Join Dr. Catherine Alicia Georges and Amy Goyer at 10:15 a.m. ET Wednesday for an AARP telephone town hall on family caregiving issues. Register here.

Reply
Treasured Social Butterfly
0
Kudos
469
Views

Re: Trump Prohibits Pre-Exisiting Conditions Defense

469 Views
Message 11 of 21

@rk9152 wrote:

@mickstuder wrote:

Unable to nullify the Affordable Care Act (ACA) in Congress, the Trump administration has instead chipped away at the ACA’s foundations in an attempt to effectuate its collapse. That collapse hasn’t happened yet. In fact, ACA exchange market appears to have recovered from last year's doldrums. But, another key ACA pillar is now vulnerable to being eliminated.

 

A lawsuit by 20 U.S. Republican states seeks to invalidate pre-existing condition protections contained in the Affordable Care Act (ACA).

 

A pre-existing condition is any disease or condition for which an applicant for health insurance has sought medical care. The lawsuit also seeks to remove ACA provisions regarding community rating. Here, community rating refers to the setting of insurance premiums without adjusting for a person’s health status.

 

The lawsuit, Texas v. Azar, was filed in February 2018 by Texas and 19 other states. It builds on the recent repeal of the ACA’s individual mandate, which was part of last year’s tax reform law. In the case, the plaintiffs argue that because the mandate was an essential part of the ACA, the entire law should be invalidated.

 

Remarkably, the U.S. Department of Justice stated in a court filing it would not defend ACA in the litigation. In fact, it went further by arguing in a court brief that ACA protections for pre-existing conditions should be ruled unconstitutional.

 

A ruling is not expected until later this year.

 

However, if the 20 states prevail, over 50 million Americans with pre-existing conditions could lose partial or whole coverage, or face much higher premiums.

 

Source - https://www.forbes.com/sites/joshuacohen/2018/10/08/possible-removal-of-pre-existing-conditions-prot...

 

 

 I am all for permitting coverage for babies born with a problem. I am all for insuring that when a person changes insurance companies due to a change in employment. And, no doubt, there are other situations I would approve of pre-existent not being used as a factor.

 

However, take a 47 year old who has been quite capable of purchasing insurance all his working life but opted not to. He is diagnosed with something dire and expensive. What do we do? Do we buy car insurance after the accident? Do we buy homeowner's insurance after the fire?


 


 

 

Does everyone with Car Insurance share the burden of the few who Crash - YES

 

Does everyone with Home Insurance share the burden for the few who's Homes Burn - YES

 

Even having covered people with Pre-existing conditions do Health Insurance Companies make Billions in Profits - YES - Absolutely and it's Obcene to try and Lump Everyone Who Has Ever Been Treated for any Medical Condition into a Category called Pre-existing Conditions

 

A Patient could break their leg in a Car Accident where they had No Fault and now for the Rest of Their Lives They Are Expected to pay Higher Health Insurance Premiums regardless of whether or not after their Broken Leg healed perfectly - ever cost the Health Insurance System another Dime

 

Pre Existing Conditions.png

 

 

Source - https://www.axios.com/profits-are-booming-at-health-insurance-companies-1513302495-18f3710a-c0b4-4ce...

 

 

( " China if You're Listening - Get Trumps Tax Returns " )

" )
" - Anonymous

Report Inappropriate Content
0
Kudos
469
Views
Highlighted
Treasured Social Butterfly
1
Kudos
467
Views

Re: Trump Prohibits Pre-Exisiting Conditions Defense

467 Views
Message 12 of 21

@GailL1 wrote:

OR premiums would be adjusted accordingly, up and down, and all states would set up a reinsurance program like Alaska, Minnesota and several others who already have or are pursuing them, to cover some of the healthcare cost of these high healthcare users over a certain limit - 

 

Thus everybody is covered at a much more reasonable premium rate.


This Comment assumes - ALL Patients with Pre-existing Conditions - are - "high healthcare users" - thats totally false & misleading....................

 

Having High Blood Pressure - a Disease that more than 75 Million Americans suffer from - is considered a PRE-EXISTING CONDITION - I've had Clinically Diagnosed High Blood Pressure for 35 years - I take a 10mg pill daily that costs my Insurance Company about $0.5 Cents per month and has controlled my High Blood Pressure for 35 years without any further expense to the American Healthcare System 

 

This is just one example of the absurd ridiculous arguments that attempts to demonize anyone who has had any kind of Medical Treatment for even the most benign common Medical Conditions that are easily controlled and inexpensive but are used to put Patients into High Risk - High Healthcare User - Categories so they can be premium gouged by Health Insurance Behemoths

 

Aetna, Anthem, Cigna, Humana and UnitedHealth Group — the big five for-profit insurers — cumulatively collected $4.5 billion in net earnings in the first three months of 2017.

 

That was by far the biggest first-quarter haul for the group since the ACA exchanges went live in 2014. Other major insurers, such as the Blue Cross and Blue Shield companyare also thriving

 

In fact the only time Health Insurance Companies report losses is when they make Poor Business Decisions and either Cheat Medicare and pay fines or they try to Merger and ceate even Bigger Monopolies that FAIL

 

Like the 1 Billion Aetna had to pay Humana

 

 

( " China if You're Listening - Get Trumps Tax Returns " )

" )
" - Anonymous

Report Inappropriate Content
1
Kudos
467
Views
Valued Social Butterfly
0
Kudos
460
Views

Re: Trump Prohibits Pre-Exisiting Conditions Defense

460 Views
Message 13 of 21

@mickstuder wrote:

Unable to nullify the Affordable Care Act (ACA) in Congress, the Trump administration has instead chipped away at the ACA’s foundations in an attempt to effectuate its collapse. That collapse hasn’t happened yet. In fact, ACA exchange market appears to have recovered from last year's doldrums. But, another key ACA pillar is now vulnerable to being eliminated.

 

A lawsuit by 20 U.S. Republican states seeks to invalidate pre-existing condition protections contained in the Affordable Care Act (ACA).

 

A pre-existing condition is any disease or condition for which an applicant for health insurance has sought medical care. The lawsuit also seeks to remove ACA provisions regarding community rating. Here, community rating refers to the setting of insurance premiums without adjusting for a person’s health status.

 

The lawsuit, Texas v. Azar, was filed in February 2018 by Texas and 19 other states. It builds on the recent repeal of the ACA’s individual mandate, which was part of last year’s tax reform law. In the case, the plaintiffs argue that because the mandate was an essential part of the ACA, the entire law should be invalidated.

 

Remarkably, the U.S. Department of Justice stated in a court filing it would not defend ACA in the litigation. In fact, it went further by arguing in a court brief that ACA protections for pre-existing conditions should be ruled unconstitutional.

 

A ruling is not expected until later this year.

 

However, if the 20 states prevail, over 50 million Americans with pre-existing conditions could lose partial or whole coverage, or face much higher premiums.

 

Source - https://www.forbes.com/sites/joshuacohen/2018/10/08/possible-removal-of-pre-existing-conditions-prot...

 

 

 I am all for permitting coverage for babies born with a problem. I am all for insuring that when a person changes insurance companies due to a change in employment. And, no doubt, there are other situations I would approve of pre-existent not being used as a factor.

 

However, take a 47 year old who has been quite capable of purchasing insurance all his working life but opted not to. He is diagnosed with something dire and expensive. What do we do? Do we buy car insurance after the accident? Do we buy homeowner's insurance after the fire?


 

Report Inappropriate Content
0
Kudos
460
Views
Valued Social Butterfly
0
Kudos
467
Views

Re: Trump Prohibits Pre-Exisiting Conditions Defense

467 Views
Message 14 of 21

Bah! Let 'em take it all the way to the Supreme Court. Justice Kavanaugh isn't about to vote yes on anything, that would in any way, gut the ACA. Senator Susan Collins said so!

 

 

http://www.politifact.com/personalities/donald-trump/statements/byruling/false/ (11 pages of lies and growing)
Report Inappropriate Content
0
Kudos
467
Views
Valued Social Butterfly
0
Kudos
462
Views

Re: Trump Prohibits Pre-Exisiting Conditions Defense

462 Views
Message 15 of 21

@ChasKy53

 

Then let's talk with numbers -

If health insurers were limited in what they had to pay out on a yearly basis for anybody - let's say to $50,000 then everybody's premium would be based on that limit.  Not singling anybody out no matter their condition or wonderful health.  

 

The premiums would still be set based on a risk assessment but not on a person-basis - it would be set based on a numbers factor of how many people, perhaps by age group, would reach those upper limits of health care cost in a single year - no matter the cause - some pre-existing condition or some health related bad luck like an accident or such.

 

We don't need to reinvent the wheel - we just need to have people's medical needs covered to a certain extent by insurance - be that insurance private or public.  

 

We don't have to single them out by personal health - the limit before going on the reinsurance program would be by medical dollar limit used.   

* * * * It's Always Something . . . Roseanne Roseannadanna
Report Inappropriate Content
0
Kudos
462
Views
Valued Social Butterfly
0
Kudos
469
Views

Re: Trump Prohibits Pre-Exisiting Conditions Defense

469 Views
Message 16 of 21

@GailL1 wrote:

@ChasKy53 wrote:

@GailL1 wrote:

OR premiums would be adjusted accordingly, up and down, and all states would set up a reinsurance program like Alaska, Minnesota and several others who already have or are pursuing them, to cover some of the healthcare cost of these high healthcare users over a certain limit - 

 

Thus everybody is covered at a much more reasonable premium rate.


Yep, premiums would be adjusted "accordingly" alright ..... "accordingly" to pre-existing conditions. And the key word (which you should have put in large bold print) is 'UP'.

 

Why try and sugar coat this?


Insurance is ALL about risk - all kinds.

IF that risk factor is limited, in this case by the reinsurance program, then premiums for everybody would NOT be adversely affected that much because of that preset risk dollar amount.

 

IF that reinsurance program was overseen by government - state or federal - like we already do for other government based coverage like Medicare and Medicaid - then we could be assured that high medical care users are getting what they need as what is deemed medically necessary.  

 

I don't think that people with any sort of pre-existing condition should be denied health insurance, but insurers and people who have the insurance who do or don't have high healthcare cost should have reasonably set premiums which are not so volitile because of high health care cost of a relatively few.  IF the limit is set on a dollar basis of what is spent during a years time, then this would NOT have the assignment made on any type of conditon - pre-existing or a sudden occurences because the risk is mitigated by the spent amount.


Your long post is actually advocating those with pre-existing conditions paying higher premiums.


"The only thing man learns from history is man learns nothing from history"
Report Inappropriate Content
0
Kudos
469
Views
Valued Social Butterfly
0
Kudos
471
Views

Re: Trump Prohibits Pre-Exisiting Conditions Defense

471 Views
Message 17 of 21

@ChasKy53 wrote:

@GailL1 wrote:

OR premiums would be adjusted accordingly, up and down, and all states would set up a reinsurance program like Alaska, Minnesota and several others who already have or are pursuing them, to cover some of the healthcare cost of these high healthcare users over a certain limit - 

 

Thus everybody is covered at a much more reasonable premium rate.


Yep, premiums would be adjusted "accordingly" alright ..... "accordingly" to pre-existing conditions. And the key word (which you should have put in large bold print) is 'UP'.

 

Why try and sugar coat this?


Insurance is ALL about risk - all kinds.

IF that risk factor is limited, in this case by the reinsurance program, then premiums for everybody would NOT be adversely affected that much because of that preset risk dollar amount.

 

IF that reinsurance program was overseen by government - state or federal - like we already do for other government based coverage like Medicare and Medicaid - then we could be assured that high medical care users are getting what they need as what is deemed medically necessary.  

 

I don't think that people with any sort of pre-existing condition should be denied health insurance, but insurers and people who have the insurance who do or don't have high healthcare cost should have reasonably set premiums which are not so volitile because of high health care cost of a relatively few.  IF the limit is set on a dollar basis of what is spent during a years time, then this would NOT have the assignment made on any type of conditon - pre-existing or a sudden occurences because the risk is mitigated by the spent amount.

* * * * It's Always Something . . . Roseanne Roseannadanna
Report Inappropriate Content
0
Kudos
471
Views
Valued Social Butterfly
0
Kudos
480
Views

Re: Trump Prohibits Pre-Exisiting Conditions Defense

480 Views
Message 18 of 21

@GailL1 wrote:

OR premiums would be adjusted accordingly, up and down, and all states would set up a reinsurance program like Alaska, Minnesota and several others who already have or are pursuing them, to cover some of the healthcare cost of these high healthcare users over a certain limit - 

 

Thus everybody is covered at a much more reasonable premium rate.


Yep, premiums would be adjusted "accordingly" alright ..... "accordingly" to pre-existing conditions. And the key word (which you should have put in large bold print) is 'UP'.

 

Why try and sugar coat this?


"The only thing man learns from history is man learns nothing from history"
Report Inappropriate Content
0
Kudos
480
Views
Valued Social Butterfly
0
Kudos
480
Views

Re: Trump Prohibits Pre-Exisiting Conditions Defense

480 Views
Message 19 of 21

Trump Prohibits Pre-Exisiting Conditions Defense

 

Republicans are doing everything they can to kill the ACA, if they do the 40K or so Americans that die every year as a result will be on them.

 

https://www.washingtonpost.com/news/politics/wp/2017/09/28/heres-how-the-trump-administration-is-hur...

 

Here’s how the Trump administration is hurting enrollment in Obamacare

 

At its heart, the Affordable Care Act — Obamacare — is about figuring out how to pay to provide more people with insurance coverage. Before the policy was enacted, insurers balked at covering those with preexisting conditions for the simple reason that such customers are expensive. Cover a lot of expensive people and you either need to enroll more healthy people (who will pay premiums but use fewer resources) or raise premiums.

 

Obamacare opted for the former, mandating that Americans have health insurance or pay a tax penalty. Without those healthy people paying into the system, insurers that have to provide coverage for those with preexisting conditions might be left with no choice but to increase premiums.

 

In other words, enrolling those healthy people is central to making Obamacare work. And in light of that, it’s probably not surprising to discover that the administration of President Trump is taking a number of steps that, intentionally or not, will undercut the number of healthy people who enroll.

Here are a number of ways that’s happening.

 

Slashed funding for enrollment groups. Earlier this month, The Post reported that navigator groups — organizations that work to enroll participants in Obamacare in states that don’t operate their own insurance exchanges — would see sharp cuts to the funding they receive from the federal government. Some groups saw reductions of as much as 92 percent of what they’d received in the past, part of the administration’s decision to cut funding overall by 41 percent.

 

The biggest cuts, we learned, were to groups in the South and the Midwest. Nebraska will lose 81 percent of its funding; Indiana, 82 percent; Louisiana, 80 percent. Among the populations targeted by navigator groups are young people, a population that tends to be much healthier on average, for perhaps obvious reasons.

 

Thirty-five organizations in 21 states targeted young people specifically.

 

Cut funding for enrollment advertising. The administration announced plans to cut its advertising budget for enrollment from $100 million to $10 million at the end of August — a 90 percent decrease. As Vox subsequently reported, a sharp decrease in advertising in Kentucky after that state elected a Republican governor led to a big drop-off in visits to the enrollment website in the state.

 

“Our analysis tells us that state-sponsored television advertising was a substantial driver of information-seeking behavior in Kentucky during open enrollment,” a report on the cuts read, “a critical step to getting consumers to shop for plans, understand their eligibility for premium tax credits or Medicaid, and enroll in coverage.”

 

Shutting down the enrollment website for hours a week. The open enrollment period for 2018 runs from Nov. 1 to Dec. 15, the critical period during which enrollment is encouraged. Last week it was revealedthat for 12-hour blocks on several Sundays during that period, Healthcare.gov would be down for maintenance. The only Sunday on which the site isn’t scheduled to be down from midnight to noon is on Dec. 10, the last Sunday of enrollment.

 

Halted participation in enrollment events. Talking Points Memo noted in August that a Latino group that had worked with the Department of Health and Human Services in past years to enroll people in Obamacare suddenly found itself shut out. While the administration of President Barack Obama had provided Spanish-language materials and sent surrogates to events to encourage enrollment, that stopped in 2017.

 

“We haven’t had any of those discussions,” the policy director of one group told TPM. “It almost completely stopped as soon as the new administration came in.”

 

This week, a similar report from Mississippi. Vox’s Dylan Scott learned that an organization in that state that had similarly worked with HHS in the past to put together events would not be receiving any such help from the federal agency in 2017. The Mississippi Health Advocacy Program had expected agency staff to participate in events aimed at encouraging enrollment across the state and, as recently as this month, had received confirmation that the partnership would move forward. Then, on Monday, it received notice that no HHS staff would be participating.

 

Asked for comment, a spokesman for HHS told Vox that as “Obamacare continues to collapse, HHS is carefully evaluating how we can best serve the American people who continue to be harmed by Obamacare’s failures.”

 

The measures above are likely to hurt enrollment numbers — helping to push Obamacare toward just such a point of failure.

Report Inappropriate Content
0
Kudos
480
Views
Valued Social Butterfly
1
Kudos
510
Views

Re: Trump Prohibits Pre-Exisiting Conditions Defense

510 Views
Message 20 of 21

OR premiums would be adjusted accordingly, up and down, and all states would set up a reinsurance program like Alaska, Minnesota and several others who already have or are pursuing them, to cover some of the healthcare cost of these high healthcare users over a certain limit - 

 

Thus everybody is covered at a much more reasonable premium rate.

* * * * It's Always Something . . . Roseanne Roseannadanna
Report Inappropriate Content
1
Kudos
510
Views
cancel
Showing results for 
Search instead for 
Did you mean: 
Users
Announcements

Roundtable Discussion:
Ask questions and get advice from fellow entrepreneurs
Now through Nov. 22

Top Authors