Monday, September 27, 2010

Pre-Existing Condition Insurance Plan — Out of Reach

Pre-Existing Condition Insurance Plan — Out of Reach
By: Niland
Friday September 17, 2010

I don’t think the site has addressed this in a while, but the new Preexisting Condition Insurance Plan has been rolled out across the country now, and the more I look into it, the more I think this is emblematic of everything that was wrong with Obama’s health care reform bill. Remember, this is the temporary high risk pool to act as a holdover until the exchanges kick in in 2014. I had high hopes for this, as my Mother is a 61 year old widow who has low income but is too young for Medicare and who we (my brother and I) have been paying $1,000+/mo for Anthem Blue Cross individual market insurance for the last three years to keep her insured. I thought the new high risk plan was going to be standardized with a 4-1 age ratio and also “affordable” for people who cannot get affordable coverage in the individual market. I looked up the rates for California where she lives, and her premium will be $799/mo with no subsidy under the new plan . Meanwhile, the premium for a child under 15 is $142/mo…how is that 4-1? How is that even remotely affordable?

Instead of imposing a unified structure with standardized rates, the bill gave extreme leeway for each State to set up its own program using private contractors guided only by very loose language regarding premiums and coverage structure. This has resulted in some states charging $600/mo for 60+ and areas of California charging $800 or more.

I’m so dejected at this point. I had such high hopes for this program and I feel like I’ve been kicked in the stomach. I cheered this bill, telling my brother, “help is on the way,” and soon we will be able to get coverage at a more reasonable rate compared to the way Anthem was ripping us off. We just can’t afford to pay $800+ per month in health insurance when we are already completely financially supporting our Mother. You mean to tell me that all this bill is going to save us for the next 4 years is 200 bucks a month? That we still have to pay 800/mo not including cost sharing? My Mom doesn’t even have a super-serious preexisting condition – she doesn’t have cancer, hasn’t had any debilitating illnesses. She is a smoker who gets episodic panic attacks.

I know there are lots of horror stories worse than this, but this type of disappointment is going to keep happening as each new element of this bill is rolled out. When 2014 hits and the means-tested subsidized rates are still going to be unaffordable for anyone but the poorest of the poor, the bill’s popularity will continue to tank.

And they wonder why there is an enthusiasm gap!

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