Thursday, September 23, 2010


a less impressive truth

On September 23, 2010, the first provisions of the new health care legislation go into effect. Or do they???

The provisions are:
(1) Dependent children must be eligible for coverage under a parent's insurance until age 26.
(2) Coverage for an illness can no longer be denied if it is related to a "preexisting condition".
(3) Coverage cannot be denied by insurers if they find, after the fact, errors on an insurance application.
(4) Preventative care must be paid for without charge or deductible.
(5) Coverage decisions can be appealed either through the insurer or through and independent source.
(6) Insurance costs will be regulated.
(7) Insurers can no longer impose annual or lifetime limits on payments.

These are important and reasonable. They actually seem straight forward, but in no way revolutionary. They are adequately called reform, in that they are ethical and appropriate.

But they are very misleading and far from equitable in their application.

(1) The dependent children must not be eligible under any other coverage. The parent's coverage must be through an employer with at least fifty employees. The coverage cannot start until the next enrollment period, probably in three months.
(2) The preexisting condition coverage only applies to newly issued insurance. Insurance already in effect is exempt. This improvement only applies to children. For adults, all insurance can exclude preexisting conditions until 2018, eight years hence.
(3) Insurance currently in effect is exempted from the after-the-fact exclusion proviso
(4) Preventative care is mandated only for newly issued insurance: insurance already in effect is excluded
(5) For insurance already in effect, only the insurer is the arbiter of appeals
(6) There is no regulation for the cost of insurance already in effect.
(7) The lifetime and annual limit elimination only applies to NEW insurance. Insurance currently in effect is still allowed to limit the payments. Even for NEW insurance, the annual limits will continue to be restricted for the next four years, as the limits are raised, only to be eliminated in 2014. Furthermore, the limits will have limits on what procedures and diagnoses will be allowed… and those are not specified.

In effect, if you are already insured, you are screwed.

It is not very impressive if the truth is told.


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