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still_one Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 09:04 AM
Original message
pre-existing condition? all you need to do is wait 6 months n pay through your nose to get coverage
http://rawstory.com/rs/2010/0630/coverage-uninsured-peo... /


"To qualify for the temporary program, a person must have a pre-existing medical condition and must have been uninsured for six months or longer. The main beneficiaries are likely to be the self-employed and their families, and those who work for small employers that don't provide coverage. Only U.S. citizens and legal residents qualify."

Let's see them put lipstick on this pig and tell us what a wonderful deal this is

Another disappointment


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Swamp Rat Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 09:06 AM
Response to Original message
1. I haven't had healthcare for 10 years
BP is probably going to finish me off.



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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 11:18 AM
Response to Reply #1
20. Maybe Sebelius will offer Medicare to people affected by the BP gusher ...
there could be a provision in the new HC bill that might allow this to happen.

:shrug:

http://fdlaction.firedoglake.com/2010/06/29/high-risk-p... /

"...Sen. Max Baucus (D-MT) made sure to include a provision in the law to expand Medicare to the victims of asbestos contamination in Libbyin his home state. I can happily report that less than two months after the President signed the new law, people in Libby were getting their Medicare cards. Too bad Baucus doesnt use his powerful Finance chairmanship to make sure millions of other Americans in need also get help so quickly..."


And this from he comments section, comment #2 ...

"I can happily report that less than two months after the President signed the new law, people in Libby were getting their Medicare cards. Too bad Baucus doesnt use his powerful Finance chairmanship to make sure millions of other Americans in need also get help so quickly.

Well played sir. No one can deny the folks of Libby Montana deserve medical coverage despite their pre-existing conditions, but that section of the bill should be amended to offer Medicare coverage to every American with a pre-existing condition (or better yet, every American full stop).

I just looked up the bill section SEC. 10323. MEDICARE COVERAGE FOR INDIVIDUALS EXPOSED TO ENVIRONMENTAL HEALTH HAZARDS man every bill should have this clause, sure to drive the CBO bonkers
8) WAIVER OF BUDGET NEUTRALITY.The Secretary shall not require that pilot programs under this subsection be budget neutral with respect to expenditures under this title.

Since were likely to see people get sick or have their health threatened by the BP oil spill, I would take note that the Secretary is given discretionary deeming authority to enroll victims of other environmental health emergencies into Medicare. Whether its asthmatics who takes ill from crude oil fumes or if were faced with a Katrina-style masss evacuation, Sebelius has the authority to create optional pilot programs with coverage eligibility starting the date of such deeming and is given broad waiver powers so premiums and other paperwork shouldnt hold anyone up. If the Administration can be bothered to act, it will be interesting to see how AHIP lobbies against it."



Here is one article with a few details on the Libby/W.R. Grace site, if Medicare can pay for Grace victims, then it can also pay for people whose health is affected by BP.


Libby Asbestos Superfund Site: W.R. Grace Acquitted
Posted by Trish Riley, May 22, 2009

http://www.gogreennation.org/2009/05/libby-asbestos-sup... /

A collective stunned silence hit the state of Montana at lunch time on Friday, May 8, as news filtered out from U.S. District Judge Donald Molloys Missoula courtroom that W.R. Grace & Co. and three of its former executives had been acquitted of all crimes in connection with the asbestos poisoning of Libby, Montana.

More than 270 people from Libby lie in their graves due to asbestos from the mine, and another 1,800 (from a community of about 12,000) walk around with the likely death sentence of an asbestos-related diagnosis..."






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walldude Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 11:25 AM
Response to Reply #1
23. Me neither brother...
Edited on Wed Jun-30-10 11:26 AM by walldude
and I don't see being able to afford it anytime soon... I guess I should take solace in the fact that BP isn't drowning my state in oil..
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Donnachaidh Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 09:09 AM
Response to Original message
2. but but but -- it's *historical*!!!!!!!!
from the piece:

"But here's the catch: Premiums will be a stretch for many, even after government subsidies to bring rates close to what healthier groups of people are charged.

And $5 billion that Congress allocated to the program through 2013 could run out well before that."

The Insurance Company Profits Before People Plan. They'd better hurry up with those debtor's prisons -- perhaps THEN those with pre-existing conditions will get appropriate care. :sarcasm:
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riderinthestorm Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 10:08 AM
Response to Reply #2
13. I actually wouldn't mind paying my fair share for universal health care
Those countries that offer it have substantial taxes to pay for their citizens' health care. At least though, everyone pays according to their ability and income level. The way we do it, it's not equitable at all. Typically those who can least afford it, pay the most.

$5 billion is a drop in the bucket to insure the 47 million without coverage for the next 4 years. If/when my husband needs treatment again, it will probably cost close to a $1 million. He's just one guy with cancer. When you think of the folks who actually are going to be flooding the application desk on July 1 when this opens up, and THEIR health needs and COSTS, it's not hard to imagine that this is going to troubled from the very start.
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still_one Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 11:33 AM
Response to Reply #13
26. I suspect you are correct, most people would not mind paying for universal health care /nt
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Ozymanithrax Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 09:09 AM
Response to Original message
3. Yes, it is much better to do without forever...or until people with pre-existing conditions die. n/t
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still_one Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 09:18 AM
Response to Reply #3
5. Your statement is very close to reality /nt
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Ozymanithrax Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 10:02 AM
Response to Reply #5
11. I forgot the sarcasm icon. So you are saying it is preferable to do without forever...
Edited on Wed Jun-30-10 10:03 AM by Ozymanithrax
Because that is not the reality, and not what I asked.

I don't think the compromise to get people some kind of insurace was the best thing we could have done. It should have started immmediatly. But, realities of politics made an immediate start impossible. No bill and no coverage is not better than what was passed, at least in my opinion.
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still_one Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 11:15 AM
Response to Reply #11
19. Not at all, what I meant is that your statement is closer to reality than it
Edited on Wed Jun-30-10 11:34 AM by still_one
should be

I am definitely not saying that is the way it should be

By using a six month waiting period what they are effectively doing is blocking those who need access to it now

It is an immoral and unethical implementation of an already very compromised healthcare plan

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Gormy Cuss Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 01:06 PM
Response to Reply #3
31. Yes, it's much better to focus just on those who can be helped and ignore those who can't
with the latter group including those with less than a six month break in insurance and those who can't afford the rates. Why would anyone want to bring up those losers?
:sarcasm:


Other than placating insurance companies, what would be a practical reason for leaving people vulnerable for six months?
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DrDan Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 09:10 AM
Response to Original message
4. looks like a good time to consider a purchase of health insurer stock
bound to significantly increase their profits
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City Lights Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 09:24 AM
Response to Original message
6. Does anyone know what happens to insured people with a rider
for a pre-existing condition? My daughter has a rider for anything asthma related, which, of course, is the thing she needs most often from her health care. We opted for the rider rather than let her go without insurance. Is she out of luck?
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TZ Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 10:14 AM
Response to Reply #6
15. As long as she has current coverage
She won't be affected by this bullshit statement. This "loophole" actually won't apply to many people: You will have to be diagnosed with a new condition and NOT have any type of insurance coverage at the time for this to actually be a problem. The scenario the OP posts about is actually VERY uncommon. Signed, chronically ill and covered person.
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City Lights Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 10:32 AM
Response to Reply #15
17. So as long as she's insured for *something* she's out of luck.
Anything related to asthma/sinus/allergies is an out-of-pocket cost for us.
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BzaDem Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 09:27 AM
Response to Original message
7. Yeah, because it's of course better to wait forever or pay MUCH MORE than the high risk pool
let alone MUCH MORE than one would pay in 2014 when discrimination on pre-existing conditions is banned. We should therefore repeal HCR and restore the pre-HCR status quo.

:sarcasm:
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cliffordu Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 09:32 AM
Response to Reply #7
9. I completely agree with this.
:sarcasm:
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TZ Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 10:16 AM
Response to Reply #9
16. Thanks for telling me how much HCR helping me
matters to you.. :sarcasm: Oh NOES someone who actually benefits from HCR, I needs to be told to SIT DOWN AND SHUT UP!!!
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BzaDem Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 11:39 AM
Response to Reply #16
27. .
Edited on Wed Jun-30-10 11:40 AM by BzaDem
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cliffordu Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-01-10 04:28 AM
Response to Reply #16
37. I fucked up reading what you wrote. I am sorry -
I meant the complete opposite. I DO agree with you completely.

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EFerrari Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-01-10 04:40 AM
Response to Reply #7
38. Some of us will be able to afford to pay the fine and that's it.
At least it won't be the status quo! :sarcasm:
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 09:31 AM
Response to Original message
8. It's even worse. You have to have been declined for coverage and then be uninsured for six months
It doesn't matter if you were offered coverage at a completely outrageous price, you were still offered coverage and that alone will eliminate you from the high risk pool. But, on the bright side, it's pretty much a sham anyway, since it was never funded adequately.

This is another smoke and mirrors thing. They passed something they could tout as a high risk pool that covered the uninsured with pre-existing conditions, but in reality it is structured to cover the least amount of people in this category they possibly can.

Telling ill people to go without coverage for six months is tantamount to telling them to forego treatment and get sicker and/or bankrupt before they are able to enroll. It's just "sensible" legislation, that's all.

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Robb Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 10:06 AM
Response to Reply #8
12. As the details of this new proposal aren't available until later this week, you're quite informed.
Do go on.
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still_one Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 11:30 AM
Response to Reply #12
25. So you are saying the Raw Story report is not valid? /nt
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 12:55 PM
Response to Reply #12
29. Yes, I do make an effort at staying informed.
Edited on Wed Jun-30-10 01:06 PM by Phoebe Loosinhouse
I have followed the entire HCR VERY closely, it's been "my" issue for years. Additionally, I have family members who are hanging on by a thread to find out if they will qualify

While I did believe based on previous reading that a denial of coverage would be required throughout the entire pool, it now appears that is not the case in all states.

But, if you read this link to a Flordia newspaper from 2 days ago, they certainly seem to be implying that you need a denial
http://www.news-press.com/apps/pbcs.dll/article?AID=201...

"Beginning Thursday, Floridians will be able to apply online for coverage that would begin Aug. 1.

Applicants should keep copies of denial letters from private insurance providers. Those without such denial letters should apply for insurance so they can obtain one."
********************************************************

Here is a great site for those who care deeply and personally about what is going on with the National High Risk Pools

http://www.ncsl.org/?tabid=14329#Submitted_2010

The description of the California law passed makes it sound like a denial is necessary. The legislation being considered in Illinois says: "Would provide health coverage for high-risk people denied insurance"

edit to correct link
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Robb Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 12:59 PM
Response to Reply #29
30. You understand, this Rawstory article is about a new federal program?
...Not a state program?
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Phoebe Loosinhouse Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 01:08 PM
Response to Reply #30
32. Did you bother to open either link? Clearly not.
The word "federal" appears prominently in both titles.
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Robb Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 01:13 PM
Response to Reply #32
33. Considering your links didn't work until you edited them, you're being a touch rude.
Unsurprising. Given the choices you offer, I pick the highway.
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riderinthestorm Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 01:55 PM
Response to Reply #30
34. In states that already have high risk pools, there's been talk of just merging them
with the fed. Each state is working it out.

I've stated in other posts that Illinois hasn't yet worked it out yet, whether one has to have a denial and been uninsured for 6 months before they can apply (which is what is required in IL now), or whether you just have to be uninsured (which seems to be implied in the new law).

I was on the phone with my congressman's office just last week and they still didn't have an answer.
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riderinthestorm Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 09:56 AM
Response to Original message
10. The left needs to come up with some kind of catchy phrase for that six month wait
Like "the death donut hole".

The gap is inexcusable. Why have such a thing? For some it just means that they will die during that wait with no-coverage, more than a few will go bankrupt paying for their healthcare at retail prices, and many more will get exponentially sicker while they put off treatment until they can get coverage.

It's pretty crappy and actually needs some kind of terrible name akin to "death panels" which was devastatingly effective imho. Wrong, but effective. At least with this six month gap, it actually IS truthful to call it the "death donut" or _________ (insert your favorite phrase here).
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TZ Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 10:12 AM
Response to Original message
14. Bullshit. IT DOES HELP ME.
IT ALSO DOESN'T ALLOW YOUR CURRENT INSURER TO DROP YOU WHEN YOU ARE DX'd -OR IF YOU LOSE YOUR JOB AND START A NEW ONE.
Frankly I'm tired of the bullshit that HCR will not help people (LIKE ME) with pre-existing conditions. It already has! I won't have to go through the bullshit I went through when I changed jobs a couple of years ago--A DU'er actually helped me pay for some expensive meds. But the new laws MAKE IT IMPOSSIBLE for the insurance companies to play that game again.
I'm so tired of people who don't have a clue what we, as chronically ill people deal with...My meds cost $2,500 a month. I pay maybe $150 per month with insurance. They HAVE to pay for the meds and thanks to the HCR, I don't have to worry about them dropping me like a hot potato if I change jobs... :grr:
I must not be a true progressive though right? :banghead:
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daa Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 10:42 AM
Response to Reply #14
18. Excuse me??
Good for you, but most of us in our 50s LOSE our job and have to pay 2500 a month for diabetic medicines and HCR does nothing. If you think that paying 3 times the rate and being in a high risk pool is a win for dems good for you. I am glad you changed jobs "a couple years ago". Today the onloy jobs are part time with no benefits and HCR is a bust.

I suppose you think the dems caving on finance reform is another win?

The only bad think about dems losing power in November is that John Boehner will be a couple heartbeats from the presidency.

Think about HCR, why do people hate it? It isn't universal and it doesn't control costs. It was another big business win and a loss for the little guy.
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still_one Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 11:24 AM
Response to Reply #18
22. Even before the HCR if you lost your job you could get COBRA as long as you could
afford the premiums, but after COBRA is up, based on the Raw Story article, you would still have to wait 6 months before you qualified for insurance with a pre-existing condition

I have to wonder who are they really trying to help with this caveat

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BzaDem Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 11:45 AM
Response to Reply #18
28. You are excused (for having no idea what is in HCR).
Edited on Wed Jun-30-10 11:46 AM by BzaDem
In 2014, your health insurance will not cost one penny more than a similarly-situated person who is healthy and does not need diabetic medicines.

Yes, older people have to pay up to 3 times as much as younger people. Prior to the bill, they would often have to pay 10+ times as much as younger people.

The entire POINT of the bill is to provide help to people who are unemployed or have jobs WITHOUT BENEFITS.

The idea that people hate HCR and think it shouldn't have been passed because it ONLY helps 30 million people as opposed to 50 million people is bonkers. To the extent that anyone believes this nonsense, they are wrong (though I think this view is quite limited, given that 85%+ of Democrats approve of the bill).

I suppose you think that increasing disclosure for everyone but the NRA/Sierra Club is WORSE than not increasing disclosure for anyone?

:rofl: :rofl: :rofl:

"The only bad think about dems losing power in November is that John Boehner will be a couple heartbeats from the presidency."

Allow me to put this bluntly. You have NO IDEA how you/we have it right now. NOT A CLUE. You will quickly learn should John Boehner take power. Reality has a tendency to focus the mind.
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daa Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-01-10 10:08 AM
Response to Reply #28
39. Dream on eom
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still_one Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 11:21 AM
Response to Reply #14
21. First of all this was a link from Raw Story NOT me personally. Is it false?
Edited on Wed Jun-30-10 11:27 AM by still_one
Are you saying there is no 6 months waiting period right now?

What about those that cannot wait 6 months?

My wife had an Uncle in the hospital for 3 weeks. He was under Medicare. One bill received from the hospital was 4110000 dollars!!!

If he didn't have Medicare and didn't have insurance, do you think he could have waited six months before treatment, provided of course if he had a pre-existing condition?


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walldude Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 11:30 AM
Response to Reply #14
24. Well then that makes it a great bill... for you.
Some of us aren't so lucky.
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eridani Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Jul-01-10 02:51 AM
Response to Reply #14
36. Well, as long as you get help, the ones who don't can just piss off n/t
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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Jun-30-10 08:14 PM
Response to Original message
35. People really need to look at the maximum annual out of pocket expenses as well...
Edited on Wed Jun-30-10 08:15 PM by slipslidingaway
as the annual deductible, our annual out of pocket is 11000+ and each year from now on that will be an additional expense for our family. Our deductible is about 2500, but you need to look at the the annual out of pocket as well.

Get your annual check ups!







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