President Obama, today, on pre-existing conditions

[Bluebear]

Sorry, this carefully-worded verse of the poem sounds like it continues hell for desperate adults with pre-existing conditions.

...Starting this year, thousands of uninsured Americans with preexisting conditions will be able to purchase health insurance, some for the very first time. (Applause.) Starting this year, insurance companies will be banned forever from denying coverage to children with preexisting conditions. (Applause.)

http://www.boston.com/news/nation/articles/2010/03/19/remarks_by_the_president_on_health_insurance_reform_in_fairfax_va/?page=2

[Skinner]

1. OK, I'll bite.

Could you parse it for me? Because when I read it, it sounds like thousands of uninsured Americans with preexisting conditions will be able to purchase health insurance.

:shrug:

[Bluebear]

2. At what cost? Able to buy and can afford to buy are two different things.

And it's clear now that only children are exempt from rules prohibiting insurance companies from denying coverage due to pre-existing conditions.

About your bite...ow! :)

[Skinner]

7. I'm pretty sure the rules prohibiting insurance companies from denying coverage...

...for preexisting conditions covers adults as well as children.

And the bill includes subsidies to help people purchase insurance. No, it's not free, but it's significantly better than what we have now.

[Bluebear]

9. You're wrong, Skinner. Only children are protected until 2014.

MR. GIBBS: .....

Tom.

Q I have two quick questions.

MR. GIBBS: Yes.

Q First, earlier this week -- sorry, I have two questions. First, earlier this week, both Rush Limbaugh and Michael Moore pointed out that the preexisting condition provision of the legislation doesn’t take effect for another four years, and I’m wondering if you could tell us, was that a concession, and if so, who fought for that and what did they -- what did you get in return?

MR. GIBBS: There is --

Q For adults, that is.

MR. GIBBS: Right. Well, again, the -- as I described earlier and as the President has described, there are certain things that cannot be instituted until you have everyone in the system. Obviously this is a piece of legislation that phases in over the course of many years those changes. And as a result of that phasing in, when that's done, preexisting conditions for adults will be outlawed. But understand this -- when this becomes law, an insurance company will no longer be able to discriminate against a child that has -- that they believe or says that has a preexisting condition.

Q That’s on day one.

MR. GIBBS: Right.

Q Children. And so it’s pegged to the mandate then, is that fair to say?

MR. GIBBS: Yes.

.....

http://www.whitehouse.gov/the-press-office/briefing-white-house-press-secretary-robert-gibbs-3182010

[Skinner]

13. I find this argument puzzing.

Yes, obviously it would be better if the rules were immediate.

But the fact that any of the bill's opponents are using this 2014 date as an argument against the bill is nonsensical. I am told to believe that this health care reform is a travesty. But what's worse is that this travesty doesn't phase in immediately!

[SidDithers]

15. Your coffee sucks, and your cups are too small!...nt

Sid

[Bluebear]

16. If it's better if the rules were immediate, why aren't they?

That is the question. At whose behest was that provision inserted? The insurance companies, obviously.

So where people tout that many more millions will be insured, sure. My liberal bleeding heart, though, is in sorrow for the people who probably need it most who will be left behind because of an insurance company insistence.

[HughMoran]

18. CBO - because covering those people is NOT FREE

It's such simple math and it's been explained a thousand times.

[rhett o rick]

29. We arent saying it's free. The cost isnt the travesty. The fact that our Congress can pass a bil

a "health care REFORM" bill and still tell people that they have to wait four years is immoral. Of course those that think it's too expensive will be the first to point out that those people that die within the four years will us save millions. Immoral.

Of course it's not free, but it's worth the cost.

[HughMoran]

32. Your moral arguments are honorable

Sadly, they miss the point in this case. The CBO score is so critical that a large number of Dems would not commit to the current bill until they reviewed the CBO score - thus the '3 days' notice after posting it before taking a vote.

As nice as it would be to have pre-existing from the git-go (and I had to be convinced of this myself as it pissed me off), we would have a very bad CBO score if pre-existing were covered from jump-street, thus is had to be put off to even have a chance at passing this bill. As Skinner so aptly pointed out, when does the pre-existing condition restriction get lifted for adults if the bill isn't passed? So, while I agree in principal, your argument is a reasonable moral stance, it's not a practical argument as it's already a close call with a budget-neutral bill. The lack of immediate pre-existing lift for all adults (many uninsured w/pre-existing conditions will be able to get insurance right-away FYI) is the linchpin that allows this legislation to proceed - like it or not. At least we're on a clock now - compare it to the alternative.

[rhett o rick]

43. Ok, I will yield to your logical argument. I know you are right and agree that the current

bill is better than Bush. Having said that, I can not come to grips with not covering existing conditions immediately because of cost. We waste hundreds of billions on defense, and yet we are going to let Americans die, not from terrorists, but from the greed of the predatory health insurance industry and their lackey Congress. I personally know people that will die before the four years are up. The emergency rooms tell them there is nothing that they can do until they are literally dying.

[EFerrari]

22. It's also the case that the delay is part of the "travesty", not a counter argument.

We've been told repeatedly about the number of people who will die if this bill isn't passed *now*.

[depakid]

45. The subtext of the message is that insurers interests are more important than patients

People affected- as well as others in the know will rightfully ask: it's a great idea and long overdue- yet we have to wait 4 years?

:wtf:

[Posteritatis]

28. My worry is that a delay that long provides lots of time for it to be repealed.

Between now and the time the ban on forbidding coverage due to preexisting conditions takes effect, there's likely to be any number of attempts to preemptively overturn it.

[jbnow]

34. It is only children the policy changes for but within 90 days the adults

with preexisting conditions will have a national high risk pool they can buy into until the exchange is set up. I don't quite get how it works. The language in the bill says things about low deductibles and standard rates... whatever. It is a stop gap measure.

Also the senate bill has a reinsurance for Americans over a certain age that starts before the exchange does (but continues). That means it would cover catastrophic, expensive things and means a lowering of their rates. Probably many of them have preesiting conditions.

So presumably many who can't afford it now will be able to get some coverage after 90 days.

Obama wanted everyone with preexisting conditions covered like anyone else as soon as the bill was signed. he talked about it through the summer. I don't know why it didn't happen even if I do understand the math. They know they will be getting new clients, millions. They wouldn't go bankrupt.

Other rules do start earlier, wish this did.

[EFerrari]

10. This is the second time in the last two days that the WH has not said

outright that adults with pre-existing conditions will be covered right away. And that's what Mike Moore was saying the other night, that kids are covered right away but not adults.

/grammar

[Missy Vixen]

17. Every article I've read states there is no cap on premiums

It's also possible to charge more due to age, specifically, over 40, which is also well-documented. The most recent figure I saw was 300% more than premiums those under 40 will pay.

Skinner, it may not apply to you, but it sure as hell applies to me and my husband. Right now.

[CreekDog]

37. Older Americans pay about 11 times more for coverage now, under the bill it will be 3 times or less

and based on community rating rather than your individual health.

that's a vast improvement from the current system and practices.

[HiFructosePronSyrup]

12. How would adults with pre-existing conditions fare under your plan to kill the bill?

[Name removed]

21. Deleted message

Message removed by moderator. Click here to review the message board rules.

[rhett o rick]

30. Yes I agree. Those that survive the four year waiting period will be so greatful. nm

[Stinky The Clown]

42. Why not you tell us, there, Gitter.

[RaleighNCDUer]

4. It's the american way - the best health care you can afford. nt

[Bluebear]

6. By the by, if you are mandated to buy insurance & you have a pre-existing condition...

...can you imagine the premium?

[RaleighNCDUer]

14. Unfortunately, I can - which is at the base of my objections.

Many, it seems, cannot.

[Missy Vixen]

19. We're dealing with it right now

We have no health insurance.

Washington State high-risk pool: $1400 per month premiums. If we're accepted.

Go ahead and tell me one more time that those with pre-existing conditions will benefit from this bill. The only relief we'll see is when we finally qualify for Medicare. If we make it.

:eyes:

[CreekDog]

39. Community Rating is how you will benefit

Your condition has to be covered
There can be no lifetime cap for your condition
They can't charge you more for having that condition

No, those provisions aren't immediate but they are in there.

It's wrong to say there is no benefit to those with preexisting conditions. It's misrepresenting the bill (at best).

[Missy Vixen]

44. They can't charge me more for the condition, but they can charge more on the basis of AGE

Please don't try to tell me this is not the case. It's been widely reported that the insurance companies refused to back down on any kind of non-age-related premium calculation.

"Not immediate"? My husband is a Type II diabetic, on insulin and over 40. I don't think he can wait four years for the provisions to kick in. Well, if we are ABLE to find health insurance at all.

[Kokonoe]

20. Mandated health insurance premiums GOOD

Mandated healthcare coverage NOT for your life.

[CreekDog]

38. "Community Rating"

I'm seriously wondering if you are criticizing a bill that you understand.

[readmoreoften]

41. Only thousands??? That's not very many people. Aren't there millions in this demographic?

[cutlassmama]

3. Yeah, too bad for the adults. Jesus, how many MORE concessions

will we have to make?

[aquart]

5. Oh, goody. The children will live but their parents drop dead.

From the outrageous unregulated costs and whatever untreated disease they happen to have.

Yeah, this helps a lot. COVERAGE IS NOT THE SAME AS CARE.

[Gman2]

8. If they were outlawed immediately, many would not wind up in the ER.

Clearing the ER from anything but trauma, would benefit medicine immensely.

[RaleighNCDUer]

11. Mr President - this is a flat out LIE.

"We have had -- we have had a year of hard debate. Every proposal has been put on the table. Every argument has been made. We have incorporated the best ideas from Democrats and from Republicans into a final proposal that builds on the system of private insurance that we currently have."

A new system, modeled after any number of European systems of Universal Single-Payer, was NEVER on the table - it was eliminated before the debate even started.

This bill is NOT universal - it leave 16-25 million (depending on who is counting) STILL uninsured, STILL unable to access the health care system.

For the first time in US history it mandates that Americans purchase a product from a for-profit corporation - this goes WAY beyond using tax dollars to bail out private corporations to keep them from failing.

The "system of private insurance" is not a system - it is a racket.

[ArcticFox]

25. agree totally

I remember thinking "liar!" when I heard him say that "every proposal has been put on the table." Wish I could have been there and shouted it out.

Hey Mr. President: remember when they arrested those single payer advocates trying to be heard in the Congress?

[quiet.american]

23. What would it take to just go look it up.

Is it really that hard to do. Obviously, those posting here have access to a computer. Why not look it up for yourselves?

Within six months of the bill being enacted, children cannot be denied insurance because of pre-existing conditions; this means they do not need to have a separate high risk pool to be created for them, because they cannot be denied coverage by insurance companies, and therefore have access to insurance

Within 90 days of the bill being enacted, a government-subsidized high risk pool will be created for adults with pre-existing conditions, so that they will have access to coverage in the time between now and 2014, when the "no discrimination" law goes into full effect. They will then be transitioned over to an Exchange plan.

http://docs.house.gov/energycommerce/IMMEDIATE_PROVISIONS.pdf

There is an initial $5 billion in funding set aside for government subsidy of the high risk pool. Government partner providers in the high risk pool will be states and non-profits.

As far as premium pricing goes, here is the language from the Senate bill with regard to the high risk pool (I didn't see it amended in the reconciliation version, so I'm assuming it's the same, although I haven't had a chance to thoroughly go through the amendment:
http://democrats.senate.gov/reform/patient-protection-affordable-care-act-as-passed.pdf

(C) ensures that with respect to the premium rate charged for health insurance coverage
offered to eligible individuals through the high risk pool, such rate shall—
(i) except as provided in clause (ii), vary only as provided for under section
2701 of the Public Health Service Act (as amended by this Act and notwithstanding
the date on which such amendments take effect);
(ii) vary on the basis of age by a factor of not greater than 4 to 1; and
(iii) be established at a standard rate for a standard population; and
(D) meets any other requirements determined appropriate by the Secretary.

[EFerrari]

24. Underscore: "so that they will have access to coverage

in the time between now and 2014, when the "no discrimination" law goes into full effect."

[RaleighNCDUer]

26. There is a huge goddam difference between 'access to coverage'

and 'health care'.

if the 'standard' is $800/mo, this allows the subsidized premium to cost up to $3200/mo for those lucky few. How much is the subsidy, and how much is the patient's cost?

Where is THAT delineated?

[EFerrari]

27. Did you ever see "Moonstruck"? There was a scene where an older man

got his drink tossed in his face by his young date who then storms out of the restaurant.

I'm remembering his instructions to his waiter: "Remove her plate, and all evidence of her existance -- and bring me a double vodka".

lol

[quiet.american]

33. The bill contains language that once it is passed --

To be implemented is,

"Sec. 1103. Immediate information that allows consumers to identify affordable coverage options."
I know that doesn't say much, but that's what I can see for now.

There's probably nothing I could say that would change any minds that health coverage can also provide health care. All I can say is, the bill doesn't just let insurance companies offer any old thing. Policies have to conform to a minimum set of standards (Essential Benefits Package) that are based on, from what I can ascertain, the basic level of coverage offered to federal employees and are referred to throughout as "qualified plans," or in this case "qualified high risk pool."

[seafan]

35. Yes, this ensures that discrimination against adults w/ preexisting cond's will continue thru 2014.

Whether they have a policy or not is irrelevant. These adults will get the shaft both ways. If they are able to buy a policy, Big Insurance can charge whatever they want.


In the other scenario, for an uninsured adult with a preexisting condition and a long-gone 5 billion dollars for a tiny, temporary high-risk pool, these people are out of luck as well until 2014 at the earliest.

Section 1101 of the PPACA authorizes the expenditure of up to $5 billion in support of a temporary national insurance pool for high-risk individuals without other health insurance.

---from p. 14, Estimated Financial Effects of the “Patient Protection and Affordable Care Act of 2009,” as Proposed by the Senate Majority Leader on November 18, 2009, CMS PDF

This ruling will only protect children, beginning 6 months from bill passage. So, Big Insurance can sock it to children for 6 more months until the law prohibits it.


And for millions of adults, it's fair game for discrimination for 4 more years, both during and after the pittance of a $5 billion temporary risk pool rapidly dries up.



And Big Insurance grins, *Thank ya very much, Democrats!*

[quiet.american]

40. More misinformation.

For one -- the HHS Secretary can appropriate funds as necessary for the high risk pool.

Two - you have a serious reading comprehension problem. This does not apply to children. They are protected from discrimination based on "pre-existing conditions" the moment the bill is passed.

Your other OP was total misinformation and now this post is, too.

Edited to add,

The provision regarding children is for enactment within 6 months.

The provision regarding those who are not children is for enactment within 90 days

How can it then be the same?

it is two different items.

From the words of the President himself, today, we understand it is two separate items.

[rhett o rick]

31. The preditory insurance industry is banking of the republicans taking back control of the

government within the four years. Win win.

[thotzRthingz]

36. re: "thousands of uninsured Americans" -- ummm, there are some 50 MILLION uninsured, and another

25 MILLION UNDERinsured (ref: Wendell Potter's testimony before CONGRESS... and he says the number is only going UP ... as more people get PRICED OUT of their existing health care insurance).

I am not impressed at all with Obama's getting all wee-weed-up over this CORPORATE WELFARE BILL!

P.S.

adding a big K&R to this thread!