For us it is definitely the provision blocking insurance companies from discriminating for pre-existing conditions.
For us, it’s like the provision for covering dependent children up to age 26.
The challenge with covering pre-existing conditions (in the current ACA), is that folks do not have much incentive to get coverage (instead they pay the tax penalty), until they have a problem, then they get coverage, use it, and then drop it again. That of course destroys the financial model for “insurance”.
IMHO a better design would be to cover pre-existing conditions, if you’re already have insurance (or if you enroll in an employer provided plan). In other words, insurance companies can’t drop you from the plan.This would give folks more incentive to get insurance and keep it. Of course, other changes would be needed to make getting insurance (or government provided services) affordable.
FYI: on Trump’s recent 60 Minute interview, he stated that they should keep the pre-existing conditions and age 26 provisions in whatever replacement gets proposed for the ACA. Both are extremely popular provisions.
Would one have to keep their plan to prevent being discriminated against for pre-existing condition? Or could they stay insured and shop plans?
ClarinetDad16 that’s my question as well.
If the ACA provisions are dumped and you want to retire before 65 when Medicare kicks in, will you be able get insurance to cover you for the period between retiring (and losing your company insurance) and Medicare? That would essentially be writing a new policy for you, With continuous coverage up until then AND pre-existing condition could you get new coverage?
I know a LOT of people who are afraid to retire until the younger spouse reaches 65 and Medicare. I think people would be surprised at how many of us might not be able to get insurance on our own if pre-existing condition is gone. Do you have high blood pressure, high cholesterol (even if managed by meds), blood sugar out of range, overweight / technically obese? Good luck…
My son has Type One Diabetes. The pre-existing conditions part is huge. For now he is covered through my employer-provided health insurance, but in the future I do not want him to be limited to choosing a career that supplies a similar blanket coverage for employees. He should be able to be self employed or whatever and still be able to find affordable comprehensive health insurance coverage.
@ClarinetDad16 and @JustGraduate - no, you would not have to keep your plan - and if repeal happens (which will be difficult and take time) - that provision will not change.
Bingo the implications of people being able to be entrepreneurs or work for an emerging company without a group healthcare plan has enormous implications. Innovation, growth, opportunity is an integral part of our way of life.
Should people have to be prisoners to large corporations or have the freedom to do what they love? Isn’t that the American Dream?
We get insurance through H’s company and not through the exchanges. The pre-existing condition clause is still important to me because it covers ALL insurance. Our two older daughters are set for now with employer coverage but of course, that could change at any time.
And that is the main thing to me: that anyone can get coverage, even though it may be expensive, etc. More than 20,000,000 people have gotten coverage since this was enacted. Who knows when and if any one of us may need the backing of this law to help us get coverage?
Nothing personally (our plan already was ACA compliant before ACA.) S is still on our plan as it doesn’t cost us extra but his company has excellent insurance coverage which he would just move over to if that provision is tossed.
The most important thing about ACA to me is that millions of people now are covered, who otherwise would not be.
@Fishnlines29 and how would that work?
- government regulating insurance companies to force them to accept people with pre existing conditions blindly without any additional cost?
- adding people with pre existing onto Medicare?
Under the ACA the companies agreed in exchange for gaining millions of new customers through the mandates. No mandate how would this happen?
I have individual insurance. I never had it before ACA, because husband just recently retired. Now I discover that I have a pre-existing condition that makes me uninsurable without ACA.
@ClarinetDad16 They are not planning to get rid of the law entirely, just revise it. the soon to be new administration says they will keep the provisions to accept people with Pre-Ex and to allow children to be covered to age 26.
My sister has Sickle Cell. The pre existent condition is a must have for her. She have been wanting to move from NYC for years but she was afraid to because she didn’t want to lose her insurance or doctors. NYC offers free resources for people with her disease. If she move and lose her insurance and those resources the medical bills will cripple her.
I also have a college age daughter. I like having the option to keep her on my insurance after she graduate. She might not need it but at least the option is there. With kids gradating with so much debt nowadays saving a few bucks by staying on your parents insurance for a few years can go a long way.
Keeping pre-ex but getting rid of the individual mandate can’t work. Nobody would buy insurance until they got sick,
Health insurance can do what dental insurance been doing for years. Pit a time limit on pre existing conditions. When you get dental insurance its usually a time limit before certain procedures are covered.
This is why this is crazy for a first world country. The only plan that makes sense is a national single payer system.
@sensation723 133 million people have pre existing conditions. When you wrap in the family members that would share their policy perhaps the majority of Americans could be seriously impacted if insurance companies could once again deny coverage to those with pre existing (like they used to do frequently) or charge them exorbitant rates.
By adding a time limit you are flagging these individuals to be discriminated against.
Nobody’s plan was fully compliant with the ACA before the law passed. You probably couldn’t get into it with pre-existing conditions, it could be cancelled if you got sick, and they could charge higher premiums for whatever reasons they wanted to. I think what you are saying is that the plan included all the basic coverages required by the ACA, but that is just one piece of the law.
The ACA has been huge for us. It has enabled me to continue my consulting practice and purchase health care worth having on the open market. Without it, I probably would have had to shutter my small business and go to work for someone else to get solid health coverage for me and my kid.
Watching the new tussle over it is fascinating. Some of the new proposals will be very damaging to health insurance companies. They strip away some of the components most beneficial to them, and leave some that are most costly to them. None of them seem to have any chance of reducing premium costs for anyone.
“Nobody’s plan was fully compliant with the ACA before the law passed. You probably couldn’t get into it with pre-existing conditions, it could be cancelled if you got sick, and they could charge higher premiums for whatever reasons they wanted to. I think what you are saying is that the plan included all the basic coverages required by the ACA, but that is just one piece of the law.”
That is not true. Many group policies were ACA compliant. I’m covered under NYS health insurance plan for employees. You are covered in full as soon as you start your employment. You are charged the same amount as everyone else no matter how sick you are or might become, or what pre-existing condition you might have. You cannot be dropped from your coverage because you become ill.
All the preventative care was also fully covered (no co-pay.) My plan also covers dental, prescriptions and eye glasses. It even covers things like infertility treatment (it did not when I was going through it 25 years ago) and transgender surgery. And not really a part of our health care but the State will cover a part of the cost of adoption (we didn’t have that 25 yrs ago either.)
ACA allowed my middle son to obtain affordable health insurance from age 26 to 28 when he graduated from college and his full-time employment provided health insurance. He fortunately did not need it except for well-care checkups, etc but it was certainly a relief to know he had it if something happened, he wouldn’t be financially devistated (nor us because of course we would help cover as much as we could).