GOP to protect pre-existing conditions?

There are many bills that are in the process of introduction in the House of Representatives to repeal and replace the Affordable Care Act, also known as Obamacare. Many of us are anxious about the future of the program and how it will affect our Seniors and the disabled community. Many of the bills propose the repeal of the ACA without any replacement, which would leave approximately 20 million Americans without health insurance.

The main sticking point for many of the Representatives and Senators seems to be the cost of insuring those with pre-existing conditions or severe illnesses.

“A Democratic aide familiar with a version of the bill said that the measure would provide for an enrollment period during which people with pre-existing conditions could get coverage. However, the aide said under the current language, insurers could charge a client any price if they have had a period of no coverage.” The Hill

In other words, if a person is discontinued from their previous insurance for any reason, the insurance company could charge any amount to re-insure the person. “The biggest problem? Both premiums and other costs remained too high for many people with health conditions to afford. The federal program ran out of money almost a year before it was scheduled to end. Sometimes the pools got so expensive for states that they had to impose waiting lists for coverage. And often, to keep costs down, risk pools set up waiting periods before they started paying bills for the very illness that made people high risk.” Kaiser Health News.

The other problem with the proposals is that, under the ACA, the Congress was supposed to provide block grants to the states to support the Act. Instead, of the grants, most states were provided with “loans” to support the program and less than one-half of the money that was supposed to fund the program was allocated.

“But the GOP plan also would likely make insurance more expensive for older people by proposing a broader range for premiums based on age. Current premiums can vary only three-fold based on age, which is “driving out younger and healthier patients” who can’t afford them, the GOP aide said.

Under the plan, insurance companies could not charge higher rates to people with pre-existing conditions so long as they maintain continuous coverage, whether from an employer or in a policy they purchase themselves. The new high-risk pools would be available for those who have a break in coverage, or who fail to purchase during a one-time open enrollment under the plan.

The plan would get rid of most of the coverage requirements under the Medicaid program for the poor, so states could make them more or less generous than they are currently. It would also limit funding. States could opt for either a per-person cap or a block grant to spend much as they wish.” Kaiser Health News

The plans to replace the Affordable Care Act are not affordable for our Seniors and would limit benefits for the most vulnerable in our society. If an elderly person were to need surgery to prolong life, would they get it? Maybe not under managed care proposals. We have all had experience with denials of care because a clerk somewhere decided it was not reasonable or necessary. I had to defend an ambulance to transport my 90 year old aunt to the hospital because Medicare said she could have taken a cab.

Be care what you wish for.

Rose Mary Zapor

Rose Mary Zapor, Esq.
Owner and Founder

The Zapor Law Office, PC

7475 W. 5th Ave., Suite 202

Lakewood, CO 80226
Phone: 303-866-0990
Fax: 303-866-0991



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