This is the wonderful "free market" solution that conservatives want to return to.
Full disclosure: My own husband has Crohn's disease, one of the conditions outlined in the below that results in automatic disqualification, meaning, we couldn't buy health insurance for him at any price should his coverage ever be interrupted, because the Crohn's disease is a pre-existing condition.
To everyone celebrating the imminent demise of the ACA. May you, very shortly, be involved in a conversation with a person doing the work Jeremy Beckham describes below, and may you receive the automatic DNQ during that conversation. Then, just maybe, the scales will fall from your eyes.
I fear it is going to require nothing short of direct personal catastrophe for thousands of people to finally wake up.
When does the US john the rest of the INDUSTRIALIZED WORLD?
When does the US john the rest of the INDUSTRIALIZED WORLD?
Jeremy Beckham
I sold health insurance from 2004-2006 for one of the largest health insurance companies in ~30 states. Maybe because we've had ACA for a while, people don't really remember what it was like then, but I want people to know that I declined people health insurance on a DAILY BASIS.
Some of the things that resulted in automatic "DNQ" (does not qualify) determination from our underwriters, which means there was NO policy we would issue you, included (and these were all standard in the industry):
- Ever, in your life, having a heart attack or stroke
- Ever, in your life, receiving any sort of mental health care or substance abuse treatment in any inpatient setting (I saw a woman in her 40s declined insurance because she was a 'cutter' in the 1980s and was hospitalized for that, yes, more than 20 years prior)
- Having a history of most (but not all) forms of cancer
- Diabetes or pre-diabetes
- Chronic obstructive pulmonary disease
- Crohn's Disease & Ulcerative colitis
- Connective tissue disorder
- Autism
- Obesity (Defined strictly by BMI score)
- Having both high blood pressure and high cholesterol
- Being pregnant (fortunately at least a lot of these women could get on Medicaid, even pre-ACA, because conservatives were worried they would just choose to have an abortion if they couldn't pay bills from delivery).
- If you were a woman of child-bearing age and you had ever given birth to a pre-term baby, we would decline coverage for YOU, even if not currently pregnant, because the risk of an additional pre-term birth was greater and we would be on the line for that in the event you did get pregnant again
- Ever, in your life, receiving any sort of mental health care or substance abuse treatment in any inpatient setting (I saw a woman in her 40s declined insurance because she was a 'cutter' in the 1980s and was hospitalized for that, yes, more than 20 years prior)
- Having a history of most (but not all) forms of cancer
- Diabetes or pre-diabetes
- Chronic obstructive pulmonary disease
- Crohn's Disease & Ulcerative colitis
- Connective tissue disorder
- Autism
- Obesity (Defined strictly by BMI score)
- Having both high blood pressure and high cholesterol
- Being pregnant (fortunately at least a lot of these women could get on Medicaid, even pre-ACA, because conservatives were worried they would just choose to have an abortion if they couldn't pay bills from delivery).
- If you were a woman of child-bearing age and you had ever given birth to a pre-term baby, we would decline coverage for YOU, even if not currently pregnant, because the risk of an additional pre-term birth was greater and we would be on the line for that in the event you did get pregnant again
Other health conditions, like asthma, allergies, high blood pressure on its own, wouldn't necessarily result in a DNQ, but would result in a permanent "rider" to your policy which mean that we agreed to cover you EXCEPT any medical bills, prescriptions, incurred related to your asthma, allergies, etc.
Another odd thing I remember: sometimes fathers would get ordered by judges as part of their child support order to pay for their kids' health insurance. But then we (and everyone else) refused to insure the kid due to health history, and they'd basically be under the threat of violating the judge's order and maybe even going to jail. It was a very odd legal issue that I never really saw resolved. lots of times the judges would think the fathers were lying about being unable to procure insurance and were just being lazy. I think lots of people didn't realize how crummy the individual health insurance landscape really was until they called to try to obtain it.
I had to console people in tears on a regular basis. We were instructed by management to just get them off the phone as quickly as possible to free the phone line for a healthy person. One line that was popular to tell people was "well you wouldn't ask a car insurance company to insure your car after it's been in an accident!" but it felt incredibly heartless to compare someone's autistic son to a car accident, so I never said that. All I could tell them to do really was either try to get in their state's crummy and expensive "high risk pool" (if there was one, some states didn't even have that) and write their members of Congress.
Looks like we might be heading back to these lovely days.
DID YOU HEAR THIS ONE?
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