(05-03-2017 08:23 AM)mptnstr@44 Wrote:  

(05-03-2017 07:51 AM)solohawks Wrote:  I have no problem with he said. Pre existing conditions evolved into a catchall so insurance could deny your claim. That was a major problem pre ACA. I don't like the ACAs solution to the problem but I comptleley understand why the average American wants to avoid going back to the days where a childhood allergy you forgot about could result in a major claim denial

The ability to be denied coverage due to a pre-existing condition was a powerful motivator to get people to carry continuous health insurance coverage and avoid lapses.
With that conditional aspect gone there is no risk in allowing coverage to lapse as now when you get sick with something you can just get health insurance at that point and be covered.
Insurance can not operate successfully on a model that lets people sit out if well and jump in when ill. No preexisting conditions has been painted to be the insurance carriers being meanies. It isn't that at all.
If I were writing the legislation I would include "no exclusion of coverage for preexisting conditions" but with the caviat "as long as prior health insurance coverage was continuous or near continuous with explanations for any lapses."

I agree with you and understand that principle. However many insurance companies were abusing the pre existing conditions concept for people who had done everything right. Also what if you lost your job and had to get individual health insurance. PreExisiting conditions from the previous policy would come into play and either leave you tough outta luck when it comes to coverage of necessary medical conditions or would make the new individual policy prohibitively expensive.

Going through a job transition myself and 1 month of Obamacare bronze (7K deductible per person) was going to be over $700 for me and my family. That is prohibitively expensive for us, and that is with a subsidy, so we found alternative coverage, not ideal but suitable for 1 month. I can only imagine the cost for someone if preexisting conditions came into play.

(05-03-2017 08:23 AM)mptnstr@44 Wrote:  

(05-03-2017 07:51 AM)solohawks Wrote:  I have no problem with he said. Pre existing conditions evolved into a catchall so insurance could deny your claim. That was a major problem pre ACA. I don't like the ACAs solution to the problem but I comptleley understand why the average American wants to avoid going back to the days where a childhood allergy you forgot about could result in a major claim denial

The ability to be denied coverage due to a pre-existing condition was a powerful motivator to get people to carry continuous health insurance coverage and avoid lapses.
With that conditional aspect gone there is no risk in allowing coverage to lapse as now when you get sick with something you can just get health insurance at that point and be covered.
Insurance can not operate successfully on a model that lets people sit out if well and jump in when ill. No preexisting conditions has been painted to be the insurance carriers being meanies. It isn't that at all.
If I were writing the legislation I would include "no exclusion of coverage for preexisting conditions" but with the caviat "as long as prior health insurance coverage was continuous or near continuous with explanations for any lapses."

That works, with the possible exception of young people who haven't gotten insurance before.

(05-03-2017 11:40 AM)bullet Wrote:  

(05-03-2017 08:23 AM)mptnstr@44 Wrote:  

(05-03-2017 07:51 AM)solohawks Wrote:  I have no problem with he said. Pre existing conditions evolved into a catchall so insurance could deny your claim. That was a major problem pre ACA. I don't like the ACAs solution to the problem but I comptleley understand why the average American wants to avoid going back to the days where a childhood allergy you forgot about could result in a major claim denial

The ability to be denied coverage due to a pre-existing condition was a powerful motivator to get people to carry continuous health insurance coverage and avoid lapses.
With that conditional aspect gone there is no risk in allowing coverage to lapse as now when you get sick with something you can just get health insurance at that point and be covered.
Insurance can not operate successfully on a model that lets people sit out if well and jump in when ill. No preexisting conditions has been painted to be the insurance carriers being meanies. It isn't that at all.
If I were writing the legislation I would include "no exclusion of coverage for preexisting conditions" but with the caviat "as long as prior health insurance coverage was continuous or near continuous with explanations for any lapses."

That works, with the possible exception of young people who haven't gotten insurance before.

I agree but young people should've been covered by a parents policy or if not that would fall into a legitimate explanation for lapse of coverage. Since young people can be covered by a parents policy the minimum age for enrolling as an adult would be by age 26.

If you don't enroll at 26 and don't have a legitimate explanation for lapse of coverage, if you develop a condition, you should run the risk of being denied coverage.

It's the threat of not being able to be covered that gets people to enroll.

I watched this last night and cried several times. I know the feeling of having a child on life support in a children's hospital. It's the worst. Glad the tetrology of Fallot was diagnosed in time to be repaired.

(05-03-2017 11:16 AM)solohawks Wrote:  

(05-03-2017 08:23 AM)mptnstr@44 Wrote:  

(05-03-2017 07:51 AM)solohawks Wrote:  I have no problem with he said. Pre existing conditions evolved into a catchall so insurance could deny your claim. That was a major problem pre ACA. I don't like the ACAs solution to the problem but I comptleley understand why the average American wants to avoid going back to the days where a childhood allergy you forgot about could result in a major claim denial

The ability to be denied coverage due to a pre-existing condition was a powerful motivator to get people to carry continuous health insurance coverage and avoid lapses.
With that conditional aspect gone there is no risk in allowing coverage to lapse as now when you get sick with something you can just get health insurance at that point and be covered.
Insurance can not operate successfully on a model that lets people sit out if well and jump in when ill. No preexisting conditions has been painted to be the insurance carriers being meanies. It isn't that at all.
If I were writing the legislation I would include "no exclusion of coverage for preexisting conditions" but with the caviat "as long as prior health insurance coverage was continuous or near continuous with explanations for any lapses."

I agree with you and understand that principle. However many insurance companies were abusing the pre existing conditions concept for people who had done everything right. Also what if you lost your job and had to get individual health insurance. PreExisiting conditions from the previous policy would come into play and either leave you tough outta luck when it comes to coverage of necessary medical conditions or would make the new individual policy prohibitively expensive.

Going through a job transition myself and 1 month of Obamacare bronze (7K deductible per person) was going to be over $700 for me and my family. That is prohibitively expensive for us, and that is with a subsidy, so we found alternative coverage, not ideal but suitable for 1 month. I can only imagine the cost for someone if preexisting conditions came into play.

I would think in a situation such as yours that a period of lapse outlined by a job transition would count as a legitimate explanation as long as coverage ended at the start of the transition and ended once the new job's benefits kicked in.

(05-03-2017 12:04 PM)mptnstr@44 Wrote:  

(05-03-2017 11:16 AM)solohawks Wrote:  

(05-03-2017 08:23 AM)mptnstr@44 Wrote:  

(05-03-2017 07:51 AM)solohawks Wrote:  I have no problem with he said. Pre existing conditions evolved into a catchall so insurance could deny your claim. That was a major problem pre ACA. I don't like the ACAs solution to the problem but I comptleley understand why the average American wants to avoid going back to the days where a childhood allergy you forgot about could result in a major claim denial

The ability to be denied coverage due to a pre-existing condition was a powerful motivator to get people to carry continuous health insurance coverage and avoid lapses.
With that conditional aspect gone there is no risk in allowing coverage to lapse as now when you get sick with something you can just get health insurance at that point and be covered.
Insurance can not operate successfully on a model that lets people sit out if well and jump in when ill. No preexisting conditions has been painted to be the insurance carriers being meanies. It isn't that at all.
If I were writing the legislation I would include "no exclusion of coverage for preexisting conditions" but with the caviat "as long as prior health insurance coverage was continuous or near continuous with explanations for any lapses."

I agree with you and understand that principle. However many insurance companies were abusing the pre existing conditions concept for people who had done everything right. Also what if you lost your job and had to get individual health insurance. PreExisiting conditions from the previous policy would come into play and either leave you tough outta luck when it comes to coverage of necessary medical conditions or would make the new individual policy prohibitively expensive.

Going through a job transition myself and 1 month of Obamacare bronze (7K deductible per person) was going to be over $700 for me and my family. That is prohibitively expensive for us, and that is with a subsidy, so we found alternative coverage, not ideal but suitable for 1 month. I can only imagine the cost for someone if preexisting conditions came into play.

I would think in a situation such as yours that a period of lapse outlined by a job transition would count as a legitimate explanation as long as coverage ended at the start of the transition and ended once the new job's benefits kicked in.

possibly, but it would depend on my state law and the new insurance company policies. People don't want to deal with that type of uncertainty.

What republicans are still against this about preexisting conditions and why?

http://www.dailywire.com/news/15993/5-th...nservative

(05-03-2017 01:38 PM)Fitbud Wrote:  What republicans are still against this about preexisting conditions and why?

I doubt there are any people against covering pec. They just don't want to see it used as a means to stay out of the insurance pool until care is needed. In order for insurance to work a majority of healthy people need to be in the pool to cover the ill.
With coverage of pecs no matter there is no penalty for sitting on the edge of the pool until care is needed.