Your pre-existing condition may be waiting for you, too

Nora McInerny, who now hosts the American Public Media podcast, “Terrible, Thanks For Asking” brings us back to an earlier time in the health care debate — when it was more disconnected from the political calculus than it is now. When people didn’t toast the misfortune of the sick.

Nora, you may recall, lost her husband, Aaron Purmort, in November 2014 after a battle with a well-chronicled brain tumor.

So she knows a little something about what it’s like to be young and healthy and have one’s whole life ahead, only to find out that it’s a mirage.

Her Twitter thread today is a good dose of the reality that exists outside the Beltway.

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Related: Here’s a list of preexisting conditions that may not be protected under GOP plan (Washington Post)

  • dukepowell

    Oh, dear…. where to start…

    Let’s begin here – I’m perfectly be willing to be proven wrong on all I’m about to say. Generally speaking, though, these are the facts as I know them.

    Given the news, one would think that tens of millions of Americans will lose their health insurance under the Republican plan due to pre-existing conditions. Here’s what the facts are:

    1. All Medicare patients will be covered by the Federal benefit set AND any private supplement policy for pre-existing conditions. This is the law and has been forever.
    2. All Medicaid patients are covered by pre-existing conditions. This is the law and has been forever.
    3. All employer provided insurance requires coverage for pre-existing conditions. This is the law and has been forever.

    Nationally, add all that up and you are covering 90% of all Americans. Before and during ObamaCare.

    How about the last 10%? This information has appeared in Federal Census data and, here in Minnesota, replicated in a 2006 report to the legislature. Seventy-five percent of the uninsured have consistently fallen into 3 categories.

    1. Illegal aliens that are not eligible for coverage.
    2. Those eligible for coverage but haven’t bothered to sign up. They will be signed up and covered once they appear at a health care provider because providers like to get paid and are quite adept at the paper work.
    3. Those who can “afford” health insurance but have chosen not to buy it. I will stipulated that “afford” is a subjective term.

    For the very small percentage that have pre-existing conditions and are denied insurance, ObamaCare has a high-risk pool. The last I heard, nationwide, that program has enrolled app. 114.000 individuals.

    • The provision in the bill just passed allows large employer health plans to provide coverage under the rules of a state that adopts the waiver on ACA rollbacks.

      A CBO score would be a fine way to get this all cleared up before a vote.

      Your party didn’t want that.

      • dukepowell

        First of all, “your party” wasn’t a font of information prior to the Obamacare vote either. Having said that, I agree that practically no one knows what’s in this bill – and that’s poor legislating.

        Secondly, the issue of pre-existing conditions is a wildly exaggerated problem.

        My solution would be for the Feds to cover these people, if shown that they either can’t get insurance or find it provably unaffordable. As an added bonus, I’d pay 100% of the provider’s bill, subject to audit for medical necessity.

        • What was the information that was unavailable to the GOP prior to the vote that you wanted?

          Was it a copy of the bill? Hearings? The opportunity to amend? A CBO score? What exactly?

          • dukepowell

            The problem is that we have a very confusing set of laws that are subject to partisan bickering. The facts don’t matter.

          • Yes, the intersection of politics and health care is toxic. We have a population that is disinterested in the details of public policy, a media that is enriched by dispensing bumper sticker pablum, and very, very poor leaders with no priority on leading.

            The fascinating part is somehow we think the nation can long endure.

          • Jack

            Your last sentence hits the nail on the head.

            There will be health insurance in some capacity left. The carriers will heavily lobby for that, one can be certain of that.

            I think it is a shame that crowd funding is the solution to health care bills.

            Note to self – better check to see if my Epipen is covered by the recall. Maybe I’ll be lucky and get a new one to replace it for free.

          • All those GoFundMe appeals should indicate who the person voted for. You know, “you broke it, you own it” ? :*)

          • theoacme

            Fortunately, for me, since I have several pre-existing conditions, and work for an employer that has nexus in several states, including some states believe that, if you have a pre-existing condition, you’re not Christian, you are a servant of Satan and a traitor, you deserve to die horribly, and deserve to burn in the Lake of Obamacare Fire for all eternity, I probably won’t be alive to see the United States no longer exist…

            …I do wish Erik Paulsen would have realized that Medtronic, St Jude’s, Boston Scientific, 3M, and all his health care corporate owners are going to lose money as a result of this law, because health care won’t cover the purchase of their products for people with pre-existing conditions…

            …it’s too bad I won’t get to see Paulsen hoist on his own petard…and it’s also too bad Paulsen will blame me for Medtronic’s losses, because I was too poor, without insurance that covers my several pre-existing conditions, to buy all Medtronic’s whiz-bang expensive gadgets, and without Paulsen having the courage to nicely put me out of my misery by giving me an Arkansas-style execution…

          • theoacme

            And Bob, I know someone that has a whole panoply of “pre-existing conditions” – including Meniere’s – that will be happy to talk with any politician on this matter, has offered to…but no one has yet taken her up on her offer…

            …she’s a wonderful person, and would be happy to share (I won’t guarantee all, but at least some, she has more than her share) of her experiences with you and your readers here at NewsCut…

            …if you’re interested, I can provide you with her contact information (I have just messaged her to confirm that she would like to share her story with NewsCut/MPR/NPR as well).

          • She is most certainly invited to share her experiences if she wants to write something. although *I* can write that Meniere’s story. It’s the worst. My heart goes out to her. It’s impossible to function even in the most basic manner in a Meniere’s attack. I can’t even fill in on the radio anymore because of it.

            It’s also the reason why I’ve canceled my plans to retire next year (sorry, kids who wanted to get into the business and get a job here funded by themoney me leaving frees up). I can’t afford leave MPR’s self-funded health plan. Golden handcuffs.

        • Jack

          Please define medical necessity.

        • kennedy

          Some call it audit, some call it death panel.

        • chris

          Can an honest person really say that pre-existing conditions is not a serious problem? Before the ACA it was a main reason people could not afford health insurance.

        • RBHolb

          “First of all, “your party” wasn’t a font of information prior to the Obamacare vote either.” The great talking points never die, do they? Before the ACA was passed, the CBO did score it, and that report was made available. For some reason (too many big words?), Republicans claim not to have read it.

          Whether that scoring was accurate is another matter. There still was an effort made to forecast the costs of the bill.

      • jon

        States rights! By saying any state law is as good as any other, regardless of what state you are in.

    • kevins

      #3 But the law does not preclude an insurance company from dropping your coverage, renegotiating the insurance contract with more favorable terms (for the company), or simply raising premiums such that the employer passes the costs along to the person or family covered until…well you know what.

      • dukepowell

        If you have a pre-existing condition and have coverage provided by you employer, they cannot drop you – at least that’s my understanding. You are correct in that premiums can rise.

        But the post here is about pre-existing conditions.

        • They can reimpose lifetime coverage limits.

          • Jack

            Or carve out special higher limits for out of pocket, if not eliminate them.

        • kevins

          Aye, there’s the rub Mr. Powell. So many with pre-existing conditions…what will the private sector do with that? There’s no profit in insuring people already ill.

        • Carolie

          but they can change the benefit set Duke… They are doing it now the prescription drugs. formularys change all the time and the co-pays go up or the drug is not longer allowed as treatment, etc.

    • theoacme

      “This is the law, and has been forever…”

      Besides the fact that the United States has, whether as its own independently corporatively organized entity, or as colony subdivisions of the United Kingdom of Great Britain, Scotland, Wales, and Ireland (an independent corporatively organized entity), NOT been around forever…

      …and no corporatively organized entity that has the ability to make law can make its laws immutable, and immune to amendment, or to evisceration, or to elimination, or to replacement by something worse…that is the nature of the republican-style, or democratic, mode of government by its own innate design

      …and is also the nature of despotism or autocracy, because none of these have ever lasted forever…

      …so, sir (or madam), if you can guarantee that no government can change any of the laws that you believe protect people with pre-existing conditions, and if you can guarantee that no government could possibly make it such that people with pre-existing conditions will be more likely to suffer an untimely death, and were selling such warranty like a Best Buy extended service plan…

      …I wouldn’t believe you, and wouldn’t buy your guarantee at any price, even if other people’s money paid for it on my behalf, tax-free to me…

    • Angry Jonny

      So you are citing data from a 10-year-old state report? Who generated said data and said report? Perhaps there are fresher sources you could use. BCBS Foundation, Kaiser FF, Portico HealthNet.

      Your use of certain terminology regarding people, as well as your strategic use of quotation marks, betrays a subtle (or not-so-subtle) pejorative sentiment within the subtext of your commentary.

    • Kassie

      In 2012, 15.4% of Americans had no insurance. Many more had plans that weren’t Medicare/Medicaid or employer sponsored. Yet you say only 10% of Americans were either not on Medicare/Medicaid or employer sponsored. Your numbers are wrong, therefore I don’t trust any of your “facts.”

  • KTFoley

    Way back when, I left a company and took the option to convert my coverage under their group insurance to an individual policy. It was total blind fortune that the rate wasn’t affected by my pre-existing condition and yet, for seven years only the mortgage was a larger expense.

    Now I’m back on an employer’s policy and the emerging truth is that no one like me can suffer a risk — start a new venture, retire, go through a layoff — if the move will jeopardize our coverage in any way.

    It’s terrifying to consider how much a policy would cost now, 10 years later with the new set of exclusions the current legislative mentality — if I could even get one. .

    • jon

      That is the goal, make it so you have to work for one of the marvelous corporate overlords to have healthcare. That way labor is cheaper because only corporate group plans give any meaningful coverage… And if you get sick and start coating to much or lose your job because of it, say good bye to your coverage.

      Disconnecting healthcare from employers would be the healthiest thing we could do for class mobility… Which is exactly why no one wants to do that.

      • Jerry

        Why would we want to promote entrepreneurs and innovation?

        • Jack

          Bingo

        • jon

          Oh we want innovation, but we want it from people who already support the GOP… Entrepreneurs are cool too, so long as they are the wealthy offspring if someone who supports the GOP…

    • Carolie

      Bingo!!! change jobs and the new employer’s insurance doesn’t have to cover the pre-existing condition. When our family relocated to Minnesota I had asthma. We got insurance through my spouse’s employer, but I had to pay out of pocket for any prescriptions and treatment for the asthma for 18 months. Luckily did not have any emergency room visits or hospitalizations during that time. We are going backwards…

  • Jack

    The list of pre-existing conditions forgot “alive”.

    We all know that somehow the insurance company will find a way to disallow a claim. You have a parent with heart disease – oops, it must be genetic and you are predisposed.

    I remember when HIPAA freed up individuals to move jobs without worrying that the pre-existing conditions wouldn’t get covered. Think people will want to become entrepreneurs and lose the company subsidized health coverage that might cover pre-existing conditions?

    Companies are already looking for ways to get family members off the employee’s coverage as it is.

    Just for the record in case no one mentioned it the earlier post today (too many comments to read right now), HSAs started under George W. Bush.

  • Will

    I’m sorry for her loss and we should listen to her perspective, it’s something I hope none of us will have to experience.

    • theoacme

      Maybe enough people in the corporate, economic, political, and corporatively organized religious sectors in the United States should experience what Ms. McInerny has experienced, so that the entire power establishment realizes what just happened yesterday…

      …and, if this really is a Christian nation, as Republicans proclaim from atop the Foshay Tower (and Democrats do not dispute, regardless of how unchristian the United States really has been since before the Puritans executed Mary Dyer), Republicans might remember the second part of the Golden Rule…

      …the power establishment has certainly got the “do unto others” bit down pat…it needs to remember the “as others would do unto you” part that Jesus also said…

      • Rob

        There’s a great Nicholas Kristof piece in the March 16 NYT, titled “And Jesus Said Unto Paul of Ryan…”

    • RBHolb

      Guess what, Will? Many of us will have to experience what she did.

      And guess what else? Not all of them are going to be lucky enough/personally responsible enough to have good employer-provided health coverage and a supportive network to ease at least the financial burden. A lot of them-us-are going to find them-our-selves bankrupted by this experience.

      One more guess what? This is what the Republicans and their supporters wanted. They may mouth platitudes about everyone having the opportunity for coverage, and dismiss concerns about things like this happening because there are always ways around things, but it is going to happen. It’s the natural and expected consequence of repealing the ACA (pity no one wanted to wait around for the CBO’s assessment, to see it for themselves). The repeal was pushed through in the face of these consequences, so it must be what the Republicans wanted.

      So they can spare us the tears.

  • kevins

    Healthcare for everyone…D. Trump.

    • Will

      Can we call it Trumpcare yet? I know liberals are itching to call it that…I’m perfectly fine with that, but it would probably be more appropriately named Ryancare…anyone have other ideas?

      • Rob

        NoCare

      • chris

        When the CBO score and analyses come out from various groups you will see a fight to shift ownership. Trump will run so fast and his voters won’t even care. No chance moderate GOP senators get on board with this.

        • Will

          Rand doesn’t seem too keen on the bill either, is he a moderate?

          • chris

            Exactly, there will be the extremists like Paul and Cruz who will never be able to square a bill with the few moderates.

      • Dan

        TrumpDoesn’tCare?

        • Will

          Still waiting for a good catch one Pelosi can start using…

  • wjc

    And then Trump says:
    “It’s going to be fantastic health care,” Trump said, referring to his new health care plan. “I shouldn’t say this to our great gentleman and my friend from Australia because you have better health care than we do.”

    Jeez!

    http://www.cnn.com/2017/05/04/politics/trump-us-australia-health-care/index.html

  • Ben Chorn

    When I was self employed I tried to get coverage and was denied for a pre-existing condition. I got lucky and my employer hired us as employees and I got covered. Then I got laid off and went months without insurance. Thankfully nothing happened.

    Now I have a new job and my health care costs more than I can imagine. I pay a lot and get little in return. My wife and I can’t afford to pay anything more, and won’t make any savings until we meet our deductible of $4,000. Unfortunately we may be putting off having kids due to health insurance costs, especially since it sounds like pregnancy can be counted as a pre-existing condition under Trumpcare.

  • king harvest

    A lot of pre-existing conditions are going to be visiting very expensive emergency rooms.