What the New Health Care Insurance Reform Bill Means For People With Pre-Existing Conditions
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I have a pre-existing condition - what does the health care reform bill do for me?
I think one of the biggest questions of the day is how will the health care reform bill affect those people with pre-existing conditions?This has always been a sore spot for me because I am one of those people that has been unfairly denied insurance coverage in the past because of a congenital heart valve condition that I was born with. Being a small business owner for many years, I was always terrified of losing my insurance coverage - knowing that if I lost my coverage I would have a hard time finding other coverage and possibly be without coverage at all.
Addressing pre-existing conditions is just one of the many parts of the health care reform bill - but a very important part - and that is what I will focus on in this first series of hubs about the new health care bill aka The Patient Protection and Affordable Care Act. In an effort to unravel all the bits and pieces of the bill, let's take a look at summaries of the government documents on how people with pre-existing conditions will fare.
What the Patient Protection and Affordable Care Act says
What the Health Care Bill Means For People With Pre-Existing Conditions:
According to the new health car bill, a short summary on pre-existing conditions gives us this:
In 2010, the bill will provide immediate assistance for patients who are uninsured because of pre-existing conditions. It will also prohibit pre-existing condition exclusion for children. In 2014, the bill will ban pre-existing condition exclusion for all patients in the U.S.
“Insurers will be prohibited from denying coverage or setting rates based on gender, health status, medical condition, claims experience, genetic information, evidence of domestic violence, or other health-related factors,” according to the summary. “Premiums will vary only by family structure, geography, actuarial value, tobacco use, participation in a health promotion program, and age (by not more than three to one).
”The Patient Protection and Affordable Care Act will ensure that ALL Americans have access to quality, affordable health care and will create the transformation within the health care system necessary to contain costs".
Pre-Existing Conditions?
You can't deny me coverage anymore!!
What this means for people like me is that I can now get insurance coverage REGARDLESS of my pre-existing condition. Not only that but I can no longer be discriminated against in the future because of this pre-existing condition. This, in my book, is a huge step towards equality in our nation. I am only one of many who have been denied coverage in the past because of a pre-existing condition - even though I have paid dearly for not only my health coverage but also for those of my children when I owned a small business. I currently have partial insurance, and plan to seek out a better plan now, knowing that I can longer be denied because of my pre-existing condition. Because I also fall into a lower income level at this time, working only part-time, I should be able to immediately get coverage without worrying about getting turned down.
And one of the beautiful things about this bill is that children, our precious children, will now also have the same rights TO HEALTH COVERAGE, regardless of their pre-existing conditions.This is also another huge leap in our society, where up to now parents of handicapped and disabled children have been unfairly denied health insurance for their children that have been born ill or gotten sick. How many times have we seen children unfairly denied medical coverage? Desperate parents seeking to get the medical attention their children needed but could not get? Holding onto jobs for dear life fearing that their children would suffer if they got laid off or fired? My own father, God bless him, stayed in the Navy just so he could provide medical coverage for my sister, who died at the age of 13 because of a congenital heart defect. My father knew how difficult it would be to help my sister without good medical coverage. He made huge life sacrifices for his family to make sure they had good medical coverage (and this was 50 years ago) How many other parents have sat on pins and needles fearing the loss of their medical coverage?
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How long do we have to wait to get help?
No Pre-existing Coverage Exclusions for Children:
The Patient Protection and Affordable Care Act eliminates pre-existing condition exclusions for all Americans beginning in 2014, when the Exchanges are operational. Recognizing the special vulnerability of children, the Patient Protection and Affordable Care Act prohibits health insurers from excluding coverage of pre-existing conditions for children, effective six months after enactment and applying to all new plans .
Access to Affordable Coverage for the Uninsured with Pre-existing Conditions:
The Patient Protection and Affordable Care Act will provide $5 billion in immediate federal support for a new program to provide affordable coverage to uninsured Americans with pre-existing conditions. This provision is effective 90 days after enactment, and coverage under this program will continue until new Exchanges are operational in 2014.
What the new Health Care Reform Bill means for people with Pre-Existing Conditions is that we no longer have to worry about whether an insurance company will deem us or our children as "acceptable" risks. This has been a long time coming, and despite the bickering back and forth, a necessary step to make sure that ALL Americans have access to health care, not just those deemed as "worthy" of insuring. I applaud the new health care reform bill, and in future hubs will break down other points of the bill, how it affects small business, the elderly and families.
(Dorsi Diaz is a freelance writer/publisher on the Internet who writes from experience and loves to help people. If this article has been helpful for you a thumbs up would be appreciated and please join her reader fan club)
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Ralph) I'm glad you are doing OK with your insurance. Sorry the Medigap is not picking up though, I've heard of those "promised" health care things that didn't turn out to be promises after all.
Thanks great information.
makes me feel better for my "special" boy..very informative..thanks doris..
It is high time that this health care bill is put through. How many people can't efford insurances? I can't understand that there is one person who object to this. Thank you for you hub
that is good news and they can't tack on higher premiums for pre-existing conditions OR can they?
I read affordable so I would presume NO. Not trying to steal your hub away. However, it is kind of like, will person "X" who is more prone to hospital visits due to whatever condition (obesity, lung cancer, diabetes) they have, person "X" cannot seriously obtain the same payment (or premium) as a triathlete. Or driver "A" has 4 accidents while driver "B" has none and are the same age.
Or a borrower with a 780 credit score should have a lower interest rate than one with a 620 credit score.
I definitely say yes to coverage to all but do not agree on the premium and I think that would be fair to everyone.
All in all I see the benefit from your hub .
I have the same question as ocbill - I have a minor pre-existing condition, and I was able to get health insurance - at 4x the rate of someone without! Will the new bill help us with pre-existing conditions get reasonable and affordable health care coverage?
BTW - I had to form an LLC with my wife, then get a group health insurance policy for the two of us in order to get health insurance under $1000 per month.
Truth from Truth) Thank you!
salvacion) I am so glad for you.
hello,hello) I agree! Who could say this is bad thing??
ocbill) My understanding so far is that there can be no discrimination regardless of the condition. If you read the summary it sounds like the only thing that could raise the cost would be smoking (which after all is a voluntary thing, and age - but even then there is a restricting formula in place to cap costs)
TJ Stephens) I can relate. I have thought of doing the same, I remember at one point being denied insurance for our small business because of my heart valve issue (we were sole proprietors) It was very very frustrating!!
Health Care Reform is far from what the American public wanted but it is a start. Let's hope it improves and takes affect before 2014. Seems senseless to have to wait that long for something so desperately needed.
Nancy) I agree. It's not perfect but a step in the right direction. And there will be help within months for people with pre-existing conditions that need help sooner.
Hopefully now the rhetoric will die down and they can get to work to improve your health care.
Welcome to the 21st century :)
Uninvited) Yes hopefully the bickering can stop and they can get to work making this new bill do what it's supposed to do!
Dorsi, I have deep philosophical differences with the individual mandate in the bill. I am also skeptical of the claims it will reduce costs as there are certain assumptions made and unfunded mandates on states. As I live in TN where TennCare nearly bankrupted the state we saw what a universal system could degrade into.
All in all, I am in favor of some of the regulations toward ins. companies, though, as some of their practices like dropping coverage to those who are paid up is reprehensible. The pre-existing conditions thing is a thorny one that I agree there should be some way for people to obtains insurance, I do not think it is sustainable for those rates to remain the same as everyone else's. The natural consequence, I believe, is the increase of everyone's premiums which is what the bill was supposed to stop. It is a very difficult thing to fix, though, and no solution offered has been perfect. Congrats on this point working to help you, though, and maybe my worries will not be borne out. :)
I did want to let you know that I also answered your reseeding question on my hub, and best of luck in your project! Thumbs up!
Jeffrey) Thanks for stopping by, reading and commenting. I agree that there are some things that could be better in the bill. Let's hope that this is just the beginning to true health care reform. There are alot of good things in it, the sticking point seems to be idea of mandated insurance which has raised some hackles. Thanks for answering too about the lawn reseeding !!
I think that the bill is a start. But, I believe that we should have a health savings option to those that could carry themselves. I know how Canada ran theirs and it's broke. That's the reason they come to the US. My Mom was diagnosed with bone cancer. She had insurance before she was diagnosed. The Ins. Company paid for all she needed thank God. She is doing great after chemo and Rad treatment. Today she said that she was needing more therapy on her leg but, medicare won't pay for anymore stuff .I hope this isn't a prelude to what we're getting into.
A++ Great Hub!
I totally agree with the pre-existing condition issue, that should have been implemented long ago. That is great that you will have the coverage that you need. My question is why are they waiting until 2014. Seems to me that we will begin paying for this right away...our taxes will go up etc. but the actual benefits will not be available. I have a hard time with some of the other little things that have been included in this bill, after you get down to the fine print - well it's not at all what we will be getting. It's a very good thing to change some things about our present health care system - but to the extent this administration is taking it is well - it is a bit scarey to me! Also I still cannot understand for the life of me why this new health care reform will not apply to congress. If it is such a good thing why are they not for it - if someone has an answer I sure would like to hear it. Thanks for the hub it was interesting and I look forward to reading your others on this issue.
Nick) Glad to hear your mother got help and doing OK. Thanks for stopping by.
mhuze) Thank-you!
Whidbeywriter) My understanding is that there will be immediate help for those that need it and qualify (income, etc) The summary in the hub describes the implementation.
Thanks for reading and part 2 on health reform and small business is up.
What the bill doesn't do is control costs in any way shape or form. So you may be eligible for insurance now with a pre-existing condition. But why the wait? 4 more years before you can apply for coverage? What is that about? There is plenty of backdoor politics ahead on this bill from both parties.
Just having a law that says they can't deny you doesn't mean you will be able to afford the rate of coverage. There is nothing to control costs.
And the Government subsidies don't make the monthly payments for you... you still have to do that. Then you can apply for the subsidies later (And hope you qualify for reimbursement in the form of a Credit). When you couple this waiting period with a mandate to buy you are going to see a lot of poor people really hurt. Again the Bill doesn't address the "how to pay for it" problem.
So if the individual plan is $800 a month you still have to figure out a way to pay for it.
Rates will go up because when you include a group of people that will make more use of the coverage they have to go up.
So it's both a good thing and a bad thing.
There is nothing in this Bill that addresses the problem of how this will be paid for. Thats the sad reality.
They could have really crafted a Bill that helped people.. instead all they did was mandate coverage. Without cost control you may be eligible but unable to afford the cost of coverage.
So including pre-existing conditions is not a bad thing from a coverage standpoint, but it certainly will not bring down the costs.
And if you are not eligible for coverage from an Employer the Insurance Companies can still descriminate against you... why? Because you are thrown into an individual risk pool group... this is where the unavailability of the public option leaves you high and dry.
So much needs to be done to craft a Bill that really works for the uninsured... and this one just doesn't.
My perspective is a bit different because I worked for a Major Health Insurance company. I've seen it from the inside out. I have family members that are Doctors and also in the Insurance Industry.
I've very much for Reforms that help the people. Sadly there just isn't enough help in this Bill. That's why I'm against it... I'm not against Reform.
The massive amount of new paperwork and regulations this Bill will create will also raise the costs. And the insurance companies will simply pass these costs along in the form of higher premiums... again because there is nothing in the Bill to prevent them from doing so.
At some point if Americans really want quality health coverage they are going to have to look at why we spend so much money on the Military. Think about how to reallocate those funds to real reform. $800 Billion in military spending in a single year? More than half the World's Military spending coming from the United States? That's 8 Trillion in the next 10 years in spending on the Military? That's insane. The money is there to provide health care to the masses... but not until the Military spending is brought under control. Americans can't fund everything!
Do we want to kill people or save them?
Hello my mostly liberal friends. With all due respect, are you all smoking crack?
First of all, I don't have health OR life insurance because of a chronic genetic disease called hemochromatosis.
But it is treatable. Do I expect my fellow taspayers to pick up the tab just because of my condition? Hell no. That's the cards I was dealt, and I would rather have my FREEDOM than subject myself to the TYRANNY of more and more government intrusion into my life.
Insurance coverage for pre-existing conditions is like selling someone car insurance the day after they have a wreck. Do you think that makes sense? In your minds it evidently does.
I'm sorry for the folks that aren't covered, but THE GOVERNMENT CAN'T MANAGE IT'S WAY OUT OF A WET PAPER BAG!
I'm glad that I am self-reliant and don't have to wait for the government to give me something all the damn time.
What part of "We're completely in debt up to our eyeballs!" don't you understand?
Keep sucking on the teat of Big Government if you want. But don't expect me to be happy about paying for it.
Some of us have had enough.
The gloves are coming off. Bring on another stinking civil war as far as I'm concerned. Have you ever heard, "Give me liberty or give me death?" Aren't you ashamed?
And MikeNV, we want to kill people. They're called terrorists. They hate you and I and want us dead. You can't have health care if you're laying dead in a pile of rubble.
If you all want socialism, move the hell out of the USA. You have plenty of other options.
Please read again carefully: Although much of the "meat" of this bill will not start till 2014, provisions have been made for people with pre-existing conditions (this is their summary, not mine):
The Patient Protection and Affordable Care Act will provide $5 billion in immediate federal support for a new program to provide affordable coverage to uninsured Americans with pre-existing conditions. This provision is effective 90 days after enactment, and coverage under this program will continue until new Exchanges are operational in 2014.
Thank-you everyone for reading, and the comments. It's a very touchy subject obviously to some people but then for some, this bill is a Godsend. As a taxpayer I don't have a problem paying more taxes to have a decent healthcare system in place, and hopefully with tweaking that will happen. This is my own personal opinion. I think it's high time the insurance industry and big pharma have some regulation and accountability also, and if big brother has to provide that than oh well. Perhaps if someone had been watching the wall street candy shop more closely we wouldn't be in the mess we are in. Or should we have waited to bail out the pharmas and the insurance industry too?
Stan, you really seem to be p****d off. You're screaming a lot of GOP/Tea Party/Fox hate, and so I think it's helpful to point out a few things.
The reason that most of the changes take until 2014 is that the main source of revenue which pays for the additional cost of the bill is the mandated health insurance. It is going to take until then for those millions of people to enter the market through purchasing insurance.
Why is this important? Well, this means that, unlike your concern that your taxes are going up and this is all socialism, strictly speaking, the only people who have any right to complain would be wealthy, young people who choose not to have insurance. It is them who would be paying for this, not you or your taxes. Why do we not hear a lot of complaining from them? Well, they benefit (in the long run) by living in a country with greater stability for their health prospects. Without this bill, as people age they will undoubtably find it harder and harder to get insurance. My mother refuses to get certain conditions of her's examined by a doctor because she doesn't want the diagnosis to affect her insurance. How's that for misaligned incentives?
Clearly this needs to stop. So quit spouting "FREEDOM" and "CIVIL WAR". Learn about what you are talking about before being another hate-spewing fear monger.
I have visited your site and read articles it is very informative i learned lot of new things you have done good job keep it up
This is one part of the bill I am for. But the bill will do more harm than good ultimately. I'd much rather have seen this bill broken down into easily explained, costed, and digestible parts and voted on separately.
becalm) Thanks for the comment. Love your name!! That's not right about your mom - I hate to hear stuff like this. This is an example of our broken healthcare system.
Amin) Thank-you.
Springboard) That would have been nice but could you imagine the fighting if it had got broken down? It would have been years if ever till something ever did get through.
Dorsi: I do not have Health Insurance currently. I am single, no kids, 39, not getting any younger but I am not old yet. I am healthy, and have a strong immune system. Could Health Insurance benefit me? Sure, emergencies happen. But today, I make UNDER $20,000, ($19,800+ last year) and insurance that is affordable, has pretty poor coverage to be honest. To get true health care, with a company that is reputable, I need to pay at least $300/month. That is TOO much for me so I go uninsured. Is it fair, for the government, to FORCE ME TO BUY Health Insurance by FINING me THREE PERCENT OF MY INCOME?!? Because that is part of the bill. Do you approve of the IRS controlling all aspects of this new Health Care program? And don't you understand that under this bill, if it is not repealed, (38 states are in process of sueing the government over this bill right now, 13 of those states are in litigations.) if not repealed, then the government will raise the premiums for private health insurance companies, and tax medical devices across the board, do you understand this? The cost of this bill on the private sector will be enourmous and will force small companies out of business within a year or two, and larger companies will raise their insurance rates AND lay off all the people they can afford to lay off, just to stay open. Companies like Johnson & Johnson, who make catheters on assembly lines to break up blockage in your main arteries, their products will have a heavy tax put on them to help the government pay for this health care system. I work for a similar company, doing just that, but I work for a temp service. I have been with my company (through the temp agency) for two years now. I could get laid off if the tax on their devices is too high. Is that fair? This bill is going to hurt many people before it helps anyone.
We NEED change in Health Care. Desperately. But this bill is JUNK, because the government's motive is not to help you, it's motive is to control the industry. They get into that position, by making you THINK they want to help you. Our government wants to become the ruling body of a new America, a SOCIALISTIC America, where they can throw you in prison at WILL just because they suspect you of something. This bill has some attractive traits, however if look deeper into it, under the surface are some very scary, even frightening mandates the govenment wants to begin implementing on American Citizens. They want complete control of your life. It is as simple as that. Then whatever money you do make will be far less than now, after taxes. In the future that will mean you will never be able to afford any luxuries, Your monthly income will barely cover rent and food. You will have to stretch just to get clothes. Those times are right around the corner, unless we can stop the madness. And this bill is madness.
What if you lose your health insurance in 2010 from the loss of your job? I have a pre-existing condition for which I have been denied coverage in the past (about 2-3 years ago), but worked for the County recently and they had to cover me. Now what is in store? Will insurance companies be able to deny me?
Preach on Derrik.
Be Calm - I refuse to 'be calm' when my freedoms are being eroded. If you want to pay more taxes, be my guest. Put your money where your mouth is and send in an extra couple thousand bucks on April 15th. I'm sure you won't. That's called hypocrisy. Look it up.
You said, "Stan, you really seem to be p****d off. You're screaming a lot of GOP/Tea Party/Fox hate, and so I think it's helpful to point out a few things."
Yes, I'm totally pissed. Along with about half the country, give or take a few million. Here you go with one of your favorite liberal words. Hate. You probably think I'm a racist because I think Obama sucks as a president too. I do hate. I hate your stupid ideas and the effect they will have on our country.
You said, "The reason that most of the changes take until 2014 is that the main source of revenue which pays for the additional cost of the bill is the mandated health insurance."
Mandated means 'forced'. Forced and Freedom both start with an F, but that's the only thing they have in common.
You said, "Why is this important? Well, this means that, unlike your concern that your taxes are going up and this is all socialism, strictly speaking, the only people who have any right to complain would be wealthy, young people who choose not to have insurance. It is them who would be paying for this, not you or your taxes. Why do we not hear a lot of complaining from them? Well, they benefit (in the long run) by living in a country with greater stability for their health prospects. Without this bill, as people age they will undoubtably find it harder and harder to get insurance. My mother refuses to get certain conditions of her's examined by a doctor because she doesn't want the diagnosis to affect her insurance. How's that for misaligned incentives?"
If you really think that this monstrous bill will be funded by wealthy young people and that our taxes will not continue to go up because of it, you don't know anything about the history of bloated government programs.
You said, "Clearly this needs to stop. So quit spouting "FREEDOM" and "CIVIL WAR". Learn about what you are talking about before being another hate-spewing fear monger."
As to your accusations about being another hate-spewing fear monger, listen closely. Kiss my A**. And that was the nicest thing I could think of. I don't give a damn what you think about me. Some of us are sick of your liberal mind mush. And we're already in a war. A war of ideas. May the best ideas win. O, and remember to be calm. I'm just another ignorant conservative. You can dismiss this hate-speech and go along your merry way.
A government big enough to give you everything you want, is strong enough to take everything you have.
- Thomas Jefferson
This health care bill has ALL of our founding fathers rolling in their graves. Shame on you.
Thanks for stopping by everyone and let's keep a calm head. There will be people that agree and disagree on this bill. I am 51 years old, had a dad that served in World War 2, and am about as patriotic as patriotic can be. Love my country, faults and all. My parents understood that we had a broken healthcare system too. If you had seen the inflated prices of their healthcare bills before they died you would have seen first hand how utterly ridiculous our health "Insurance" industry has become. I have files and files of their bills. You just have NO IDEA the things they were charged for. NO IDEA. There has to be accountability in the health insurance industry, and for big pharma, otherwise we will be facing another Wall Street debacle. This bill may not be perfect, and what everyone wants, but it is a start. For those that are lower income this bill will also be beneficial. Special interest groups have done a great job at a smear campaign against health reform, just like the smear campaign on climate change. We have to make changes.
I go by my own personal experiences, as a mother to children with special needs, the daughter of parents that had massive healthcare costs, the former owner of a small business that had trouble obtaining health insurance, the wife of a Vietnam vet that has health issues now. I have been there and done that and we need changes in our healthcare system. I will not back down from this. I have lived it and seen too many of my family and friends taken down by an outdated broken, poorly regulated health care system in the US.
I agree that the care system is in need of major reformation. I just think this bill is sending us further over a cliff financially. Sorry about the 'kiss my a**' comment. I just hate to be labeled by someone who doesn't know me. I'll be a better citizen of Hubpages from now on.
Ah Stan it's OK. We can agree to disagree.Let's hope this bill does some good.
Seeking or know anyone in need of medical coverage but cant afford health insurance have them inbox me ASAP. Plans starting at $79 to $119 a month with RX. Spread the word because there are to many people and their kids going uncovered and its not necessary! Lets change this one person at a time!
After watching Michael Moore's Sicko, I've realized how messed up our government. The United States is basically saying to our people that, if you can not afford medical payments, you should just die. There are millions and millions of people out there that die because they can not afford medical treatment.
Repeal the law. I have read all 1500 pages I told everyone the goal was to push everyone onto medicaid as a national health care program. I was told I was wrong. Seems it is starting to come out despite the administrations best efforts to keep it under wraps. What about this idea for healthcare. Let me know what you think:
@American View) Thanks for your comment and WOW to you for reading all those 1,500 pages!! I'll be checking out your hub. Thanks for coming by.
I have long felt "pre-existing medical stuff" insurance denials were shameful,if not sinful, and long tried to get congress critters to do something about it without success. Glad it is finally a reality. Just too bad it had to come with all of the baggage of ObamaCare. And we won't know what all the baggage is until the bureaucrats finish writing the implementing regulations. It is not so important what the law says but what the regulations say. The devil is in the regulations.
Thanks Bruce for your input and yes, the devil is in those regulations)
Here we go again, not letting things fall as they should. For example, if you arrive at the emergency room and are treated, but don't have health care, you should have to pay out of pocket. Simple. Not "individual mandates" and other medieval penalties.
@Jeff) Thanks for the comment but I see no reason why the USA can't manage a equitable health plan. Canada does and has for quite sometime.
So does anyone know how many people yearly are denied health care due to pre-existing conditions?
@Issac) No I don't but that would be an interesting subject to research and write about. Thanks for coming by.
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