What You Need to Know About Pre-Existing Conditions With Trumpcare
The current Trumpcare release is pretty dire for people with pre-existing medical conditions, a Congressional Budget Office analysis (“CBO estimate”) confirmed this week . But do you know if you have a pre-existing medical condition? Is sexual assault a crime ? Let’s take a look.
This is important because a new health bill will allow insurers to charge you higher fees due to your health condition. Before the ACA, it was difficult or impossible to buy your own insurance if you had anything other than a clean medical record. Under Trumpcare, that wouldn’t be so bad: you only have to worry about pre-existing conditions if you have a two-month gap without insurance and you live in a state that has been granted a waiver permit allowing it to defy the law.
In addition, insurers cannot outright deny you a pre-existing condition. But they can charge such high prices that you cannot afford it. The Center for American Progress estimates that women who have given birth will be paid $ 17,060 more per year than those who did not. If you had cancer, your premiums would be somewhere over $ 140,000 a year. Your bonuses .
Okay, you can say I am not planning a lighting break. But remember that for many, insurance will cost more than it is now. If you lose your job and cannot afford COBRA payments, you may well be the person with the coverage gap. (Before the ACA, people with chronic illnesses were often trapped in poor jobs because they could not risk losing their health insurance.)
According to a new CBO rating, one-sixth of the country’s population lives in areas where the market could “become unstable” if new legislation becomes law. In other words, the following scenario is likely in the states where waivers are being requested:
Community-calculated premiums will increase over time, and people who are less healthy (including those with pre-existing or recent illnesses) will ultimately be unable to purchase comprehensive non-group health insurance with premiums comparable to current legislation. if they could get it. in general – despite the additional funding that will be available under HR 1628 to help lower insurance premiums.
So, technically, insurers should sell you insurance coverage even if you already have a previous condition, but they may end up charging such a large amount that you can’t afford it anyway.
Trumpcare does not identify pre-existing conditions
There is a myth of sorts that health care law defines sexual abuse, domestic abuse, and previous caesarean sections – but not erectile dysfunction – as pre-existing conditions. This is technically incorrect: the account does not contain a list of pre-existing conditions.
The ACA also did not define pre-existing terms because it essentially outlawed the concept. Insurers had to set their rates for entire groups of people based on age and smoking status – “community rating” – and could not charge you a different price because of your health condition.
The new health care bill has removed this provision. If a state requests a waiver, then insurers in that state can use the health condition to re-establish premiums. Insurance is cheap for young and healthy people. But as soon as you have any health problems, you have problems. If you ever run into a coverage gap and have to go shopping again, you may find that the price of coverage is astronomical.
Many of us have pre-existing conditions
It is not a law that decides what a pre-existing state is; these are the insurance companies themselves. If the CEO of Aetna wakes up one day and decides to increase spending for people with a history of burrs, baldness, or broken ankles, they may well do so. More realistically, insurance companies are increasing costs for people who are more likely to need expensive medical treatment in the future.
According to a report from the Kaiser Family Foundation, about a quarter of American adults under age 65 have pre-existing conditions that made them “prone to deviating” – you might be denied coverage – prior to the ACA. In 2015, 6.5 million people had pre-existing conditions and had an insurance gap .
The Kaiser Family Foundation also has information on what these pre-existing conditions were . These varied from one insurer to the next, but conditions that commonly featured on “rejected” lists include:
- AIDS / HIV
- Alcohol / drug abuse with recent treatment
- Alzheimer’s disease / dementia
- Arthritis (rheumatoid), fibromyalgia, other inflammatory diseases of the joints
- Cancer over a period of time (eg, 10 years, often other than basal skin cancer)
- Cerebral paralysis
- Chronic heart failure
- Coronary artery disease / heart bypass surgery
- Crohn’s disease / ulcerative colitis
- Chronic Obstructive Pulmonary Disease (COPD) / Emphysema
- Diabetes
- Epilepsy
- Hemophilia
- Hepatitis (Hep C)
- Kidney disease, renal failure
- Lupus
- Mental disorders (severe, such as bipolar disorder, eating disorder)
- Multiple sclerosis
- Muscular dystrophy
- Severe obesity
- Organ transplant
- Paraplegia
- Paralysis
- Parkinson’s disease
- Surgery or hospitalization pending
- Pneumocystis pneumonia
- Pregnancy or future parent
- Sleep apnea
- Iron
- “Transsexualism”
Remember that these are just the most common things in pre-existing state lists. Could Sexual Assault Be A Preexisting Illness? Maybe, but there is no evidence that it was ever widespread. It’s the same with minor ailments like acne and mild depression: can they raise your rates for them? Certainly, some insurers. Will they be in the future? We do not know.
In other words, the health care bill does not name any conditions that are fair play; but they also clearly do not defend any of them.
Insurers also kept lists of drugs that could disqualify you, including drugs for HIV, cancer, heart disease, diabetes, and more. There were also decadent professions, including firefighters, taxi drivers, and our president’s favorites, coal miners. This is unlikely to be considered a pre-existing condition, although it is difficult to say for sure what will happen to insurance policies under the new law since they have not been written yet.
The bill has not yet become law. It was passed by the House of Representatives, but the Senate is now writing its own version. If you have an opinion on what should be included, call your Senator.