Ezra Klein: Insurance companies cannot charge more for pre-exisiting conditions. Dean says no.

[flpoljunkie]

Potomac, Md: Ezra, thanks for explaining everything so clearly. I understand that insurance companies can't exclude people for pre-existing conditions, but can they charge higher premiums, which could have the effect of excluding them?

Ezra Klein: Nope.

http://www.washingtonpost.com/wp-dyn/content/discussion/2009/12/10/DI2009121002481.html

Someone's got it wrong here. I'd like to know who.

[Armstead]

1. Everything keeps changing and no one is telling us...So who knows?

[napi21]

2. I believe Dean is right. I've heard too many others say the same thing.

Yes the ins co's will have to ignore pre-exist. conds but you won't be able to afford the premiums.

[Renew Deal]

12. Links?

[Mass]

3. This is a stupid discussion and everybody knows it. It is about the side effects of other parts of

the bill. Insurances cannot charge more for pre-existing conditions, but they can charge three times more for age. Who do you think have the most pre-existing conditions, in average: older or younger people?

The intent of the law is not necessarily what the law ends up accomplishing. In MA, older people (who generally need more healthcare) end up getting less coverage because their insurance can be as much as two times more than younger people. In the Senate bill, it is three times more. What do you think the effect will be.

The White House and other people behave as if each condition on the bill had no effect on the other parts. They do.

[flpoljunkie]

5. What we need is stricter regulations on the insurance companies. What is ratio in House bill?

These kind of things could be fixed in conference.

[flpoljunkie]

7. The house 'age' ratio is 2:1 while the Senate bill age ratio is 4:1. No surprise here.

http://www.kff.org/healthreform/sidebyside.cfm

This info comes from 'Changes to Private Insurance' comparison between the Senate and House Leadership bills:

Senate leadership bill:


Establish a temporary national high-risk pool to provide health coverage to individuals with pre-existing medical conditions. U.S. citizens and legal immigrants who have a pre-existing medical condition and who have been uninsured for at least six months will be eligible to enroll in the high-risk pool and receive subsidized premiums. Premiums for the pool will be established for a standard population and may vary by no more than 4 to 1 due to age; maximum cost-sharing will be limited to the current law HSA limit ($5,950/individual and $11,900/family in 2010). Appropriate $5 billion to finance the program. (Effective within 90 days of enactment until January 1, 2014.)

House leadership bill:

Establish a temporary national high-risk pool to provide health coverage to individuals (and spouses and dependents) with pre-existing medical conditions. Individuals who have been denied coverage, offered unaffordable coverage, have an eligible medical condition or who have been uninsured for at least six months will be eligible to enroll in the national high-risk pool. Premiums for the high-risk pool will be set at not higher than 125% of the prevailing rate for comparable coverage in the state and could vary by no more than 2:1 due to age; annual deductibles will be limited to $1,500 for an individual; and maximum cost-sharing will be limited to $5,000 for individuals. (Effective January 1, 2010 and until the Health Insurance Exchange is established)

[flpoljunkie]

8. More from Kaiser on the 'age' ratio. Neither Germany nor the Netherlands charge older people more.

However Congress decides the issue, they could look to other countries that have both universal health care and a private insurance industry. None of them, including Germany and the Netherlands, use age or any other personal characteristic to set premiums.

http://www.kaiserhealthnews.org/Stories/2009/October/28/npr-young-invincibles-health.aspx

[FiveGoodMen]

13. What we need is to outlaw for-profit health care.

[flpoljunkie]

16. No. What we need is much tighter regulations. BCBS FL's non-profit, state family plan is $13,500+.

...although it is heavily subsidized. The state legislature, controlled by Republicans, is thinking of making employees pay the full cost of their insurance because of their looming financial crisis. They raised 'fees'--not 'taxes'--this past session on driver's licenses, auto registration--which really hits working people very hard. Republicans are despicable!

[FiveGoodMen]

27. We need single payer.

I know there are lots of ways to skirt the non-profit restrictions and still steal peoples' money.

Health care is too important to make it part of everyone's get-rich-quick schemes.

Most of the industrialized world has figured that out.

[SpartanDem]

4. Dean is wrong it is age that they can charge you more for

they can't charge based on any health issues.

[eleny]

6. At what time of life do most people have preexisting conditions - young or old?

[Jennicut]

9. It depends, I am 33 and was diagonosed as a diabetic at 28.

[flpoljunkie]

10. We need to be more like Germany and the Netherlands.

Of course, their private insurance companies are not on their stock market and may be non-profit, as well. Of course Florida's Blue Cross Blue Shield is 'non-profit' and their rates are over $13,500 for a family in their state insurance plan, heavily subsidized by the state--at least, for now.

[eleny]

14. My question asks about "most people"

It was to illustrate that Dean was right when he said that premiums would escalate for many because older people, as a group, have more existing conditions.

[Donnachaidh]

11. my kid was diagnosed with his condition IN UTERO

And I fully expect to be charged through the teeth by these companies just to get him on some sort of coverage.

This is based on the FACT that he could NOT get insurance at all before.

[eleny]

15. My question asked about "most people"

I never denied the fact that younger people can also have preexisting conditions.

[flpoljunkie]

18. We need to 'spread the risk' and charge everyone the same like they do in Germany, Netherlands.

It's the civic and moral thing to do. We will all get old some day.

[eleny]

24. Agreed

[burning rain]

17. Oh... Ezra Klein... another fiscal moderate conservative, social liberal from the Washington Post.

How unsurprising that he and his paper would love this bill.

[amborin]

19. Dean has it correct

[amborin]

20. good explanation here:

<http://www.dailykos.com/story/2009/12/17/815568/-Insurance-premiums,-lack-of-cost-controls,-and-the-great-Massachusetts-experiment>

[blueworld]

21. Ezra has been wrong many times already about this

The insurance companies must cover pre-existing conditions and they cannot make "unreasonable" annual or lifetime caps on benefits paid out, HOWEVER, there's nothing I've yet found that limits their ability to assign policy-holders to different categories and charge accordingly. In fact that's the only bloody purpose to having insurance companies at ALL! That's what their actuaries DO all day long.

They've already announced their planned premium increases for next year and tentatively suggested a 13% increase over the next couple of years, which will probably grow like toenail fungus once they start whining about problems & costs.

If you can't afford their premiums, presumably you'll get a subsidy of some kind - but private insurers CAN kick your sorry ass out, otherwise it would be universal health care.

Lastly, how can anyone "know" for sure what's in two different versions of this bill with all the pending amendments? I can't even find a "summary du jour" for pete's sake.

[madfloridian]

23. There are several bloggers who rely on the party talking points

on several issues and have been off at times.

[optimator]

22. Ezra Klein has no qualifications

just a punk ass little 25 yr old blogger who is probably paid to say whatever the white house wants.

[Writer]

25. Brilliant.

"And I thought, and think, we've moved to a level of abstraction in this debate that has obscured the human cost of losing this bill and the real benefit of passing it."

:thumbsup:

[slinkerwink]

26. Ezra Klein is wrong on this issue. Yes, private insurers can charge

higher premiums. There are no cost caps in this bill.

[PHIMG]

28. Ezra Klien = fake liberal, status quo toady.

I'll take Dr. Dean's word over this careerist anyway.

[Scarsdale Vibe]

29. Ezra Klein is right. Actual language of the bill.

‘SEC. 2701. FAIR HEALTH INSURANCE PREMIUMS.

‘(a) Prohibiting Discriminatory Premium Rates

‘(1) IN GENERAL- With respect to the premium rate charged by a health insurance issuer for health insurance coverage offered in the individual or small group market

‘(A) such rate shall vary with respect to the particular plan or coverage involved only by

‘(i) whether such plan or coverage covers an individual or family;

‘(ii) rating area, as established in accordance with paragraph (2);

‘(iii) age, except that such rate shall not vary by more than 3 to 1 for adults (consistent with section 2707(c));

‘(iv) tobacco use, except that such rate shall not vary by more than 1.5 to 1;

‘(B) such rate shall not vary with respect to the particular plan or coverage involved by any other factor not described in subparagraph (A).

Unless you consider tobacco use, geographical location, marital status, or age to be pre-existing medical condtions. Unfortunately, gender rating is still allowed in large market plans, which actually is a problem because different industries and large businesses sometimes do attract a pool of employees weighted towards one gender.

[depakid]

30. Wow- that's a LOT of waste going toward adverse selection

dollars that COULD be used to "produce health."

[freddie mertz]

32. Age is kind of a major issue. Don't you think?

How old are you anyway?

I'm over 50, and believe me, I use a lot more HC than I did at 20 or even 40.

[flpoljunkie]

33. An improvement from Reid's original 4:1 ratio for age, but 3:1 still not affordable.

This is one thing that definitely needs to get fixed in conference.

[amborin]

34. here:

http://www.dailykos.com/

[flpoljunkie]

35. If you're directing me to Al Franken denying Lieberman more time, all I can say is...

I love Al Franken! In defense of Franken, his spokesman said they had been told to keep speeches to the allotted ten minutes as many Senators wanted to speak.

[MISSDem]

31. I read that the insurance company can also apply

a yearly maximum per illness so for some illnesses that would amount to no coverage after a point.