Obamacare and high-risk pools: what gives?
There have been a spate of articles about how wonderful it is that this person or that person was able to quit a nasty job (or not take on a nasty job they thought they’d have to get) because of Obamacare lifting the burden of health insurance from their shoulders.
Here’s one, for example, from Diana Reese. She lives in Kansas, and writes:
Had the ACA not become law, I would have considered a job as a “lunch lady” in one of the nearby elementary schools ”” just to get health insurance.
My inspiration was an out-of-work accountant I met at a social event a couple of years ago. When asked what he did for a living, he laughed and said, “lunch lady.” Then he explained that he’d been laid off during the recession, and though his wife worked at a job she loved, she had no benefits. So he took a job at his children’s school, working a few hours a day to qualify for health insurance for his family…
Because of my own pre-existing condition, I couldn’t buy health insurance ”” at any price ”” before the ACA.
She goes on to add that, actually, her husband had been employed and she was covered under his health insurance, but that they knew it would end soon because it was a contract position. Therefore, since she was uninsurable any other way, she was considering the lunch lady route.
Only thing is, Kansas had a high-risk pool even prior to Obamacare, as did most states. And in Kansas it seems to have been a pretty good one. The following is taken from a piece on the subject that appeared in April of 2010 and describes the high-risk pool situation in Kansas right around the time Obamacare was passed, before Obamacare’s provisions had ever been implemented:
Kansas is among about 35 states that already have a high-risk pool and Sebelius signaled that her agency would work with existing programs rather than force upon them a new federal plan, though the law allows or requires the national government to create high-risk pools in states that don’t have or develop them in accordance with the new law’s provisions.
High-risk pools provide health insurance for people whose medical history makes it difficult or impossible for them to otherwise find affordable coverage.
In Kansas, about 1,800 people are enrolled in the state’s existing plan, which is managed by the Kansas Health Insurance Association.
Nationally, existing state high-risk pools cover about 200,000 people…
Kansas law governing the existing high-risk pool here allows for premiums up 150 percent the cost of a standard, non-group policy, though that has been held to 128 percent by decision of the risk-pool’s governing board.
So there was a high-risk pool that covered people with pre-existing conditions. It was somewhat more expensive than regular insurance, to be sure, but not so very very much more expensive. Most high-risk pools (which existed prior to Obamacare in most states) also provided subsidies for those with low incomes.
So, if Diana Reese had lived in Kansas when all of her insurance woes (or prospective insurance woes; it seems that Obamacare passed before her husband’s job ended) occurred—and the focus on Kansas in the article implies that she did—then she absolutely could have purchased insurance, and the price would not have been so very much higher either.
If you look at the chart in the middle of this page you’ll see that 35 states ran high-risk pools prior to Obamacare, and most had been in operation for many many years (Kansas had started its high-risk pool in 1993). The 15 states that didn’t have them didn’t necessarily leave their high-risk individual health insurance customers in the lurch, either. Some were guaranteed issue states, which meant pre-existing conditions could not be excluded at all: New Jersey, New York, Maine, Massachusetts, and Vermont had straight guaranteed issue, with Ohio, Oregon, Rhode Island, and Idaho having guaranteed issue with some restrictions involving previous continuous coverage.
There were some states where people were in a situation much like Reese describes, but it would appear that Reese (if she lived in Kansas immediately prior to Obamacare) could not have been considered one of those people, even potentially.
How do I know this sort of thing? I was in a high-risk pool for quite a few years. It was far from perfect—I paid about the same as I would have if I hadn’t had a pre-existing condition, and my deductibles were significantly higher—but I could certainly get insurance.
So I really, really wonder what Reese is talking about.
Well, there were always going to be winners as well as losers under the new regime. We’ve heard a lot from the losers, but not so much from the winners. It’s all part of the Grand Plan to redistribute assets.
The new scheme has its ins and outs and wrinkles. Humans have an ingenuity when it comes to gaming the system, whatever system, and here it is in evidence. I don’t think the redistributionists give a hoot, as long as wealth gets redistributed.
Except, in many/most cases, the redistributionists’ wealth; they’ll see to it they’re taken care of or otherwise replenished.
There is no mystery here.
Reese is a Democrat.
Democrats lie for profit and political gain.
It is what they do because of what they are – vicious degenerates (who are also too full of themselves to consider they might actually be a lunch lady).
When my daughter had corrective heart surgery at 16 months, on thing I thought about was that only a wealthy society could devote the resources to make this possible. There were several children on Medicaid in the Childrens ICU at the time and they got the same high standard of care (but less from their parents, another story). I don’t care if you don’t like your job, suck it in and realize that only a more productive job can afford to pay for the high quality medical care we get (got?) in the USA. If you truly care about people with serious conditions, work hard and stop bitchin’
“So I really, really wonder what Reese is talking about.”
This is probably a set up and she is merely talking the talking points to feed the MSM machine to create positive spin for the failures of obamacare.
parker, Mike, and everyone else:
My last sentence in the post “So I really, really wonder what Reese is talking about” was meant to be ironic. Sarcastic.
To spell it out for you, I wonder in the sense that I’m not sure whether she’s lying or ignorant. She clearly wants to shill for Obamacare.
Of course, it’s possible I got something wrong here. Maybe she didn’t live in Kansas back then; maybe she lived in one of the few states with no high-risk pool and/or guaranteed issue. I doubt it. And if so, why not say where she lived?
My guess: either she’s flat-out lying about not being able to get insurance, or was so ignorant (and did so little research back then) that she didn’t even know that Kansas had a high-risk pool, that premiums were capped on it, and that she therefore could most definitely have gotten insurance. After all, it doesn’t sound like she had to go too far with it (far enough to actually, like, find out about it) because she still had her husband’s insurance, and then Obamacare took over. So maybe she was just relying on cocktail party gossip and really didn’t know she could indeed have purchased health insurance.
That said, it’s funny how the Democratic Party, Obama included, have consistently lied about high-risk pools and pre-existing conditions and acted as though no one with a pre-existing condition could obtain individual health insurance in pre-Obamacare America. They most certainly could obtain it for the most part, although in most states it was somewhat more expensive (unless you were low-income and received subsidies).
I also think it’s funny (and not funny ha-ha) that, if I am correct about where Reese lived and what was available to her, no one at the WaPo seems to have known or cared to discover the facts. Maybe they are just that ignorant, too. It’s not outside the realm of possibility. Or maybe they are just spreading lies. Either/or.
I realized you were being sarcastic…. just wanted to put in my 2 cents of disgust with the MSM spin machine. 🙂
I vote for ignorance. Just as most people don’t really shop around for car insurance until they change vehicles or get into an accident, people wait until there’s a problem before they change other routine costs.
This is yet another example of how dealing with health care issues one at a time rather than taking over the whole health care system in one huge law could have worked.
It’s almost as if the Left thinks there are no real/good jobs except government zero sum jobs.
This feeds a lot into why they concentrate resources on the GLBT movement, it’s a way to shatter personal ownership and love.
So long as two people feel love for each other, the state can never fully control the people’s motivations and loyalty. The people will always be able to refuse at least one order when it comes to killing their loved ones. That cannot be allowed by the Society for Totalitarianism Utopian Perfection under the Left’s Deus Ex Machina, man made god. The government desires full control of a person’s mind, body, and soul. And that means complete and utter obedience.
They need to get rid of people’s “substandard” jobs, to free them of job lock, just like they need the lower and middle classes to free themselves of marriage and the economic benefits that result from stable families and financial situations. They don’t want the middle class catching up to their elite born to rule upper class. They’d rather have 6 to 0, vs having 8 to your 6.
When shysters advertise ambulance chasing gambits on TV — at least they end by saying: “I’m a paid non-attorney spokesman.”
In the case at issue, she’s a paid shill, de facto.
However did she find her way to the microphone?
Accidentally?
ACORN must have been beating the wheat fields to find her.
BTW, Sebelius must still have (D) contacts back in Kansas.
Does that explain why our heroine is talking tall?
Pre-existing conditions and high priced coverage were two of the excuses used for enacting the ACA. Both bogus. This post provides the facts debunking the pre-existing chestnut.
Many people believe that Obama is plotting the downfall of our economy and our sovereign ability to defend ourselves. Maybe. I could more readily believe that he and his backers see the ACA as a necessary transition to single payer and have actually engineered it to fail. The hard core left of 25 – 35% of citizens favor single payer. I’ve been in the town hall meetings where they hold forth. They are fanatic True Believers. However, with a small margin of victory in the national election, I cannot believe that Obama and his backers believe that it made sense to screw up the ACA rollout. There are still 30-40% of the so-called independents out there that could turn on them. It appears that is what is setting up to happen in November.
Can the whole thing be cancelled? Well, Obama just gave a waiver to employers with 50 to 99 workers (about 80 million employees.) If all these different groups can get waivers, then it seems to me a law providing waivers for every citizen and letting insurance companies provide whatever insurance they think will sell would restore things pretty quickly. With, of course, much fanfare given to the high risk pools available in most states.
Is that supposed to be a hardship????? Next thing you know, pole dancers will say they were forced into their occupation.
J.J.:
One problem—the high-risk pools are now all gone. In anticipation of Obamacare becoming operative, the states had been phasing out the high-risk pools as the national high-risk pool was phased in, and then in preparation for January 2014. As far as I know, they all went out of business by January 2014, because Obamacare was supposed to take over at that time.
It would be a big mess to try to reinstate the state pools, although I suppose it could be done. But Humpty Dumpty is pretty well broken and hard to put back together again.
neo: “But Humpty Dumpty is pretty well broken and hard to put back together again.”
Drat, foiled again!! Somehow, someway, there’s got to be a way to set things right. Not just go back to pre-ACA but to really improve our healthcare insurance system and hold down the price increases of care itself. Maybe it will all have to fall down. Do we really want that? I hope not.
JJ says, “Not just go back to pre-ACA but to really improve our healthcare insurance system and hold down the price increases of care itself.”
Forbid DC to poke its nose into doctor offices, clinics, and hospitals; and costs will go down. Open up the insurance market across state borders and costs will go down. Stop the cronyism and corruption and costs will go down.
J.J. – Today’s WSJ indicates the new waiver for employers with 50-99 employees will affect 7.9 million people, not 80 million.
It’s foolish to believe anything coming out of the MSM that concerns Obama and the administration’s policies. You can/could find these kind state-manufactured state stories in Chinese and former Soviet controlled papers. Lots of crap from regular people extolling the virtues of wildly unpopular government programs or policies. Americans have so long relied on and trusted in a free and honest (usually), it’s nearly impossible for them to distinguish between manufactured propaganda and reality. These stories are part of the full court marketing blitz that Obama and his slime balls have put into hi gear since the roll out. They’re BS.
Neo Said: “To spell it out for you, I wonder in the sense that I’m not sure whether she’s lying or ignorant.”
I have had a variation of this question about Liberals and Democrats for a long time. Are they lying or are they ignorant?
There is a whole history of this question going back to Aristotle and Aquinas about ignorance and invincible ignorance and so on…
My take is that at some point an adult is responsible for their own ignorance. In effect, they are liars (even the ignorant). They have lied to themselves all these many years and so they naturally tell “untruths” that are in effect lies, and the “moral equivalent” of a lie.
They do this because they are cowards. They do not want to know the real effect of their policies, and if they are ever caught they can say they just “didn’t know”.
Ignorance of the Law, they say, is no excuse (these days I do not hold that to be true but that’s a different matter). Ignorance of the harmful effects of your voting history is no excuse either. If you didn’t know shame on you! You should have known!
Liberals are loathsome creatures. There is hardly one good one out of every hundred.
Somehow, someway, there’s got to be a way to set things right.
If you had destroyed the Left, you wouldn’t need to worry about things like that. Without the Left, things will fix themselves.
Glen H, I stand corrected. My source was, apparently, making a WAG. Quite a difference! Arrgh!
As far as I know, the Oklahoma high risk pool still exists. I was in it due to having a blood clot long time ago. They increased rates so I moved to a private plan.
liz:
Take a look.
Because Obamacare covers people with pre-existing conditions, high-risk pools become obsolete, supposedly, so they are being (or have already been) phased out.
Even if the pools don’t want to be phased out, they will be effectively phased out when doctors retire, as they are already doing. One cannot operate a civilization without the necessary resources. Neither military force nor brutal totalitarianism can produce food out of thin air.