Wed – 5/8: Call today, the House votes tomorrow. HR 986 – Protecting Americans with pre-existing Conditions Act

Remember the bad old days? When our profit-centric insurance industry wouldn’t cover people with existing (and common) conditions or a job they thought was dangerous? When they refused to cover long lists of common medications? When they capped yearly or lifetime coverage? When they “rescissioned” people off plans for a missed notation in their file? The insurance industry can hardly wait to get back to business as usual. Until we can get rid of them entirely, let’s make them wait.

Democrats in the House and Senate have introduced the Protecting Americans with Pre-existing Conditions Act (H.R.986/S.466) to prohibit the use of ACA subsidies to pay for junk plans that don’t include the 10 essential benefits of the ACA. These plans put patients at huge financial risk. Urge your representatives to support this legislation and protect the ACA—and consumers—from the Trump administrations ongoing attempts at ACA sabotage.

Background

“Every day, Republicans further expose their brutal agenda to destroy Americans’ health care,” President Trump is once again cynically pushing families into shoddy junk plans that can discriminate against pre-existing conditions and that do not cover essential health benefits, while making dependable health coverage more expensive for everyone else.” – House Minority Leader Nancy Pelosi (D-Calif.)

(from 5calls) Last fall, the Trump administration approved a new rule allowing consumers to use Affordable Care Act tax subsidies to purchase short-term health insurance plans. Short-term, limited duration health insurance — known as short-term plans — was originally intended to fill short gaps when people transitioned between coverage, but is now being sold as a replacement for year-round comprehensive coverage. These substandard plans can charge people with preexisting conditions higher premiums and aren’t required to cover essential health benefits like maternity, mental health, or hospital services.

Healthcare advocates have warned that the proliferation of these junk plans steers healthy people away from the long-term insurance market, which in turn drives up prices for sicker consumers. Short-term plans also put buyers at risk for financial devastation in case of an accident or an illness like cancer; for example, one short-term insurance plan buyer faced $200,000 in bills after their insurer declined to cover the vast majority of their heart surgery costs.

Here’s a quick comparison of coverage between ACA-compliant plans and the wild west of for-profit insurance.

Pre-existing conditions that were commonly used to deny coverage: (not a complete list..) AIDS/HIV, lupus, alcohol abuse/drug abuse with recent treatment, severe mental disorders such as bipolar disorder or an eating disorder, Alzheimer’s/dementia, multiple sclerosis, rheumatoid arthritis, fibromyalgia and other inflammatory joint disease, muscular dystrophy, cancer, severe obesity, cerebral palsy, organ transplant, congestive heart failure, paraplegia, coronary artery/heart disease, bypass surgery, paralysis, Crohn’s disease/ulcerative colitis, Parkinson’s disease, chronic obstructive pulmonary disease/emphysema, pending surgery or hospitalization, diabetes mellitus, pneumocystis pneumonia, epilepsy, pregnancy or expectant parent, hemophilia, sleep apnea, hepatitis C, stroke, kidney disease, renal failure, transsexualism.

Conditions that could be used to deny insurance coverage: (not a complete list..) Acne, allergies, anxiety, asthma, basal cell skin cancer (a type of skin cancer that doesn’t tend to spread), depression, ear infections, fractures, high cholesterol, hypertension, incontinence, joint injuries, kidney stones, menstrual irregularities, migraine headaches, being overweight, restless leg syndrome, tonsillitis, urinary tract infections, varicose veins, and vertigo.

Medications that used to be “declinable”.