I SO glad we got the health insurance bill through Congress!

[laconicsax]

I'm finally able to afford health insurance, so I applied. Now thanks to the FANTASTIC bill we got, I was able to get a letter stating that I've been denied for a pre-existing condition!!! Not only that, but because of administrative crap and red-tape, I didn't get the letter until after the deadline to appeal the decision.

:woohoo: Hope and Change FTW!!! :woohoo:

:applause::applause::applause::applause::applause::applause::applause::applause::applause:
:party::party::party::party::party::party::party::party::party::party:

edit: typo

[Hawkeye-X]

1. Get a lawyer, if you can...

That insurance crap has gone too far. It's time to sue the fuck out of them.

[BlueCheese]

7. Wait.

Are they doing something illegal? I thought the pre-existing conditions (for adults) part doesn't kick in until 2014.

[laconicsax]

13. It doesn't. n/t

[Name removed]

51. Deleted message

Message removed by moderator. Click here to review the message board rules.

[neitherherenortheirs]

43. haha right..

if he couldn't afford health insurance until now, and they screwed him over using loopholes, what makes you think he'd have the money to challenge it with a lawyer? and lawyers don't take that kind of stuff up pro-bono. they would make their own friends angry. They'd rather just keep casting out the Mesothelioma net.

[truedelphi]

50. Hi there. Welcome to DU.

And stay healthy until 2014 now, okay! (At least that is my insurance plan for now.

[kenny blankenship]

2. But you were saved from the horrors of Socialized Medicine

So there's that. Live free and prosper, O Pioneer!

[tridim]

3. Your insurance company is breaking the law. Sue them. nt

[Cleita]

4. Send this to your Congressperson and Senators.

If they don't know how their constituents are being screwed, they are going to think they did all right.

[Ruby the Liberal]

5. I second this. Let your critters know.

You also might want to call the Consumer News department of your local news. They eat this kind of thing up.

[Hawkeye-X]

10. Thirded.

Fax 'em! Tell them it is a CRISIS for you.

[laconicsax]

16. Done and done.

[johnnie]

6. That doesn't go into effect until 2014

Unless you are under 19.

[Skittles]

8. WHY?

WHY does it not go into effect until 2014? WTF.

[laconicsax]

14. Because it was more politically expedient than fighting. n/t

[Skittles]

23. LOLOL

riiiiiiiiiiiiiight

[laconicsax]

12. So I'm on the Republican plan for another three years and that's the best I can hope for?

1.Don't get sick.
2. If you get sick, die quickly.

Sorry, I've been on this plan for long enough.

[frazzled]

9. Try waiting until the law goes into effect

Your story is exactly why we needed the Affordable Care Act. Unfortunately, the provision that prevents denial of coverage based on pre-existing conditions is not yet in effect for you (only for children right now).

[laconicsax]

15. Good idea! I'll just wait another three years to get coverage!

I'd say something impolite to you right now, but that's against the rules so I won't.

[frazzled]

20. I expressed regret that you can not do this now in my post

But that doesn't make the bill bad--just slow in getting all the provisions implemented. The OP implied that the bill was worthless. We have been trying to point out that it is not the bill but the schedule for its implementation.

What is totally useless is the current system, which would deny coverage to people like you.

In the meantime, if you are a high-risk person, you can perhaps contact your state. The insurance pools for uninsurable people are part of the new law and have been put in place as a stop-gap until the full law is implemented.

[laconicsax]

22. For otherwise healthy adults with pre-existing conditions, the bill is worthless.

I can't afford the pre-existing coverage plan offered by Oregon, so all I can do is re-apply and hope to get the denial letter in time to appeal. I also get to hope that the Republican plan works well enough in the mean time.

[frazzled]

34. I know so many people this has happened to

All over the age of fifty, all healthy except for the minor things that virtually everyone gets as they age: denied coverage because of things like moderately elevated blood pressure, a bone density test that came back showing beginning of osteoporosis, or on cholesterol meds. One friend was given the reason for being denied because she had injured her finger several months earlier! The real reason is: you're over fifty and we don't want to insure you.

It's why I thought (and still believe) this bill is so important, no matter what else. I know where you are right now--it's where so many people have been for the last 8 or 10 years who have to get into the private insurance market. It sucks. And yes, it sucks that the provisions that would guarantee you insurance, and even a subsidy if you are middle class or below economically, are being phased in so slowly. It's going to be a rough few years for you, and I hope you stay healthy.

One last possible piece of interim advice. When this happened to my brother-in-law and sister, it was because he'd been laid off and his COBRA finally ran out. They were denied coverage from the same company that had been covering them under COBRA. I helped them find the law (I forget the name now) that REQUIRES them to take you if you've been covered with them before. The trick was, you had to apply under a different format, with a special application related to this law. If this is your situation, let me know, and I'll try to find that provision again. It worked for my relatives, once they reapplied.

[laconicsax]

35. Thanks for the advice, but it isn't applicable in my case. n/t

[MannyGoldstein]

11. Why do you want the Palin in 2012?

Barack Obama is the strongest, most progressive president ever.

[laconicsax]

17. I guess I never really loved him in the first place. n/t

[jaxx]

18. That's right Manny.

I'm glad you've seen the light. Because without this most progressive President ever 2014 would be just another year to come.

[laconicsax]

21. 2014 should be just another year to come.

Setting the timeline for the Affordale Care Act so that it isn't fully implemented for four years after being signed into law was ridiculously stupid.

Why on Earth have a central piece of legislation for your (Obama's) agenda be reliant on both him winning a second term and the Dems controlling Congress through two elections?

[jaxx]

24. Because it takes time to get it all set up and the ins co crybabies

got it in the bill. It might seem ridiculously stupid, but it was the only way to get it done...and getting it done was important to us all.


This link will show you what comes into effect each year:

http://www.healthcare.gov/law/timeline/index.html

[TBF]

28. "Getting it done" is not worth it if there is no relief -

you mean "getting it done" so it looks nice on the campaign marketing literature.

[LooseWilly]

53. Yes, "getting it done" is just a campaign marketing literature trinket.

If it meant more than that, the contents might have to correspond in some way to the campaign promises. Since that obviously hasn't been the case, with most Obama White House ideational legislation...which hasn't demonstrated the least concern with those caught in cross-fires.

Do you feel warm and/or fuzzy inside yet?

[TBF]

56. Net Neutrality is next - does this guy ever sleep?

I will say this man sure knows how to get stuff done - if only he were working on our side.

[laconicsax]

49. Really? The only way to get it done?

There's no way for a law prohibiting specific business practices to take effect in less than four years?

[MannyGoldstein]

26. Maybe waiting until 2014 was the best for Obama's re-election prospects

Only the lobbyists really know what will happen when the law kicks in. There's all kinds of mines and booby traps in the 2,500+ pages.

[Hoyt]

31. And those 2500 pages included a lot of good too.

Could it have been better, yes. But to get nothing would have meant 20 more years of the same crap or worse.

I'm really sorry for the OP's situation, but it won't happen after 2013 (well, unless our beaching coupled with the Republicons' result in overturning what was passed).

[MannyGoldstein]

32. We really don't know until it takes effect

Remember the claim that children could no longer be denied coverage for pre existing conditions? Then it turned out that there was no cap on premiums, so insurers can just charge so much that children with pre existing conditions actually can't get insurance.

I have little doubt that this bill contains anything other than 2500 pages of this kind of marvelous stuff.

[Hoyt]

37. That's right, we don't know -- therefore, it might be better than you recognize.

There is a limit on the premium insurers can charge children with pre-existing conditions, read the bill. Maybe it will be difficult to afford for some (probably many), but everyone has a chance to get it at an affordable rate compared to flat denials of any coverage and parents paying for everything out-of-pocket until they are destitute and can qualify for Medicaid.

It's not perfect, but it gets better -- My understanding is that in 2014 there will be no differential in premiums for pre-existing conditions for adults or children. That is a major achievement. As is the Medical Loss Ratio requirements in 2014 and the exchanges which will help control premiums. I'm basically a pessimist, but this is much better than what we've had. Even if we had the preferable single payer system, it would not be free. Health coverage would still be painful to afford for most of us.

[laconicsax]

39. It's beyond "not perfect."

There's no mechanism in place to prevent insurers from simply raising everyone's premiums continually between now and eternity to compensate for having to accept everyone.

[Hoyt]

44. Apparently, you have not read about the Medical Loss Ratio and Exhanges.

If you would do that, you'd see there are mechanisms to control rates. But, until we are ready to make some really tough choices, health care will always be costly. Single payer -- which has always been my preference -- wouldn't make much difference in premium cost either (a one shot 20% at best, which would still be unaffordable for many).

As long as we strive to pay for everything, right up until our (including my) last breath, and have the ultimate in technology (no matter how little the improvement or how much the cost) it is always going to be more expensive than some (perhaps most) can afford. You think folks are ready for that?

[TheKentuckian]

46. I don't get why folks think the MLR is cost containment.

1. It is set where the industry supposedly is anyway.

2. It is a natural disincentive to contain cost, the goal is just to get as many dollars as possible pass through the system. You think providers have a big issue with charging more?

How are these small state regulated pools on available to a small portion of the population going to control systemic cost? They will limit premiums until you bust the bank and get an exemption from the mandate because the subsidy cannot keep up.

We're simply doing some marginal tweaks to the existing system that are carefully crafted as not to burden the bottom line of the insurance cartel and pharma.

[laconicsax]

47. +1

[Hoyt]

55. And that is where the Exchanges come in.

In most areas, there are hundreds of health insurance companies. Do you think maybe one, or two, or three, or many more will realize that when they are listed on the Exchanges next to all the other insurers that qualify a few will want their premiums to be the most affordable. If people flat cannot afford an insurance company's premiums, people will leave for a more affordable premium. And guess what, with no pre-existing condition exclusions, we can move to another insurer almost any time. That will put significant downward pressure on premiums.

Personally, I would like a public option to add more pressure. And, I think we'll end up with a public option sooner than most of us think. Heck, even the so-called Catfood Commission recommended it.

But, even with a single payer system, health insurance costs are not going to be cheap unless we make some tough choices. Choices that I don't think most of us are ready to make -- but will have to at some point.

[TheKentuckian]

65. The exchanges are state regulated (aka probably captured) and accessible to a tiny portion of the

population.

How are these things going to apply pressure to a predatory cartel?

If the industry walks lockstep then you have zero hand. All you can do is boot offenders, if they decide to all offend we are sitting there with out pants around our ankles and sucking our thumbs.

[Hoyt]

66. The entire "industry" won't walk lockstep, or pigeon-toed, for long.

There will be plans designed to capture those who can't afford the higher cost plans.

Again, it doesn't matter if it is Medicare for all -- it will still be more than any of us "want" to pay until we start making tough decisions.

[TheKentuckian]

68. Why wouldn't they, at least until they break the exchange's stick?

It isn't like they don't set territories, rates, and even coverage, policy and procedure.

The cartel is already very cooperative and there is nothing acting as gravity to hold them in line.

If the industry is out of compliance for the exchanges then there will be no alternative but to grant waivers and "compromise" in some fashion.

[TBF]

57. He doesn't wait until 2014 when it's important to rich folks -

continued tax breaks immediate, payroll tax holiday starts in 2 weeks, net neutrality - gonna get that one done today.

[salinen]

19. But he plays basketball!

you fool.

[Kennah]

25. The Fat Lady Ain't Yet Sung

This ain't over by a longshot. SCOTUS might toss the whole thing, and as in the case of Citizens United, who knows. The fuckers might ask the plaintiff to refile so the high court can rule allowing pre-existing conditions is welfare, like the Drugster has asserted.

We could yet be screwed over royally, more. That might lead to a populist backlash which hands Obama re-election in 2012 and a progressive majority in the House and 60+ real Democratic votes in the Senate. Or we might go further down the Third World America path.

Lots of possibilities.

[Motown_Johnny]

27. well, if we had got it done back when Clinton tried you would be ok now

and people who apply 5 years from now will be ok too


but until 2014 you are screwed


I sincerely hope your condition is not serious and that 2014 will be soon enough to help.

[TBF]

29. That would be funny if people were not dying out there. Well, just wait until 2092,

then it will be all better ...

[laconicsax]

42. If I'm hospitalized or die before 2014, it won't be for the pre-existing that got me denied. n/t

[Juche]

30. You can apply for a pre-existing plan

Depending on your age, they range from about $200-800/month. So pretty effing steep. They should've passed some kind of tax credit for insurance along with the pre-existing plan.

On the subject of health reform, I was googling it to see if there were any tax credits and I was reminded that the medicare tax was hiked on the wealthy. However I think (not sure) that the tax credit only applies to businesses, not individuals.

http://taxes.about.com/b/2010/03/30/tax-provisions-in-the-health-care-reform-law.htm

There's an increase in the Medicare tax for high income earners. Currently the Medicare tax rate is a flat 2.9% on all wage income, with both the employer and the employee paying exactly one-half of this amount. Starting in 2013, the flat 2.9% Medicare tax will continue to apply to wages under $200,000 (or under $250,000 for married couples filing a joint return). There will be an additional 0.9% Medicare tax on wages over $200,000 ($250,000 for joint filers). This additional tax is to be withheld from wages, or if not withheld, it is to be paid directly by the employee. This additional Medicare tax also effects self-employed persons paying the self-employment tax.

Additional Medicare tax on investment income. HR 4872 modifies the health care act to impose the expanded 3.8% Medicare tax on investment income for people with income over $200,000 (or $250,000 for joint filers). Investment income for the purposes of the Medicare tax base would include interest, dividends, royalties, rent, passive activity income (such as income passed-through from partnerships and S-corporations), and gain from the sale of property. This additional Medicare tax is technically called the unearned income Medicare contribution tax.







So it was an imperfect bill. But wealthy people who used to pay 0% in medicare taxes on dividends, interest, royalties, etc. are now paying 3.8% medicare taxes on them. It sounds like a small number, but a jump from a 0% to 3.8% tax on gross income isn't something to sneeze at.

[laconicsax]

41. Yeah, I already looked into that and can't afford it.

As it stands my best bet is to re-apply, and hope I get denied before the appeal deadline so I can appeal with an explanation of why my pre-existing condition won't cost the insurer too much.

[Warren DeMontague]

33. And we would be better if the bill hadn't passed?

Denial for pre-existing conditions is one area where we won. If they're still doing it, they can't do it much longer.

[laconicsax]

38. I wouldn't say we won.

It doesn't go into effect for another three years and in the mean time, premiums will continue to rise and probably rise a whole hell of a lot in advance of insurers being forced to accept expensive cases.

Plus, there's no guarantee that that, or any other portion of the bill won't be repealed by a Republican-controlled Congress/White House before 1/1/14 and there's no guarantee that an insurer won't be able to challenge that part of the law in court and win. It's really easy to see the Supreme Court (or even a circuit court) deciding that a private corporation has the right to refuse service to whomever it wants for whatever reason it wants.

[Warren DeMontague]

45. I'm just not sure how it could possibly have been better to have done nothing.

I would have preferred a SPHC, and certainly at the very least the robust public option we were promised. But at least this is an attempt to right some of the most egregious wrongs in the situation.

[laconicsax]

48. I never said it would have been better to do nothing. n/t

[Hoyt]

67. Couple the displeasure of the Dems and callousness of the right, and it will be repealed or worse.

The displeasure is understandable. But it's too late to make the legislation much better, especially if the Rethugs think they can leverage Democrats' displeasure with their don't give a crap attitude.

[Dappleganger]

36. Oh, you people and your pet issues!

:sarcasm: :sarcasm: :sarcasm:

Now be a good little Dem and go back under the bus with the rest of the gang.

[Name removed]

40. Deleted message

Message removed by moderator. Click here to review the message board rules.

[earth mom]

52. Sorry to hear this...

and sorry that I unrecced the thread because I had a knee jerk reaction when I read the title of the thread. :hide:

[Name removed]

54. Deleted message

Message removed by moderator. Click here to review the message board rules.

[TBF]

58. How come tax relief and payroll "holidays" for the wealthy are immediate,

but health care for normal folks takes "5 years" to implement?

:eyes:

[laconicsax]

63. Because all legislation takes 5 years to take effect.

Didn't you know? Saying otherwise might make you a freeper.

:sarcasm:

[laconicsax]

62. You are factually incorrect.

Bills take effect immediately or at the beginning of the following year all the time.

Your post implies that your denial was due to the new bill.

My post implies nothing of the sort. It's because the bill we got is a watered-down piece of shit that I have to wait three more years before I can have the honor of buying insurance from an insurance company. That is preferable to the alternative of being out of luck entirely, but that's no different from saying that you'd rather be tortured for the next 3 years than indefinitely.

[TZ]

59. So I guess it would have been

Okay for me to be screwed over by no reform right? If one person suffers we should all suffer? Btw you cannot fucking lay clearly illegal behavior on HCR. You should be fucking attacking your HR department- I suspect they are responsible for this idiocy but obviously it's all Obamas fault and we should never ever try to pass HCR unless it's absolutely perfect right? Oy. I understand your frustration but HCR isn't some kind of magic bill that makes all idiocy disappear.

[SoCalDem]

60. and from here on in, you will have to report it when and if you apply elsewhere

There will no doubt, be a question that says:
"Have you ever been denied coverage"? a truthful answer will eliminate you as a potential customer..and a lie will invalidate coverage, should they "give" it to you, and you ever file a pricey claim that they choose to investigate..

[laconicsax]

61. Yep. n/t

[autorank]

64. I'm thrilled too. My self insured family rate doubled!

That's democracy for you, isn't it. There's a lot in the health bill for insurers and some for public health, but over all it's a giant POS and a fraud on the country. Shame is appropriate but the perpetrators are incapable of that emotion.