Clearing the Air: Pre-Existing Condition Insurance for Medical Care

The facts and the figures on pre-existing condition insurance

Pre-existent condition insurance is one of the many perks touted by advocates of Obamacare. For many years now, millions of Americans fought insurance companies that would block their access to health insurance and health care because of their chronic issues made them ineligible (and thus left them uncovered) for health plans. Those who couldn’t afford it spent their lives worrying to death about their health and their future, as there are not few who have to endure heart disease, cancer, diabetes or asthma. By “pre – existing condition” specialists from WebMD also understand depression, high cholesterol, old sports injuries or even the Gulf War Syndrome. What are these conditions through the eyes of health insurance companies? A reason to deny coverage, as a sick person might cost them tenfold than a healthy one.

In 2012, The U.S. Department of Health and Human Services estimated that a number of 50 million to 129 million Americans (19 to 50 percent) live with some form of a chronic, pre-existent health condition, while the latest Kaiser Family Foundation Health Tracking Poll published in August 2013 showed that 57% of the American population has at least one family member back home suffering from a type of chronic illness.

Given this amount of data, all these millions of people can’t wait for the next year, when the Affordable Care Act gains full force and will make sure that health insurers will no longer be able to block access to pre-existing condition insurance.

What is the change that’s about to come?

People who have been denied health insurance before, because of their chronic diseases, feel that this law is a life saver and a safety net for the future, since it allows for pre-existing condition insurance. Starting with 2014, insurance companies won’t be able to deny even those people who are healthy, but exposed to future health risks they can’t do anything about (and who have been long – term subjects of debate for insurance companies and often victims of health insurance denials) reports an article on WebMD.

The downside

To every bright side of the moon, there is, of course, a darker one. In an extensive article in The Tampa Tribune treating the stories of some uncovered patients with a history of pre – existing conditions, journalist Mary Shedden emphasizes the point of view of Uwe Reinhardt, a Princeton University economist. In his opinion, starting with 2014, some people will feel released, while others will live the shock of their lives when starting to hunt for health insurance companies. He calls the phenomenon the Premium Shock, which will be the most felt by the young, hard working, healthy, low – risk American, who will have to read a few times the numbers printed on his premium monthly check in order to understand what stroke him. In Reinhardt’s words, “Premium shock refers to the healthiest people. For those with chronic conditions, watching others pay more will be a novelty.”

Win some, lose some

Either way, the shock will hit both sides. People who are now not able to work anymore, as their pre-existing conditions made it impossible for them to have access to an optimal health care plan embrace the “Obamacare” act and feel like justice has finally made its entrance into their lives. The young generation, on the other hand, is suspicious, if not downright frightened by the coverage costs they will have to pay for many years from now. At a political and economical level, things are even more complicated and many fear the failure of the new law, while in the same time, employing companies are already re-thinking their own internal policies regarding their workers health care plans and coverage.

“Who doesn’t want to be healthy?”, asks Reinhardt and the fact that even the young generation has to think about their safety nets and caring for their own elders spikes even more burning questions that will find and answer in January.