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About That Gap In Coverage

Category: Health Care
Posted: 05/19/17 10:48

by Dave Mindeman

As the GOP publicly defends the GOP Congress version of health care, the biggest item to keep in mind is their "promise" to maintain the mandate about pre-existing conditions.

The Kaiser Foundation examined this concept and stated publicly that this is what we face:

Using the most recent National Health Interview Survey (NHIS), we estimate that 27.4 million non-elderly adults nationally had a gap in coverage of at least several months in 2015. This includes 6.3 million people (or 23% of everyone with at least a several-month gap) who have a pre-existing condition that would have led to a denial of insurance in the pre-ACA individual market and would lead to a substantial premium surcharge under AHCA community rating waiver."

The reason the "gap" in coverage is important is that under a law that Ted Kennedy passed years ago, if a person has had continuous coverage under some form of insurance, they cannot be denied coverage, or have surcharges, via an insurer. In the AHCA bill, an opt out by a state can grant the insurers an option of significant surcharges for pre-existing conditions, making the coverage completely unaffordable.

We all know how life intervenes. People get laid off. Bills get overwhelming and health premiums get lower priority. Jobs change and coverages change. Coverage gaps happen. It is a fact of life and people in lower wage jobs are the first victims.

The ACA (Obamacare) understood this and ended the issue of pre-existing conditions. With the Republican bill, it is has been brought back for the sake of insurance profitability.

No matter how Jason Lewis and his cohorts try to spin this, the loop hole is there. And it was placed there intentionally so that insurers can find ways to opt out of coverage for the people with the most need.

It is cynical politics and we have to keep fighting this.
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Pre-Existing Conditions

Category: Health Care
Posted: 05/05/17 18:46, Edited: 05/05/17 18:47

by Dave Mindeman

Here is another thing to consider as the AHCA GOP bill further weakens the protections on pre-existing conditions.

In the future you will probably find that health insurance companies will require you to take a DNA chromosome test. This will go onto your medical file and held confidential like all of your medical records.

But let's say that later on in life, you contract a debilitating illness. And let's also stipulate that it has genetic marker components.

Before you get your treatment covered, the health insurance company will point out that your chromosome test had a genetic marker that predicted a high probability that the disease you have was "always there".

Coverage denied.

Due to a pre-existing condition.

Does the AHCA protect you from that, should a state request a waiver?

No.

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House Passes Trumpcare Giving the GOP A Mixed Future

Category: Health Care
Posted: 05/04/17 14:47

by Dave Mindeman

OK - the Republican House has voted to repeal and replace Obamacare. That has a number of ramifications.

First, it sends it to the Senate and the Senators will now have to be on the record with this as well...unless they bury it somehow.

Second, Democrats have the GOPers on the record. They have a vote that they must explain. Erik Paulsen had to get off the fence in order for this to pass, and it may be a sign off for his defeat in 2018.

Third, the bill now has to be officially scored by the CBO. That will be bad optics. The bill stays in the news for probably most of the summer, and we will continue to learn more about its shortcomings.

Fourth, although this is a method to fulfill a promise to their base, it will alienate independents and motivate Democrats.

Fifth, the bill clearly shows that there are divided factions within their own party which will continue to make it difficult to govern.


This bill is not law. This bill has a long way to go to be law. As the debate rages, the voters will make their judgments. Trump will put this on a win list, but it will also work against him in other ways.

When Nancy Pelosi held her pre-vote press conference, she almost looked happy. She knows this will be a potent issue in 2018 and that the healthcare responsibility has now officially landed into the GOP court. Pelosi knows how that feels and she is more than willing to be on the opposition side this time.

This is one of those, be careful what you wish for, moments....bigly.
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