START A PETITION 25,136,189 members: the world's largest community for good
START A PETITION
x
1,535,461 people care about Health Policy

3 Danger Zones on the Bridge to Health Care Reform

3 Danger Zones on the Bridge to Health Care Reform

As we attempt to cross the bridge to health care reform, we’ve got to watch our footing.

People with pre-existing conditions were a main focus of the legislation, but millions of us will have to wait until 2014 for even the slightest relief.

High-Risk Pools

For people with pre-existing conditions who have been uninsured or under-insured, the high risk pools have the potential to change everything. Or nothing at all.

The newly created high risk pools will cover primary and special care, hospital care, and prescription medications. You cannot be charged a higher premium because of your medical condition, and eligibility is not based on income. So far, so good.

Premiums will vary from state to state and there will be deductibles and co-pays. Some estimates range from $320 per month to $600 per month. If you can afford that, it’s still great news. The official rates will be available after July 15.

According to the new government website HealthCare.gov, there are three requirements for the high-risk pools:

  • You must be a U.S. citizen or a legal resident.
  • You must have been uninsured for at least the last six months.
  • You must have had a problem getting insurance due to a pre-existing condition.

Did you catch that second requirement? You must have been uninsured for at least the last six months, a huge problem if you have a pre-existing condition and buy your insurance on the individual market. Sure, we knew it was coming, but it hurts anyway.

In order to take advantage of the relative bargain of the new high-risk pools, many people with pre-existing conditions would have to risk economic disaster and potential bankruptcy, not to mention lack of access to health care, by going without insurance for six months.

For the millions of people who will be helped by the new high-risk pools, millions more will continue to be left out because they cannot afford the premiums, or because they are stuck paying ever-increasing premiums in the individual market.

All this will change again in 2014 when insurers can no longer refuse coverage to people with pre-existing conditions.

Disability and the Wait for Medicare

Since a 1972 law extending Medicare to the disabled, there has been a two year wait for enrollment.

Almost two million people living with disability are trying to survive in the zone between qualifying for disability but not for Medicare. Some are uninsured; some are under-insured; putting their health and well-being at serious risk. Government subsidies to help people in this situation will go into effect in 2014.

Availability of Medical Pricing Information

If you have ever tried to get an estimate on a medical procedure, or tried to decipher a hospital bill, you know how difficult it is to prepare for medical expenses.

If you are uninsured, the cards are stacked against you. You will be charged more than an insured person, although you can attempt negotiation. Then again, medical procedures are subject to great variation and the price may be much higher than expected.

Paul Ginsburg of the Center for Studying Health System Change is quoted is Kaiser Health News as saying published hospital charges are “useless for consumers.” One reason is that hospital prices vary with patients’ needs and doctors’ treatment strategies. Patients have little recourse.

The uninsured and people with high-deductible health plans are most vulnerable. If you are doing your best to plan for and pay for your health care, you might wonder where you can get a secret de-coder ring to make sense of it all.

Let’s be careful out there.

Related Reading on Care2:

Read more: , , , , , ,

Photo: http://www.sxc.hu/photo/896851


have you shared this story yet?

some of the best people we know are doing it

32 comments

+ add your own
12:51PM PST on Dec 29, 2010

We'll watch and be careful.

5:35PM PDT on Jul 25, 2010

You think health care is expensive now, wait until it's free.

3:25PM PDT on Jul 11, 2010

Yes and it could have been much better except the political shenanigans were more important to those people we elected to represent us, than trying to make a fair and usable system. The up-coming elections are crucial to all of us if we truly want to see changes.

11:43PM PDT on Jul 6, 2010

EVERYBODY SHOULD AVAIL THE BENEFITS OF PUBLIC HEALTH.

10:03PM PDT on Jul 4, 2010

Thanks

5:29AM PDT on Jul 4, 2010

I think Public health care should be equally avaiable to everyone

8:42AM PDT on Jul 3, 2010

Socialism is such a wonderful thing, but eventually you run out of other people’s money

7:50AM PDT on Jul 3, 2010

Healthcare for is is a challenge that needs to be met. It won't be easy but it can be done.

4:26AM PDT on Jul 3, 2010

thanks for the article.

10:13PM PDT on Jul 2, 2010

Thanks for post.

add your comment



Disclaimer: The views expressed above are solely those of the author and may not reflect those of
Care2, Inc., its employees or advertisers.

Recent Comments from Causes

I've eaten the byproduct of a car accident, so yes.

I'm not sure how many people realise this, but eating food which has been either killed or prepared negatively,…

It's wonderful to see the follow-up pictures and stories of some of the chimps rescued from New Iberia.…

meet our writers

Julie M. Rodriguez Julie M. Rodriguez is an arts, green living, and political writer based in San Mateo, CA. Her work... more
Story idea? Want to blog? Contact the editors!
ads keep care2 free



Select names from your address book   |   Help
   

We hate spam. We do not sell or share the email addresses you provide.