Posts Tagged ‘pre-existing medical conditions’

Half of Americans Support Obamacare Repeal

Monday, November 28th, 2011

A recent Gallup poll found that 47 percent of Americans support the repeal of the Patient Protection and Affordable Care Act (ACA), compared with the 42 percent who want the law kept in place.  The remaining 11 percent offered no opinion.  In an ironic twist, the survey also determined that half of Americans believe the federal government has a responsibility to make certain that all citizens have healthcare coverage, compared with 46 percent who do not.

“Views on this issue are highly partisan, with Republicans strongly in favor of repeal and the large majority of Democrats wanting the law kept in place,” according to Gallup.

Republicans claim that the healthcare law is unconstitutional because of the individual mandate that requires all Americans to purchase health insurance.  Approximately eight in 10 Republicans think Congress should repeal the healthcare law, including 54 percent who want the entire law thrown out.  Democrats have an opposing view: 60 percent support keeping the healthcare law as is.  Independents are split.

Fully 80 percent of Republicans support repeal, while a mere 10 percent support the law.  Democrats, not surprisingly support the healthcare law by 64 – 21 percent.  The intensity of the issue on both sides is also striking.  Among those who favor repeal of the so-called Obamacare, 66 percent say it is a “very important” issue.  Fully 60 percent of the ACA’s supporters described it is a “very important” issue.

Another finding of the survey is that 56 percent of respondents prefer an insurance system run by private companies; while 39 percent prefer a government-run system.

Writing for CBS News, Jennifer De Pinto says that “Even though overall support for the healthcare law is mixed, majorities have favored some individual elements of the law, including requiring health insurance companies to cover people with pre-existing conditions and allowing children to stay on their parents’ healthcare plan until age 26.  However, the provision that requires all Americans get health insurance is not as popular.  A CNN/ORC Poll conducted this past summer found 54 percent of Americans oppose that provision.”

In a poll taken by the Kaiser Foundation, 34 percent said they view the law either “very” (12 percent) or “somewhat” (22 percent) favorably while 51 percent saw it in either as “somewhat” (20 percent) or “very” (31 percent) unfavorably.  In April 2010, the favorable view of the law was 50 percent only one time (July 2010).  With the exception of the October dip, support has generally been between 39 and 43 percent since the start of this year.  Even as the overall bill remains consistently unpopular, parts of it — including the individual mandate, which would require all Americans to carry health insurance — are viewed more positively.

Even if the Supreme Court overturns the ACA or it is repealed, President Barack Obama said that the healthcare law he signed in 2010 represents “a reform that will finally make sure that nobody goes bankrupt in America just because they get sick.”  Obama said the law assures coverage for people with preexisting medical conditions and is the kind of change he promised during the 2008 presidential campaign.  “Everything we fought for in the last election is now at stake in the next election,” Obama said.  “The very core of what this country stands for is on the line.”

ObamaCare Covers Pre-Existing Conditions: So Why Are So Few People Enrolling?

Monday, June 20th, 2011

Premiums and eligibility standards for many federally run state-based pre-existing insurance pools will be cut, according to the Department of Health and Human Services (HHS).  The changes will impact some- of the state-based insurance programs, which have attracted fewer enrollees than the Obama administration originally estimated.  The plan will reduce Pre-Existing Condition Insurance Plan (PCIP) premiums between two percent and 40 percent in Washington, D.C., and in 17 of the 23 states where the federal government runs the program.  Another 27 states run their programs by using federal funding through the Patient Protection and Affordable Care Act (ACA).

According to HHS, the changes will bring the premiums closer to the individual insurance market rates in each state.  The change will not affect premiums in states where they are “well-aligned” with the individual insurance market premiums.  “That means real savings for people across the country,” HHS Secretary Kathleen Sebelius said.  “The Pre-Existing Condition Insurance Plan changes lives, and in many cases, literally saves lives.  These changes will decrease costs and help insure more Americans.”

Changes include allowing adults — beginning July 1 — to qualify for the program if a physician, physician assistant or nurse practitioner provides a letter from the last year stating that the individual has had “a medical condition, disability or illness.”  The change no longer requires that applicants provide an insurance company denial letter, although the programs will still require citizenship or legal residency and no health insurance coverage for the previous six months.  PCIP provides comprehensive health coverage, including primary and specialty care, hospital care, prescription drugs, home health and hospice care, skilled nursing care and preventive health and maternity care.  It limits yearly out-of-pocket spending and does not carve out benefits the people need.  Eligibility is not based on income and people who enroll are not charged a higher premium because of their medical condition.

According to the MyHealthCafe.com blog, the move is a good one.  “Based on PCIP enrollment so far, it may not be an issue.  California may have a budget to provide health insurance coverage for 20,000 in its PCIP, but so far only 513 Californians have enrolled in its PCIP.  That is still more than the paltry 101 residents of Missouri who have enrolled for health insurance coverage in that state’s PCIP.  In contrast, Pennsylvania, which is running its own PCIP and is limiting health insurance premiums to a comparably affordable $283 a month, has enrolled 1,657 in its PCIP, 1,000 more than any other PCIP in the nation.  Overall, only 8,000 Americans have enrolled in a PCIP so far.  Although Americans with pre-existing conditions were expected to stampede into the newly-formed PCIPs, applications for most of the PCIPs have only trickled in so far.  It is astonishing to many who predicted that the PCIPs would be flooded with applications from Americans with pre-existing conditions who have been long-denied health insurance.  Experts questioned whether the $5 billion dollars would be enough to cover the 375,000 expected to enroll until 2014,when all health insurers will be required to offer insurance regardless of pre-existing conditions.”

As an example, HHS said that a 50-year-old Floridian can now get comprehensive health coverage for as low as $270 per month. “This option became available to children under age 19 in February, and we are extending this pathway to all applicants regardless of age,” Sebelius said.  “Applicants will no longer have to wait on an insurance company to send them a denial letter.”

“These changes will get more people covered,” said Steven Larsen, the director of the Center for Consumer Information and Insurance Oversight.  “We’re encouraged by recent increases in enrollment and we’re excited to build on these efforts and reach even more people.”

Nine Million Americans Lost Healthcare Coverage During the Recession

Monday, April 4th, 2011

The financial crisis not only robbed nine million Americans of their jobs – but also their healthcare insurance. According to a new study by The Commonwealth Fund, only 25 percent of Americans who lost employer-sponsored healthcare coverage succeeded at finding another source.  As a result, an estimated 52 million Americans did not have healthcare coverage in 2010.  Even though the federal government provides a subsidy, just 14 percent of people who lost their jobs continued their coverage through COBRA.

According to The Commonwealth Fund Biennial Health Insurance Survey of 2010, “Using data from The Commonwealth Biennial Health Insurance Survey of 2010 and prior years, this report examines the effect of the recession on the health insurance coverage of adults between the ages of 19 and 64 and the implications for both their finances and their access to healthcare.  The survey of 3,033 adults, conducted by Princeton Survey Research Associates International from July 2010 to November 2010, finds that in the last two years a majority of men and women who lost a job that had health benefits became uninsured.  Adults who sought coverage on the individual insurance market over the past three years struggled to find plans they could afford and many were charged higher premiums, had a health condition excluded from their coverage, or were denied coverage altogether because of a pre-existing condition.  Meanwhile, Americans with health insurance had higher deductibles and consequently greater exposure to medical costs.  And millions were struggling to pay medical bills, facing cost-related barriers to getting the care they need, or skipping or delaying needed care, including prescription medications, because of the cost.”

Just 50 percent of adults aged 64 or less are current with preventive care.  Fully 49 million employed Americans spent 10 percent or more of their yearly income on out-of-pocket costs and insurance premiums, a sharp increase from the 31 million reported in 2001.  Once the Patient Protection and Affordable Care Act (ACA) goes into full effect in 2014, the situation is likely to improve dramatically.  “These reforms have enormous potential to begin solving the problems identified in this report,” said Sara Collins, vice president of The Commonwealth Fund, a private foundation that promotes a high performing healthcare system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, minority Americans, children, and the elderly.

“The report tells the story of the continuing deterioration of healthcare accessibility, efficiency, safety and affordability over the past decade,” said The Commonwealth Fund president Karen Davis. “All this despite the fact that the United States spends more than any other country on healthcare.  Most recently it has failed the millions of Americans who lost their jobs during the recession and lost health benefits as well, leaving them with no place to turn for affordable healthcare coverage.  The silver lining is that the Patient Protection and Affordable Care Act has already begun to bring relief to families,” Davis said.  “Once the new law is fully implemented, we can be confident that no future recession will have the power to strip so many Americans of their health security.”

Of those people who attempted to buy an individual plan during the study’s timeframe — 19 million individuals – or 71 percent found it difficult or impossible to locate a plan they could afford and met their needs, were denied coverage or charged extra because of a pre-existing medical condition.  Adults with family incomes of less than $22,050 for a family of four were hardest hit with 54 percent having no healthcare insurance.  An additional 41 percent of families with incomes of between $22,050 and $44,100 had no coverage.  Of higher-income families, just 13 percent lacked healthcare coverage in 2010.

Conservative groups such as the Heritage Foundation are critical of the healthcare reform law.  The Washington, D.C.-based think tank wants changes made to the healthcare system to make it less reliant on government and to have individuals “own and control their own healthcare policies.”  Additionally, Heritage believes that the healthcare law will increase government spending.  “Of course there’s some people who will benefit from the law, but just focusing on individuals with benefits is misleading,” said Brian Blase, a policy analyst in health studies.  “You have to look at the law in its totality.”

Insurer Denies Teenage Girl Coverage Because She Was Diagnosed With an Overbite at Age 8

Thursday, July 15th, 2010

Insurance company cancelled teenager’s coverage because she was diagnosed with an overbite at age 8.  A suburban Chicago teenager had her healthcare coverage rescinded when her parents’ insurance company learned that she had been diagnosed with an overbite at age eight. An orthodontist and braces cured the overbite, but the insurer cancelled the girl’s coverage by claiming it was a pre-existing condition.  The girl’s parents fought back and – thanks to strong support from Illinois insurance regulators – the coverage has now been reinstated.

Thanks to healthcare reform legislation, this practice – known as rescission – will no longer be allowed as of late September except in cases where fraud is involved.  Illinois has one of the nation’s highest rescission rates with 12.9 for every 1,000 policies written.  The girl’s father, an attorney employed at a small firm, buys individual coverage for his family.  Insurance regulators say that rescission is most common in these circumstances.  People who are covered by company-sponsored programs rarely face rescission.  According to the girl’s father, “We didn’t try to hide anything.  Our orthodontist told us her mandibular hypoplasia was routine, and it was nothing the insurance company even asked us about on our application.  From our perspective, they didn’t even ask for the names of any of our children’s dentists or orthodontists.”

“There’s now a defined legal standard for when a rescission is appropriate,” said Michael McRaith, Illinois Insurance Director.  “In Illinois, our law was ambiguous, vague and left wide latitude and discretion with the insurance industry.”  The insurance industry defends rescissions as a necessary business practice when people misrepresented or lied about their medical histories on their applications.  Rescissions affect approximately seven percent of the population with private insurance who purchase individual policies.  Robert Zirkelbach, spokesman for America’s Health Insurance Plans, a lobbying group, said “Rescissions are very rare.  They are only used as a last resort.”

Congressional Democrats take another view.  “It was viewed by Congress as the tip of the spear,” said Representative Jan Schakowsky (D-IL).  “It typifies the practices of the insurance industry to maximize their profits that were so clearly anti-consumer and harmful to people who were counting on their health insurance at the moment they needed it the most.”

Kids With Pre-Existing Conditions May Get Insurance Coverage Before September 23

Thursday, June 24th, 2010

Starting in September, the approximately five million Americans under the age of 19 who have pre-existing medical conditions cannot be denied health insurance coverage. The healthcare reform law also gives these patients expanded physician choices because many previously had to rely on government programs such as Medicaid.  Children account for approximately nine percent of the 57.2 million Americans under the age of 65 who have pre-existing conditions.

Although Congress wanted to implement this section of the bill immediately instead of waiting until September 23, some private insurers are showing signs of stepping up to the plate and providing coverage as soon as the Obama administration issues regulations on final implementation.  According to Illinois Insurance Director Michael McRaith, “It would not surprise me if insurers would undertake this earlier.”

Although there were some concerns that insurers might try to deny coverage to children with pre-existing conditions or set rates too high, Secretary of Health and Human Services Kathleen Sebelius sent a letter to Karen Ignani, CEO of America’s Health Insurance Plans directing the trade organization to comply with the new law.  “To ensure there is no ambiguity on this point, I am preparing to issue regulations in the weeks ahead ensuring that the term ‘pre-existing condition exclusion’ applies to both a child’s access to a plan or to his or her benefits once he or she is in the plan,” Sebelius wrote.

“This is a confidence builder in what healthcare reform does,” said Ron Pollack, executive director of Families USA, a consumer health advocacy group that backed expanding healthcare coverage.  “It’s a popular group to reach out to…and it’s not going to have as big of an impact on costs as, say, somebody between the ages of 56 and 64 who has multiple chronic conditions.”