Sometimes watching the media and the social media is like the reruns of Monty Python’s Flying circus. The elected officials on both local and national levels have no clue on what they are talking about, especially in regards to the American health care system. So I finally saw an interview of someone who understands the health care system. Being in the system for 25 years I would say I qualify as an expert. Reince Priebus finally seemed to pull all the pieces together on Chris Wallace’s show over the weekend. No question that more people in system will drive down the costs of medical insurance. Medical insurance companies adjust their rates annually based on profits and losses. That is what corporations do- they run businesses to make profits. They have no obligation to give products and services away. They work to produce profits for their owners/shareholders. Fact of life get over it that is what companies do. Over 60% of Americans are covered by private health insurance companies typically through their employers. Another 30% or so are covered under federal system Medicare (which most people paid into for 50 years) and state run Medicaid programs. The Health Insurance Portability Accountability Act (HIPAA) is a federal law that covers people for preexisting conditions provided they had carried coverage for 12 or 18 months prior to getting an illness*. That being said under the Affordable Care Act everyone was supposed to be covered (under the penalty of law). So if everyone had purchased and had insurance when they were supposed to, they would be covered today. HIPAA has been around long before Obamacare. Obamacare mandated everyone to have coverage and at that it has been a failure. Unfortunately, fixing the healthcare system which was started in 2009 with the passing of the Affordable Care Act is less an issue than who is positioned best to win the mid-terms in 2018. In the meantime who suffers, we do!
*Title I requires the coverage of and also limits restrictions that a group health plan can place on benefits for preexisting conditions. Group health plans may refuse to provide benefits relating to preexisting conditions for a period of 12 months after enrollment in the plan or 18 months in the case of late enrollment. Title I allows individuals to reduce the exclusion period by the amount of time that they had “creditable coverage” prior to enrolling in the plan and after any “significant breaks” in coverage. “Creditable coverage” is defined quite broadly and includes nearly all group and individual health plans, Medicare, and Medicaid. A “significant break” in coverage is defined as any 63-day period without any creditable coverage.
Bottom line: The pre-existing condition issue was addressed back in the 1990’s when HIPAA was enacted. If you have coverage for 12 or 18 months and switch insurance companies you are not subject to preexisting exclusions.
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