The Speaker took issue this week with how Republicans are addressing the issue of pre-existing conditions. I'd like to take issue with how she's distorting this issue to create confusion instead of clarity.
In most states, group plans only restrict care for pre-existing conditions if there's been a gap in coverage for a month or more. In these situations, treatment for pre-existing conditions is usually restricted for just a year.
Individual plans are another matter though. With individually underwritten plans, carriers can frequently just deny coverage if they don't like your pre-existing conditions. If they don't deny you, they can simply make it too expensive or force you to sign waivers. In most states, however, once you have individual coverage you can't get dropped. So, if you obtain and maintain coverage before conditions develop, you don't have an issue after the fact (aside from the issue group and individual policies have - premium inflation).
So, individual policies present some problems, which I think a freed up market can resolve. For group plans and for those who maintain continuity of coverage, the issue is minor. Let's stop creating confusion and fear by suggesting that the problem is more widespread than it is. It's sensational when you tell the story of a person it impacts, but in perspective, it's not the biggest problem we have.
Our biggest problem is that we've not allowed the healthcare market to operate freely to control costs and improve value/quality. If the government promotes competition and sensible regulations, insures can be incentivized to compete even for those with pre-existing conditions. Insurance is risk shifting, so the known risks matter, but it's an opportunity for an issuer if the competitive and regulatory environment are properly aligned.
Levi
Sent from blackberry
In most states, group plans only restrict care for pre-existing conditions if there's been a gap in coverage for a month or more. In these situations, treatment for pre-existing conditions is usually restricted for just a year.
Individual plans are another matter though. With individually underwritten plans, carriers can frequently just deny coverage if they don't like your pre-existing conditions. If they don't deny you, they can simply make it too expensive or force you to sign waivers. In most states, however, once you have individual coverage you can't get dropped. So, if you obtain and maintain coverage before conditions develop, you don't have an issue after the fact (aside from the issue group and individual policies have - premium inflation).
So, individual policies present some problems, which I think a freed up market can resolve. For group plans and for those who maintain continuity of coverage, the issue is minor. Let's stop creating confusion and fear by suggesting that the problem is more widespread than it is. It's sensational when you tell the story of a person it impacts, but in perspective, it's not the biggest problem we have.
Our biggest problem is that we've not allowed the healthcare market to operate freely to control costs and improve value/quality. If the government promotes competition and sensible regulations, insures can be incentivized to compete even for those with pre-existing conditions. Insurance is risk shifting, so the known risks matter, but it's an opportunity for an issuer if the competitive and regulatory environment are properly aligned.
Levi
Sent from blackberry
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