Senate Health Plan: People with pre-existing conditions have a 6 month waiting period for insurance

[Better Believe It]

Democrats' Plan to Help 'Uninsurables' Questioned
ASSOCIATED PRESS
November 5, 2009

WASHINGTON (AP) -- You're afraid your cancer is back, and a health insurance company just turned you down. Under the health care bills in Congress, you could apply for coverage through a new high-risk pool that President Barack Obama promises would immediately start serving patients with pre-existing medical problems. Wait a second. Read the fine print. You may have to be uninsured for six months to qualify.

''If you are a cancer patient and have cancer now, you can't wait six months to go into a plan because your condition can go from bad to death,'' said Stephen Finan, a policy expert with the American Cancer Society Cancer Action Network. He called the waiting period in the Senate bill ''unacceptable.''

Advocates for people with serious health problems, as well as some insurance experts, are raising questions about one of the most important upfront benefits in the Democratic health care legislation: a high-risk pool for the medically uninsurable.

Obama proposed the pool in his September health care speech to Congress. Intended to serve the most vulnerable as a temporary fail-safe, it would stay in place until 2013. That's when insurance companies would be banned from denying coverage because of medical problems. Government subsidies to make coverage more affordable for millions of uninsured would also start that year.

Now, concerns are being raised about the design of the high-risk pools. In addition to the six-month wait, there's a more fundamental issue -- whether $5 billion set aside for the three-year program is enough. The money would be used to help people in poor health pay premiums.

The six-month wait is in the health care bill the Senate Finance Committee approved last month. To qualify for the pool, patients must be turned down for coverage because of a pre-existing condition and uninsured for at least six months.

''If you are somebody with cancer or a heart condition who needs immediate coverage and immediate treatment, that's not very helpful,'' said Karen Pollitz, a Georgetown University health policy professor.

Read the complete article at:

http://www.nytimes.com/aponline/2009/11/05/us/politics/AP-US-Health-Care-Uninsurables.html

[AndyA]

1. Thanks for the change, Obama. Nice work.

So much for everyone being equal, eh? How many will die during that six months? How many will progress to the point where they can't be treated.

Stupid, stupid, stupid.

Get it together, Barack. This isn't what we voted for.

[CTyankee]

2. This is ridiculous. There has GOT to be a mistake.

This is the most boneheaded idea I have ever seen. What Einstein's came up with this idea?

[Jennicut]

7. The Senate Finance Committee? Max Baucus?

I don't know when it got it.

[Autumn]

3. Okay

Pretty fucking sad.

[Tom Rinaldo]

4. This is what happens when your goal becomes "getting something passed" rather than

doing what it makes sense to do. The accomplishment sought for becomes "enacting health care reform legislation" rather than solving the actual problems.

The phrase "demanding their pound of flesh" was never more apt than it for the private insurance lobby in America and the law makers beholden to them, Democrats included.

[BootinUp]

5. I predict this will be amended

I won't predict when the bill will be ready for Obama to sign though.

[Tom Rinaldo]

9. Good chance you are right. But...

How does this type thinking get this far to begin with? Don't tell me I'll guess. For every detail like this that looks foolish in the harsh light of a spotlight a dozen more lurk in the shadows of fine print. These giveaways to special interests are like animals that travel in a herd. A few might get picked off by determined lions but the bulk of them always get through.

[BootinUp]

11. Seems to be the way things work

we just have to stay on them to get the best possible result I guess.

[CTyankee]

13. Heh, maybe through "waivers"? I can see it now. You are really sick, you go the

"high risk" folks who look at your medical records and say, OK, maybe you haven't YET been turned down for insurance but it's certain you WOULD be and you are waived in. But the 6 month thing is DOA. Health care reform that makes really sick people wait 6 months before getting affordable insurance, yeah, that makes SO much sense...

[TwilightGardener]

6. They don't want people dumping their private coverage to sign up

with the high risk pool--OK, then make proof of insurance co. rejection part of the deal--as soon as you can forward the rejection notice, and apply for the public pool, you should be covered.

[Jennicut]

8. I have a preexisting condition though I currently have insurance through my husband's job.

Bad idea, and perhaps not Obama's original idea. The Senate Finance Committee sucks.

[Aramchek]

10. don't be dishonest, this is not the permanent plan.

just the temporary until the bill goes into full effect.

but you really don't care about getting the truth out to people, do you?

you have your agenda, and you are willing to mislead people to get it.

[Raineyb]

16. Going 6 months without insurance when you have something that you know can kill you

is unforgivable I don't care how temporary this bone headed proposal is.

[Phoebe Loosinhouse]

12. I thought it was :

you were not eligible under an employers plan, you had not had coverage for six months OR had been denied to a pre-exisiting condition or had been offered an unaffordable plan due to pre-exisitings, but I guess youhad to document the pre-exisiting stuff.

Very frustrated. I posted a site that had ALL the information about the bill in one place and then I didn't bookmark my own post!!!

Anybody here have a link to that site. It had at least 50 documents on it with live links - the bill, the summaries, the timelines, and a whole bunch of other documents.

edit - ok, I found it again --- here is the site


http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1687&catid=156&Itemid=55

[Better Believe It]

14. Thanks. Do you have a link to about 45 recently adopted amendments to the House bill?

I think Pelosi indicated those amendments are now available somewhere on the internet.

[depakid]

15. 2013 until the pre-existing condition ban kicks in?

Sometimes it seems like Democrats WANT TO LOSE their majority.

There's absolutely no excuse, nor rational reason for that.

[vaberella]

17. I came so close to calling you a bad name. This is the BAUCUS bill.

Obama hasn't endorsed this bill. For fuck's sake. Even AARP and AMA are endorsing the HOuse Bill. Most everyone from Dean to most Senate Dems are pushing the House bill. Even Ried is looking more at the House bill than the Baucus bill and your touting the Baucus bill s though it's THE bill. It's not. Where in the House Bill does it say this?

Edited to add.. Nothing is set in stone and most things will be Amended, if not tomorrow when the vote goes down if there is a vote. In the final mixed version or what ever version goes down in the Senate. Your pimpin misinformation for what the "Obama" health care bill will be---as the article so names the bill.

[Better Believe It]

23. Once again .... you should read an article before you write a post about it.

You seem to always shoot from the lip about articles and posts you haven't read.

That's a bad habit.

Do you also write movie reviews about films you haven't seen?

The article clearly states:

"But the House health care bill unveiled last week by Speaker Nancy Pelosi, D-Calif., doesn't include a waiting period. Instead, it would require insurance plans who ''dump'' seriously ill patients to repay the federal pool. ''The House provision will provide immediate relief for people with high-risk conditions who have no alternative for coverage,'' said Finan."

And have you totally forgotten about Senator Reid's work on a "merged" bill?

If you need help in keeping informed and in touch with what is happening in Congress regarding health care just ask for it! That would be better than spending hours and hours prancing all over DU looking for opportunities to rant about topics you're not at all familiar with.

[joeycola]

18. Die first then Congress might, just might approve your insurance.

[joeycola]

19. at least the House bill does not condemn you to death before treatment..

Senate Finance staffers say the restriction is meant to prevent people from dropping more expensive coverage to take advantage of government assistance.

But the House health care bill unveiled last week by Speaker Nancy Pelosi, D-Calif., doesn't include a waiting period. Instead, it would require insurance plans who ''dump'' seriously ill patients to repay the federal pool. ''The House provision will provide immediate relief for people with high-risk conditions who have no alternative for coverage,'' said Finan.

[joeycola]

20. It all comes down to money.............

If the Democrats' risk pool starts running out of money, the government may have to start a waiting list, raise premiums or take other unpopular measures. Congress could be asked for a bailout.

Several independent experts say concerns about the financing are valid.

''It would seem that ($5 billion) is going to be small relative to the need,'' said Thomas Buchmueller, a University of Michigan business professor.

Some 30 states now have risk pools for those who can't get health insurance on the private market, covering about 200,000 people at a cost of about $1 billion a year.

''This is clearly not going to be enough money to cover everybody,'' said Pollitz.

Insurance expert John Bertko, a visiting scholar at the Brookings Institution, said it may be possible to stretch the $5 billion, but there's a small margin for error.

Bertko said his ''back of the envelope'' math suggests there are about 1 million uninsured Americans in poor health, or five times the number currently covered by state high-risk pools. If all signed up for the new federal pool, it would burn through the $5 billion in a year.

However, people eligible for government benefits often fail to sign up. And if only one-third were to enroll, the budget could work.

[lumberjack_jeff]

21. The house bill has no such limitation.

http://www.opencongress.org/bill/111-h3962/text

Read section 101.

Anyone who was turned down for insurance or was offered insurance at a prohibitive price within the last 6 months is eligible to participate in the high risk pool.

Once the exchange becomes effective, the high risk pool is phased out.

The article misuses "congress" and "democrats". This article is only germane to the Baucus bill.

[ramapo]

22. Why???

This high-risk pool is bullshit. Nothing but a gift to insurance companies.

Yes it is better than nothing for those denied insurance (like my son) but the 2013 time line is inexcusable. I say the legislation should ban pre-existing condition exclusion six months from signature.

[bluethruandthru]

24. Why does nothing in these bills surprise me anymore?

The more I find out, the more disappointed I am. Hopefully, it will eventually be taken out of the bill...but I won't hold my breath.