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Rejected! 71 Percent Face Roadblocks in Individual Health Insurance Market

Rejected! 71 Percent Face Roadblocks in Individual Health Insurance Market

Seventy-one percent of the estimated 26 million people who braved the individual health insurance market in the previous three years found significant roadblocks or were rejected, according to a report by the Commonwealth Fund.

The majority of adults seeking health insurance on the individual market face outright rejection due to pre-existing conditions, pre-existing condition exclusions, or higher premiums and higher deductibles.

Sadly, millions of Americans are delaying or skipping care due to cost.

The State of Health Care in the U.S.

  • 24 percent of working-age adults report they or their spouse lost their job within the past few years
  • 47 percent of those said either they, or their spouse, lost health benefits provided through that job
  • 57 percent of those who lost health benefits along with their job became uninsured. Only one-quarter of those were able to go on their spouse’s insurance or obtain other coverage. Just 14 percent were able to continue coverage through COBRA, a temporary fix at best.
  • There are now 52 million uninsured adults in the U.S.
  • 73 million adults had trouble paying for health care and 75 million put off treatment due to cost

Source: CommonwealthFund.org

The state of health care in America is precarious at best. 

Affordable Care Act

The Affordable Care Act is inadequate, but it is poised to begin moving us toward a more compassionate system, one where Americans lacking employer-provided health insurance are not left out in the cold.

When the full force of the Affordable Care Act goes into effect in 2014, insurers will no longer be able to rescind policies when people get sick, reject people who have a pre-existing condition, or place lifetime limits or restrictive annual limits on care.

Until then, the Pre-Existing Condition Insurance Plan (PCIP) was set up to help Americans with pre-existing conditions who have been denied health coverage or priced out of the individual market. PCIP is far from perfect. There are no bargains in the current high-risk pool, and one must be uninsured for six months to be eligible. Still, it is a lifeline for those who can afford it. (High-Risk Insurance Pool Enrollment Climbing: Are You Eligible?)

It’s time we get our act together.

 

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Image courtesy of PhotoXpress.com


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102 comments

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8:59AM PDT on Mar 31, 2011

Healthcare has become a monopoly just like the drug companies who has the drug you really need to get better. They can get away with the prices as there is no competition and healthcare is not a choice purchase.

1:10AM PDT on Mar 25, 2011

Sad thing is, I had to bring my mother, who is a registered nurse to come with me, just to ensure that I had an advocate for my medical care. Can you believe it? I'm 42, I'm vocal, proactive about my health, and I need my mother to come in with me because my primary NP won't proactively take care of me, unless I bring in someone? SHEESH! It's crazy, and the thing is, this wasn't the first time she ignored me or misdiagnosed something, and she's never done an urine analysis on me. I would have thought that upon finding that the prescribed meds did nothing to help, she should have referred me to the gyno then, rather than have me wait almost 6 weeks in misery...

Then another sad thing, is that why should I have to have a babysitter just to get things done? I'm wondering how many people who don't have someone end up in the E.R. or where ever else because they're not heard in the Dr.'s office.

Then I hear that because I'm on medicaid, that I may be automatically be discriminated against in the health care field. Yet here was the last walk in doctor saying if my numbers were worse, he'd have hospitalized me.

1:03AM PDT on Mar 25, 2011

Oh, and it's just in the health insurance? It's much worse than just insurance. The whole system is fragmented. I've been diabetic for a little over a year now, and instead of my primary physician, I'm seeing his work partner, a nurse practitioner for it. My 3 month average is pretty high, and the last 3 times, it's been that way.

Recently, I had a very severe and chronic infection in the private area, to where a visual said yeast, so she prescribed a pill to take, and the internal pelvic exam came back no to cancer, yeast and bacterial vaginosis. I needed an appointment to get creams, I get sent to another nurse practitioner, who just tells me to get blood work and go back to the other NP. I couldn't stand it, and not even OTC creams were working, so I went to a walk in clinic. They said see an OB/BYN. That wasn't for two more weeks... in the mean time, I go back to my primary NP, she gives me antibiotics, no creams. I finally go to another walk in clinic, a male doctor does a urine test, finds sugars, protein & bacteria in the urine, and then gives me a script for a cream & antibiotics. The internal yeast test was still negative, it's only on the outside, it's the sugars in the urine causing the outer yeast infection. Cream works, I follow up w/ gyn, they back it up and tell me to go back to my Dr, not the NP. This was over the course of 5.5 weeks, that I had to live through this. Finally, today, 2 months later, my NP's being aggressive w/ my diabet

10:13AM PDT on Mar 22, 2011

thx

12:28AM PDT on Mar 20, 2011

Thanks for the article.

3:26PM PDT on Mar 18, 2011

I am Canadian, my family all lives in Canada. I live in the US. The US system simply sucks. No ifs ands or buts. The Canadian system is just fine thank you. There are those who complain about it but they complain about everything. After being here for ten years and paying 1024 $ per month for a plan that has copays, deductibles, and other limits, I will take the Canadian plan any day. I used to get my physical/medical every year. Here, I have not seen the doctor for over three years-can't afford it. Other countries have good plans too, not just Canada. The US has nothing. You can't even see a real doctor is you do go in-you get a wannabe called a 'Doctors Assistant' kinda like you don't get to see the teacher, you get to see the teaching assistant.

Making money off the sick is immoral. Some things should just not be private.

2:50PM PDT on Mar 18, 2011

You don't even have to be sick to get in trouble with insurance. I had an EKG before a minor surgery, and because the technician misplaced the leads, I had several unnecessary tests before the mistake was found. I was still 'on the hook' for all the copays from the unnecessary tests, and I had to get a cardiologist to write to the insurance company when they raised my monthly payments by $200.

8:00AM PDT on Mar 18, 2011

As for the Canadian argument. Doesn't hold water. If Canada has health care issues with their government run system then why do we think we have to follow that model? What about France, Germany, Japan, etc... They all have great healthcare systems. Why does everyone always bring up Canada? Because the the Politicians want you too! Ask your reps. Why America has the highest infant mortality rate and deaths during child-birth in the western world? This is a measure of our healthcare system and we are failing miserably. Don't be fooled by fear mongering special interest groups or right-wing politicians who are out for their own financial gain. Ask your Senator or Congress person what insurance plan they have? Ask them if they are willing to do their part in balancing the budget and take a cut in their healthcare plan and salary. Ask them if they will give up there Cadillac retirement plan that allows them to retire if they want after serving one term in office. I bet they avoid you like the plaque and side skirt your questions? Or ignore you all together. Jane

7:44AM PDT on Mar 18, 2011

We are self-employed and dropped I full coverage health plan when it went up to over $16,000.00 for a family of 4. Now we have a catastrophe care plan that covers nothing but major medical conditions for up to 3 months only. And yet the Republican and Tea Party say our health care system isn't broken. Blue Cross/ Blue Shield CEO's got a multi-million dollars bonus last year. That's just the bonus, they also got a salary. We are hard working, tax paying citizens. It's about time our politicians get their hands out of the pockets of the corporations like the Koch brothers and do right by the middle class. We are the backbone of this country.

12:50AM PDT on Mar 18, 2011

I think we all agree all the road blocks their are for health insurance., How many people can afford it. To much red tape ..

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