What Obama, Romney preexisting condition plans mean for Minnesotans

REUTERS/Jonathan Ernst
Mitt Romney: “We’re going to have to make sure that the law we replace Obamacare with assures that people who have a preexisting condition.”

“The concept of uninterrupted coverage is just really not practical for most working people,” she said.

“They’re hanging their entire hat on the notion that the only way to make this work is to force people to buy insurance,” James Capretta, a fellow at the Ethics and Policy Center, said. He proposed a plan that would use tax breaks to encourage individuals to buy insurance when they’re healthy, thus giving them the preexisting conditions protections currently offered to those in group plans (he went much more in-depth on the issue here).

Capretta said such a plan would best suit low-income, unemployed or sporadically employed people who might not be able to afford individual insurance but don’t have the group plans offered by big employers to fill in the holes in coverage.

As for Boyer, she entered Minnesota’s state-created high-risk insurance plan to tide her over until the bulk of the Affordable Care Act takes effect in 2014. She said she’s even delayed receiving some preventative procedures until the state-run health exchanges, and the preexisting conditions provision, kick in that January.

“The ACA, as it’s currently structured, offers me hope that I am going to get the opportunity now to go into these health exchanges and be able to find reasonably prices policies that will offer me actual coverage,” she said.

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Comments (17)

  1. Submitted by Tim Walker on 09/17/2012 - 01:31 am.

    There’s a reason why Romney’s vague

    “Romney has been vague on how, exactly, he’d introduce the continuous coverage provision to the individual market.”

    He’s vague because there’s no way to make this work without the individual mandate.

    Like a shady used-car salesman, Romney is just hoping that people will be sold on the chrome and wax job, and not be bothered to read the fine print.

  2. Submitted by Matt Haas on 09/17/2012 - 06:09 am.

    Sounds peachy

    That is of course if you are lucky enough to have never been sick. I have a niece with CF and a young cousin with type 1 diabetes. One was diagnosed at 2 the other around 8. I seriously worry for their future if the right succeeds in their goals of further restricting healthcare access. How anyone can think it a priority for health insurance cos to profit from the misfortune visited upon two little girls is beyond me.

  3. Submitted by mark wallek on 09/17/2012 - 10:19 am.

    Corporate based health care

    Insurance companies and Health care organizations are thoroughly disgusting. Nothing more need be said about it. They are only profit concerned, as the homes and vehicles of the corporate officers indicate. The fact that there are no alternatives is amazing. If I want a cheaper, or more expensive potato chip, in some flavor or another, salted or nor, rippled or not, I can find it. Humane, affordable, person based health care? Forget it. It’s dead. Thiis is a new america, and it had little to do with democracy and allot to do with payola.

    • Submitted by T J Simplot on 09/17/2012 - 01:10 pm.

      MN Health Plans are Non-profit

      You do realize that the major health plans here in Minnesota are non-profit, right? Yes…UnitedhealthCare is located here but it cannot sell here because they are for profit. All of the health plans in MN spend at least 85 – 90 cents of every dollar on medical claims.

      Your analogy of a potato chip is not a good one. The 4 major health plans (BCBSM, HealhPartners, Medica, Preferred One) use their market share to obtain deep discounts from health care providers. What kind of discount do you think a Fairview, Allina, Park Nicollet, etc is going to give to a health plan from another state that has no market share?

      Here are some other random things to think about regarding health care.

      1. With the implementation of ‘Obamacare’. 7% of the US still will not have health insurance. Thats one percentage point lower than it is in Minnesota already without health care reform.
      2. In my opinion, the uninsured rate is not 100% due to cost. There are several other factors too 1. They are unaware of public programs available to them. 2. They are too proud to take any sort of government health care and 3. they can afford it, they just don’t want to buy it (we call them ‘the indestructibles)
      3. It is noble to offer insurance coverage to those with pre-existing conditions but it does not come for free. You can expect a 50% – 70% increase in the cost for an individual plan when the become available to everyone.

      • Submitted by Michael Friedman on 09/18/2012 - 10:36 am.

        Negotiations

        Even better discounts can be obtained if the State of Minnesota took over from the four nonprofits. Further reductions would result as well in medical practices not having to hire thousands of coders and hagglers to fight about what gets covered and how to properly present it to a particular company’s satisfaction. Further savings would come from similar negotiations with drug companies, and the elimination of replicative management overhead and the fight for “market share”. All that savings will allow the 7-8% uninsured to have health care like the rest of us.

        • Submitted by T J Simplot on 09/18/2012 - 12:34 pm.

          Ask doctors and other medical professionals how they like the reimbursement rates that the governmnent gives them on Medicare and Medicaid. And, they have no control in negotiating them. There’s a reason why many are choosing not to see new Medicare patients. .

          Guess what, even in a single payor system, claims will still have to be coded. Working for an insurance company I can tell you that the days of fighting to get something covered are long gone. Are there times it’s not perfect, absolutely, but it is not nearly as common as it used to be.

          Plus, if you think that a state run plan isn’t going to set up some sort of payment guidelines and coverage limitations, you will be sadly disappointed.

  4. Submitted by Jackson Cage on 09/17/2012 - 10:30 am.

    Just once….ONCE

    I want Conservatives to explain to me what happens to those people that are seriously ill and have no insurance. Either (a) those people still get treated and someone (i.e. taxpayers) pick up the tab, or (b) we let them die and pile up on the side of the road like raccoons. I just want an answer.

    • Submitted by Dennis Tester on 09/17/2012 - 03:05 pm.

      Medicaid

      or Medicare. Doesn’t mean that everyone should be on Medicaid or Medicare does it?

      • Submitted by Matt Haas on 09/17/2012 - 03:46 pm.

        Except

        The only problem Mr. Tester is of course that your side has designs on eliminating both.
        Since the right is so full of ideas on this issue perhaps you could illuminate the market based approach to a problem where there is zero possibility for profit a la providing healthcare for the destitute.

  5. Submitted by Arito Moerair on 09/17/2012 - 11:18 am.

    Here’s your answer

    Personal responsibility. Also, freedom.

    Don’t ask for specifics. Mitt Romney, more than anyone else, will refuse to provide them. He told Jay Leno back in March that you should get to keep your insurance if you’d been “previously insured.” Leno didn’t press him too much, unfortunately. Who knows what Romney’s position is today?

  6. Submitted by Mark Kulda on 09/17/2012 - 05:00 pm.

    Boyer apparently had never heard of MCHA

    Apparently, neither has the author of the this article.
    Minnesota already has a mechanism to deal with the very situation that Ms. Boyer was in.
    It’s called the Minnesota Comprehensive Health Association and it provides insurance to people with pre-existing conditions. The plan is required to only charge policyholders about 120% of what the private market charges, so the premiums are subsidized. The plan runs a deficit of about $100-million a year or so which is then assessed to the rest of the fully insured market in Minnesota. This means that all Minnesotans who buy such any fully insured policies (not from their self-insured employers) already pool the risk.
    Many other states don’t have such a beneficial program. It’s one reason why Minnesota has one of the highest insured rates in the country.
    But apparently that’s not enough for some people.
    Most states would take our 6% uninsurance rate and call that a big win.
    The fact is this new federal health care program isn’t really going to help very much, but it will cost a LOT. FICA taxes are going up by 14% next year and insurers will start paying a $10-billion new tax next year which will be added to premiums, in addition to the new medical device tax and many others, Americans will finally get a good idea of just how much this plan is going to cost.
    While the new ACA does a fine job tacking the accessability issue, it does absolutely NOTHING to address the affordability issue.
    Insurance isn’t the problem. The very high cost of health care is the problem and people are refusing to accept that.
    People want to have the highest quality health care possible (nothing wrong with that) but they want somebody else to pay for it and in the end that just won’t work. Mark my words.

    • Submitted by Matt Haas on 09/17/2012 - 09:08 pm.

      you are correct

      Its not enough because 120% may be far more than someone can afford. As for 6% thats 6% less than the 100% of people who deserve access to quality care, the cost of which should not drive them into bankruptcy. As for ACA, is it perfect? Not at all, but it is the first step for those of us willing to strive for the perfect system. You don’t think that its attainable, that some folks will inevitably be sacrificed? That’s fine, feel free to stand aside and let those of us who actually have faith that our country’s healthcare system can made affordable and effective for all of our citizens will keep pushing forward without you.
      .

  7. Submitted by Richard Schulze on 09/17/2012 - 07:47 pm.

    Here are the facts: 30 % of Medicare dollars are spent in the last months of life. That amounts to more than $150 billion annually. On top of that, a quarter of Medicare recipients spend more than the total value of all their assets on out-of-pocket health care expenses during the last five years of their lives. Every day in an intensive care unit can cost $10,000. Nearly 1 in 5 Americans spend their last days in an ICU.

    Technology and intensive care treatment have limitations when misapplied. People spend fortunes on the last months of life. The high expectations and demands of grieving family members fuel this process. And because someone else is always paying, it is inevitable that unnecessary tests and procedures and high-intensity services creep into the equation. The system is set up and incentivized to bend to the whim of an unusual family member’s demand to “keep mom alive at all costs,” even if she is 93 and hopelessly ill.

    The way to begin is to initiate a rational national dialogue, as uncomfortable as the conversation may seem to be. But please don’t call it a death panel.

    • Submitted by Thomas Swift on 09/18/2012 - 06:58 am.

      But please don’t call it a death panel.

      For purposes of discussion on Minnpost I think the presently accepted euphemism is “piling ’em up on the roadside”, Richard.

      • Submitted by Pat Berg on 09/18/2012 - 09:35 am.

        Inaccurate comparison (again)

        The “death panel” charge was leveled at the idea of a patient having a discussion with their physician over what end of life choices they might wish to willingly make while they are still of sound mind and body.

        That is not even remotely close to the situation of saying that people who can’t afford healthcare should simply be allowed to get sick and die which is what the “piling ’em up on the roadside” euphimism was made in reference to.

        False equivalencies do nothing to move the discussion forward.

  8. Submitted by Patty Gaetz on 11/03/2012 - 08:38 pm.

    Surviving

    I am 44 years old and was diagnosed with Lupus (SLE) four years ago. The road to my diagnosis was brutal. I started a new job a year and a half ago that is less physical and less stressful – and I love it. But I cannot get the coverage that I need through my new corporate employer so I’m forced to continue working two jobs to keep my BCBS (through my first employer). My health suffers but the alternative is little to no insurance which would eventually lead to unemployment. I learned this week that I do not qualify for life insurance because I have a pre existing condition with a 10 – 15% fatality rate. However, I can purchase burial insurance. That’s optimistic. I work to live and live to work.

    Having a long term disease changes everything – I’m fortunate that I have an amazing team of Doctors and a supportive family.

    This conversation could go on and on discussing preventative care and educating people about healthier choices, but at the end of the day if we don’t have the right people making responsible decisions, then we wil continue to go in circles. This is not an issue that belongs to politicians.
    And it also runs deeper than providing health care for all. It involves making people responsible for their choices, which often comes with sacrifice.
    I don’t have answers but I can tell you that I have a voice of experience and I am an example of why health care is a necessity. I began paying for health insurance when it became available through my employer when I was 22 years old. I’ve never regretted the cost.

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