lawsuits against major insurers for "recission," or dropping people for "fraud," etc....

""California recently dropped an attempt to enforce its anti-rescission law against a major insurer, saying that it was financially outgunned by the insurer's legal team.

The rescission law, according to the legislation, "shall not apply to a covered individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation of material fact as prohibited by the terms of the plan or coverage."

Insurers today routinely claim that patients engaged in "fraud" or "intentional misrepresentation" when dropping them from coverage. Much depends on who defines the terms in the bill.

It won't be the federal government. There will be no federal agency tasked with overseeing the enforcement of the bill's rules. Rather, a Senate leadership aide told reporters in a briefing Saturday, individual states will police the new system.

That's a task the California Department of Managed Health Care was unable to perform when battling Anthem Blue Cross, which has rescinded 1,770 policies since 2004.

"In each and every one of those rescissions, the right to contest each, and that could tie us up in court forever," the department's director, Cindy Ehnes, told The Associated Press. A million-dollar fine was announced in March 2007, but has not been enforced.

If the enforcement for these regulations falls on the individual states, and the individual states will have to litigate them, which could take a very long time in each case. The regulations are unlikely to be uniformly enforced state to state--some of them have extremely proactive insurance commissioners and strong regulatory structures in place, others don't. And in the states that don't, don't expect insurers to end some of these practices out of the goodness of their hearts."

common dreams.org

[bornskeptic]

24. The California law is bad. That's no argument against the Senate bill.

In California pre-existing conditions can be considered at the beginning, so an insurer may try to claim a person concealed a pre-existing condition, and rescind that person's policy on those grounds. The Senate bill allows absolutely no discrimination based on pre-existing conditions, so that possible loophole would not exist.

[ibegurpard]

38. but we have to pass SOMETHING...

or something

[HopeOverFear]

12. *throws temper tantrum* I WANT IT NOOOOOOOW!!!!!!

*stomps around the room, falls to the ground, screams*

:sarcasm:

[kiva]

17. Do you have fun mocking people who have real health

concerns who may not be alive in 2014? Does it feel really good to pretend that anyone who disagrees with this timetable MUST be a selfish toddler? Isn't it too bad that this would cover children so that you can't make snarky comments about parents who are worried about their children? The only whine on this thread is coming from you.

[Blue-Jay]

22. Easy for you to say

I lose my COBRA next month and can't get insurance even though I'm willing to pay for it.

I guess I'll just crawl in a corner and die.

[Name removed]

29. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Name removed]

31. Deleted message

Message removed by moderator. Click here to review the message board rules.

[DRoseDARs]

37. HopeOverFear pm'd me: "fuck you back and suck a dick while you're at it...BITCH."

Lovely little pm HopeOverFear sent me today:

"fuck you back
From: HopeOverFear
Date: Jan-25-10 11:18 AM

and suck a dick while you're at it...BITCH."

In response to my post "On behalf of my 54 yrold mother who despite insurance has had back problems for 15+ years: Fuck you"

I don't care if this new post gets deleted, but if a few people see HopeOverFear's character, then it will have served it's purpose.

Edit: Forgot to say the "On behalf" post was deleted, as was what I assume HOF's response to it.

[Zoeisright]

43. Thanks - updating my ignore list now.

[DRoseDARs]

44. I admit that the fu in my original post was rude, but her pm'd response was vile and uncalled for.

I can only imagine what she had posted in this thread as response to my post, given both were deleted before I checked in today.

Good grief, some people just lose their shit whenever any kind of criticism is directed at them.

[Zoeisright]

42. Tell that to the Americans this clause dooms to death.

And try to grow up, please.

[jesus_of_suburbia]

13. Better 2014 than never.

[totodeinhere]

26. Better now than 2014. Too many will die between now and then.

Am I being some kind of purist because I want to save lives now rather than wait until 2014?

[jesus_of_suburbia]

28. I agree with you, I really do.... but I don't want to waste this opportunity only to get nothing

for another 20 years.

[glinda]

14. Would be be even having this discussion if Insurance Companies were out of the picture?

[mzmolly]

15. Thank you for this very important clarification. K and R and asking others to join me!

:kick:

[RaleighNCDUer]

23. At what cost?

It's all fine and well that they MUST provide insurance coverage, but where is info on what they can CHARGE for that coverage? If the premiums cost 20K a year, and have $6ooo deductibles, what's the point? Only the rich will afford to get the CARE, just as it is today.

Is this reform?

[totodeinhere]

27. No, it's not reform. It's business as usual in Washington.

It's why the people are so angry and why the Dems might very well get their clocks cleaned next November.

[Mass]

35. At the same price as other people same age, same location.\nt

[Clio the Leo]

30. good news! NT

[Armstead]

32. This is fucking 2010 -- An adult with a serious condition won't last that long

[SKKY]

33. This seems to me like selling an old car...

...you could sell it for $300.00 whole, or break it up and sell it in pieces for $900.00 or $1000.00. I'm starting to like that approach.

[Jennicut]

36. Whatever else the WH and Congress do, they need to at the very last pass this

part of health care reform. It is popular with the public. It is necessary to save lives. And yes, I have a pre-existing condition and while I have insurance (luckily) there are many like me that do not.

[Rosa Luxemburg]

39. why can't the pre-existing thing be put in NOW for all