I’ve seen several people of late, in discussing the Patient Protection and Affordable Care Act (“PPACA”, or in many circles, “Obamacare”), complaining about increases in their health insurance premiums as some of the regulations of
the PPACA have begun to become effective. It may well be that, particularly in the short run, some folks’ insurance premiums will go up. But before moaning and groaning too much about the higher premiums, perhaps they should consider the things they will get under the new law that they didn’t have before—and what they stand to lose if the Supreme Court overturns the PPACA.
The coverage for preexisting conditions alone is an enormous benefit to almost everyone, whether they realize it or not. Oh, you think you don’t have a preexisting condition and none of your loved ones has one either? You might want to rethink that. Consider this: if you or one of your family members has ever been treated for hypertension, high cholesterol, asthma, diabetes, arthritis, obesity—even, in many cases, common emotional and mental health issues such as depression or anxiety (and we haven’t even mentioned any of the really major stuff like coronary artery disease, cancer, stroke, etc.), then you (or your loved one) has a preexisting condition which, under the old underwriting rules, could be used as a basis to deny you health insurance coverage in the future. That is, should you for any reason lose your current coverage say, as a result of a job loss or change, the health insurance plan offered by your next employer (assuming it is offered at all), would be legally entitled to either deny you coverage or charge you a premium that is astronomically higher than what everyone else pays. Look at that list above again. Have you, or a loved one, ever been prescribed medication for any of those conditions? I think it’s fair to say that most of us have either been treated for one of those conditions or has a family member who has.
The PPACA also bans lifetime benefit caps—another source of worry for someone with a preexisting condition that requires ongoing medical monitoring and maintenance. Under the old system, you could find yourself having managed your condition very well for years, but then later on having another, unrelated serious health issue arise that requires expensive treatment. It is possible that treatment will be unavailable to you unless you either have the money to pay for it yourself, or you have not maxed out your lifetime benefit under your health care plan.I found this very good article at healthcare.gov that lays it all out in painful detail exactly what we will lose of the PPACA is struck down (or repealed). Consider that starting in 2014:
- Insurers can no longer use health status to determine eligibility, benefits, or premiums;
- Individuals and small businesses can choose from a range of private insurance plans through competitive marketplaces called Exchanges in their States; and
- Annual dollar limits on coverage will be banned in group and new individual market plans, critical benefits will be covered, and out-of-pocket spending will be limited.
And consider what the new law is already doing:Insurers can no longer limit lifetime coverage to a fixed dollar amount;
- Insurers can no longer take away your coverage because of a mistake on an application;
- Insurers can no longer deny coverage to a child because of a pre-existing condition;
- Thousands of uninsured people with pre-existing conditions have enrolled in the temporary high-risk pool program called the Pre-existing Condition Insurance Plan, which has literally saved people’s lives by covering services like chemotherapy.
And finally, consider what will happen immediately if the law is struck down by the high court or repealed:
- Reduce the health care and health insurance options of the 50 to 129 million Americans with pre-existing conditions;
- Take away, for the 32 to 82 million people with both a pre-existing condition and job-based insurance, the ban on lifetime limits on benefits, restrictions on annual limits on benefits, new protections in the small group market from discrimination based on health status, and the security of knowing you can change jobs without losing your health coverage and care;
- Lock older Americans into their current coverage if they have it, since up to 86 percent of people ages 55 to 64 have some type of pre-existing condition;
- Limit insurance options for the parents of the up to 2 million uninsured children with pre-existing conditions, who today can no longer be blocked from purchasing individual market insurance due to their pre-existing condition.
The entire article is worth a read (see http://www.healthcare.gov/law/
The new law is not perfect. Many of us would have preferred to see a single-payer system or even a national health care system like most of the developed world enjoys. But make no mistake: the existing law accomplishes some hugely important things that will benefit virtually everybody. Yes, premiums might be higher at the outset; but over time you will actually pay less out of pocket for healthcare than you now do. Don’t you think that’s worth it?