pre-existing…

pre-existing…

Hello. My name is Lindsay, and I’m a former Republican. (Hi, Lindsay!)

It may not surprise you to hear that, as someone who holds an undergraduate degree in political science and a law degree, I’m slightly turned on by a good political debate. However, I have a longstanding rule: I don’t discuss politics on the internet.

I’m about to break that rule.

My reasons for registering as a Republican when I first turned 18 were actually very non-political and no longer relevant. Over the past decade, I have become disenchanted with the GOP party (and for the record, no, I didn’t vote for Him). I believe in less government intrusion and state’s rights, but I have never supported Republican ideals that exclude certain groups. However, the Democratic party has made mistakes as well, and I don’t believe in a two-party system anyway. So, I belong to that lost group of political expatriates that have no identity: the “No Party” party.

I’m afraid it is sad commentary on the state of American politics that I would rather be a “No Party” than register with either major party.

I’m telling you all this so that when I start to bitch about the American Health Care Act (AHCA) in a moment, you’ll understand that it’s non-partisan bitching.

health insurance documents
photo via freedigitalphotos.net
Photo by everydayplus

For my international friends, the American Health Care Act is a health care bill that is intended to replace our current law. I refuse to refer to the American Health Care Act as “Trumpcare” or “Ryancare” for the same reason I refuse to refer to the Affordable Care Act (ACA) as “Obamacare”: because no single person should get credit, or blame, for a law. It takes hundreds of affirmative votes to get a federal law passed in the US.

The AHCA has been approved by the House and currently awaits vote in the Senate. But before we discuss the bill, allow me to tell you a little about my situation: I work at a law firm which is small enough that it doesn’t meet the employer mandate of the ACA, meaning my employer doesn’t have to legally provide health insurance. And it doesn’t.

So, I have an individual plan. I have been on the plan for about 10 years, and over that time my monthly premiums have increased to approximately $400 per month, which is what I pay now. My plan has no deductibles, but it only covers 60% of in-network treatment, and I have a $45 co-pay for visits. It doesn’t cover a lot of major tests. Because I require ongoing care, and my insurance doesn’t cover everything, I’m always making monthly payments to providers for my portion of previous medical care  – like, every single month for the past 8 years.

via freedigitalphotos.net
Photo by adamr

I signed up for the plan right before I started experiencing symptoms. By the time I was diagnosed with POTS, the ACA had been passed and insurance companies couldn’t exclude or charge higher premiums for people with pre-existing conditions, except plans purchased prior to the enactment of ACA were grandfathered and could still charge more for pre-existing conditions. I have a grandfathered plan, and there is speculation that autonomic dysfunction constitutes a pre-existing condition. I don’t know if the increase in my premiums is due to standard inflation, or my pre-existing illness. My insurance plan starts to feel expensive when I have to pay thousands for simple tests, so occasionally I check the exchange for better deals. There aren’t any. Health insurance is fucking expensive.

So, although my insurer can raise my rates at any time under current law because I have a pre-existing condition, I stick with them because they offer the best prices. I can never leave Blue Cross. They own me.

The bill has a number of issues, including limiting what services insurance would have to cover, cuts to Medicaid, and defunding Planned Parenthood. Although, in my opinion, it gets a few things right, too.

If the AHCA is passed, it will eliminate the prohibition against pre-existing conditions. Or, rather, it will allow states to waive the prohibition against pre-existing conditions. For those states that waive, they can only engage in medical underwriting (basing insurance premiums on the insured’s health status or pre-existing conditions) if the patient has been without insurance for at least 63 days, and even then, they can only engage in medical underwriting for the first year. So, to be affected, you would have to not have an employer (or VA) paid plan, live in a waiver state, AND have had a gap in coverage for at least 63 days. Even then, funds can be taken from a high-risk pool to help pay for the increase in your premiums.

So what’s the problem? A report from Kaiser Family Foundation estimates that 6.3 million Americans would be affected. Out of over 300 million of us, only 6.3 million would be subject to higher premiums. But that same report estimates that those premiums could be 3-5 times higher. So, if my premiums of $400 per month are pretty average, that means someone could have to pay $2,000 per month. Friends, that’s $24,000 per year. The only people who can afford that are the healthy ones who have employer-paid plans anyway. That doesn’t even factor in the portion of office visits, ER visits, labs, procedures and surgery that are the patient’s responsibility. The funds in the high-risk pools only go towards high-risk illnesses.

I get it – having to use your hard-earned money to help pay for my health issues is dangerously evocative of socialism. If my health condition is my own fault – as some Republicans have claimed – why should  you have to pay for it??

Because disability is a protected class. Because my clean driving record has been paying your auto insurance for years.

And because, although my illness is “pre-existing”, I pre-exist my illness.

I suspect the Senate will make some conservative changes to the bill, and we’ll be back to square one. I’ll post any major developments, if you’re interested.

“The marks humans leave are too often scars.” – John Green

Smell ya later.
– Linds

 

4 thoughts on “pre-existing…

  1. Hay girl, good read! I doubt we will EVER have the right balance of anything in this world, not trying to sound negative, its just like we would have to start all over like ALL over and then maybe we’d try a new way of life then.Or maybe we just need to try an independent one time and see what happens.But that will never happen. Hope your as good as you can be.xxoo Summer

    1. I completely agree. With changes in administrations every 4-8 years here, it’s hard to imagine any healthcare law, even a really good one, will last for longer than that.

  2. I’ve been reading Elizabeth Milo’s jaw dropped and stressful journey through the health-care maize and now after reading this as an outsider I’m mortified. It’s so incredibly complicated I can’t make head nor tail of it, so how do less well educated Americans fair? No wonder our NHS here in the UK is the envy of the world, even if it is skint and broken and I wait 2 months just to see my GP! At least everyone is treated here regardless of ability to pay and if you need a procedure or a prescription you get it. Having said all that, the range of care in the States is far superior and having read about what’s available to you I often feel like we’re living in the dark ages, but I’d still rather be here than there 🙁 Jak x

    1. It’s awful, Jak. Everything here is a battle! We do have some great doctors and research centers here, but it takes forever to get in! Some of the better POTS/autonomic centers around the country take 1-2 years to get in. Even my cardiologist who is knowledgeable about POTS, but isn’t specially trained, takes 3 months to see. Insurance companies are in the business of making money, and will do what they can to avoid having to pay for people like me who don’t make them any money. You find a plan that works, then you’re trapped for life.

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