Health care reform

[cptacek]

I don't know if anyone knows this but pre-existing conditions include things like pregnancy. In otherwords, if you get pregnant while uninsured, most insurance companies will not allow you to sign up for their insurance after the fact (because they known the cost associated with it). If you say that you are not pregnant and get insurance, and later the insurance company finds out you lied, then you owe them money.

I do know this. When I got laid off last year, I found out I was pregnant. I stayed on my previous insurance because the COBRA provisions allowed me to keep it. We were going to get my husband a HDHP, but I found a job before we did that. It is also the law that if you join your employer health plan after you are pregnant, they have to accept you.

Seems to me having insurance tied into your job is the big problem here. If my employer just paid me the amount they currently pay for my insurance, and I could buy health insurance on my own and deduct the expense from my taxes (which they are allowed to do, while at the same time not paying Social Security taxes or Medicare taxes on that benefit to me), losing my job wouldn't matter as much.

[LivingAlmostLarge]

Except that cptacek, what happens when the insurance you buy refuses to COVER your care? That you have a terrible labor and delivery and then they say SCREW you, you individual? You have no leverage, no power. You sit there holding your behind, praying it's covered.

After all all labor and deliveries are a cinch and a healthy 30 year old woman should pop out a baby without a problem. Especially one who works out, not overweight, no smoking, no drinking, did yoga, walked 3-5 miles a day, etc. Right??? Yeah no, didn't happen.

Oh and I got pregnant first try, and it was up to 30 weeks a dream pregnancy, I barely looked pregnant and only gained 15 lbs. Then trouble happened.

Wanna bet if I had independent insurance they would have hemmed and hawed over everything? I know it. I know people with HDHP and the insurance company says this and that isn't covered and that's too expensive. They just pass the buck onto you anyway. You're a nobody and you'll get some coverage independently, but not fully. And why should they care?

I've seen my medical bills and they were outrageous. I haven't even seen my daughters NICU bills. That should be interesting.

Steve, sign me up for gold unicorn poop. I'd like it in spades.

[cptacek]

How does having group coverage help in the above situation, and how does the current legislation help in the above situation?

p.s., I know things go wrong. I got to use that COBRA insurance coverage for my miscarriage.

[geojen]

I don't know if anyone knows this but pre-existing conditions include things like pregnancy. In otherwords, if you get pregnant while uninsured, most insurance companies will not allow you to sign up for their insurance after the fact (because they known the cost associated with it). If you say that you are not pregnant and get insurance, and later the insurance company finds out you lied, then you owe them money.

If, as a nation, we think denying insurance based on pre-existing conditions is wrong, then we need a law that says you can't deny insurance based on preexisting conditions. But then the only way an insurance company can make a profit/break even/ stay in business is by having a large pool of relatively healthy people in the health plan -- to spread the cost. As my neurosurgeon friend on mine said recently, "This is not rocket science. The more healthy people in the health plan, the cost will be lower for everyone."

I am sure you've heard of Anthem Blue Cross in California's plan to raise premiums 30-35% in a month or two, affecting most small business and self-employed plans affecting about 600,000 to 700,000 people. Their justification is that with so many people losing their jobs (and hence their health insurance) the pool of "the really sick people" or those with a preexisting condition is greater (they stay because they can't afford to leave), so Anthem Blue's cost is going up -- they don't have enough healthy people to spread the cost. Unfortunately this will most likely cause the remaining healthy people on the plan to drop their health insurance since it is too costly AND they are healthy anyway. As commentators have pointed out, this, in turn, will force Anthem Blue to raise premiums again... This is already happening in California.

Thank you markusk for this well-said post about why it is necesary that everyone be required to act like responsible adults and get in the pool. I mean really. How many of us have posted rants about irresponsible people not doing the right thing and it makes it harder for those of us who do? Now the government is trying to compel people to do the right thing in the form of a tax penalty (which is consititutional) and we are mad about it? What gives? You can't have it both ways. The people who don't buy insurance are banking on not getting sick, which is idiotic and we will pay for it in the end because they will still use the system. Think of the tax penalty people have to pay as a downpayment on future care they will demand of the system.

[feh]

http://www.ncsl.org/?tabid=18906

36 State bringing this to court. Some are proposing an amendment againts the requirement of the people to purchase health insurance.

This is not over yet people

I've read several articles regarding the suit being brought by some state AGs based on the new law violating the constitution, and in short, they have no chance of winning. Here's an example:

FiveThirtyEight: Politics Done Right: Constitutionality of Mandatory Insurance

Regarding states amending their constitutions, federal law takes precedence over state law, if push comes to shove.

[cptacek]

That article doesn't make sense. It is comparing apples to oranges. Social Security and Medicare taxes are paid to the federal government, the money goes into the general fund, and the federal government provides services back to the citizens. This law requires someone to buy a product from a third party, an insurance company.

Also, another argument that I've heard saying this actually is Constitutional is pretty much "regulating interstate commerce allows the federal government to do anything." How is there interstate commerce if it is against the law to buy insurance across state lines, meaning that by law, buying insurance cannot be interstate commerce?

[geojen]

That article doesn't make sense. It is comparing apples to oranges. Social Security and Medicare taxes are paid to the federal government, the money goes into the general fund, and the federal government provides services back to the citizens. This law requires someone to buy a product from a third party, an insurance company.

Also, another argument that I've heard saying this actually is Constitutional is pretty much "regulating interstate commerce allows the federal government to do anything." How is there interstate commerce if it is against the law to buy insurance across state lines, meaning that by law, buying insurance cannot be interstate commerce?

Because the insurance companies operate across state lines, not the consumers. This makes them subject to the interstate commerce clause.

Because the penalty for not buying insurance is basically a tax fee collected by the IRS, the federal government has the right to levy it. These will be the 2 arguments used in court by the Justice Department, and they will probably win.

[cptacek]

Well, I guess we will see. Neither of us are qualified to be constitutional lawyers (at least I know I'm not, and I'm guessing you aren't either).

However, I don't know of another instance of the federal government being able to levy taxes-as-fines in any other situation. And they have never used "regulation of commerce" to mean "regulation if you don't engage in commerce"

[geojen]

Well, I guess we will see. Neither of us are qualified to be constitutional lawyers (at least I know I'm not, and I'm guessing you aren't either).

However, I don't know of another instance of the federal government being able to levy taxes-as-fines in any other situation. And they have never used "regulation of commerce" to mean "regulation if you don't engage in commerce"

You are right, I am far from an expert. I was just repeating the arguments that the Justice Department has said they will pursue in defense of the bill.

[KTP]

I can see all sides of the argument.

The liberals want to provide health care to everyone but want to pay for it with golden unicorn poop.

The conservatives reluctantly are ok with everyone getting health care even if they can't afford it but would rather pay for it using real money (hence the penalty for not getting insured)

The libertarians would rather there be less government and more left up to the individual, so they hate the idea of being forced to pay a penalty.

Which one is right?

[cptacek]

I can see all sides of the argument.
...
Which one is right?

In unison now: "MY SIDE!!!"
lol