Pre-existing conditions

[spanone]

Major Health Care Changes in the Senate GOP Bill

Pre-existing conditions

The Senate bill would weaken protections for people with pre-existing conditions and push sicker customers toward more expensive plans and healthier customers toward cheaper, less generous plans.

Under Obamacare, insurers are not allowed to deny anyone health coverage for a pre-existing condition or charge them a different price. In addition, every plan has to include the same minimum level of coverage — called “essential health benefits” — so that insurers can’t herd healthier patients into cheap plans that wouldn’t meet basic needs for sicker customers.

The Senate bill would change that. It includes a modified version of a proposal by conservative Senators Ted Cruz, R-Texas, and Mike Lee, R-Utah, that would allow insurers to sell plans that do not meet Obamacare’s regulations.

That means they don’t have to not cover “essential health benefits,” which include everything from hospitalization to maternity care. They could also deny plans to people with pre-existing conditions or charge them more based on their health.

http://www.nbcnews.com/politics/congress/major-health-care-changes-senate-gop-bill-n782691

[Solly Mack]

1. K&R

[Skittles]

2. "they dont have to not cover"

what does that even mean

[Qutzupalotl]

3. Typo, probably.

Should be "they don't have to cover."

[Skittles]

4. OK

yes, knowing repukes, that's it

[ThoughtCriminal]

5. Rarely discussed: How often insurance companies abused "Pre-existing Condition"

to avoid paying claims. Bad enough that almost every human on Earth has some kind of pre-existing condition. But prior to HIPAA, even group policies had an exclusion period.

Insurance companies frequently abused the exclusion and would try to find something, anything in a patient's medical history that they would claim as evidence of a pre-existing condition. Documentation from your doctor(s) be damned if some agent who's bonus was based on how many claims were rejected could find something as an excuse. It was you against the insurance company and their lawyers, while the collection agencies came after you for the bills that they did not pay.

I can guarantee that they will do the same thing to charge insane rates for all but the young and healthy (until they get sick).

Any policy that has any exclusions in this category is fraudulent.

I personally fought this battle before when one of my children had to have an operation and it was ugly.

[Ms. Toad]

6. Non-conforming plans can only be sold by companies that offer conforming plans -

(i.e. that cover people with pre-existing conditions and charge community rated premiums).

BUT that ability to create a separate set of plans that will separate people who need little health care from people who need massive medical care means only sicker people will buy the full-coverage plans, driving the rates sky high for the sickest people.

That's essentially the same unworkable system that was available in many states pre ACA - a pool of sickies paying premiums based on their status as heavy consumers of medical care.