November 2018 Newsletter

Who is Protecting Preexisting Conditions?

During the run up to the midterms elections, some politicians claim to support protections for preexisting conditions. It’s not a surprise as a majority of Americans support this provision of the Affordable Care Act (ACA). In a recent Kaiser Family Foundation poll, most respondents agreed that protecting people with preexisting conditions and guaranteeing coverage is “very important." (1) In fact, people planning to vote on November 6 report that health care is among their biggest concerns.

While paying lip service to protecting consumers, some elected officials currently running for office have been or are currently engaged in undermining the ACA in a way that directly weakens or eliminates protections for people with preexisting conditions. There are a number of efforts underway that include lawsuits to try to repeal parts of the ACA, offering so-called "lean" insurance plans and legislative proposals.

Lawsuits

One of the largest lawsuits against the ACA is currently being heard in Federal District Court for the Northern District of Texas. It was brought by a group of Republican state attorneys general and the governors of Maine and Mississippi. Their argument is that the law is unconstitutional and, because the provision requiring most people to have insurance was struck down in December 2017 (the individual mandate), the rest of the law must be repealed as well (2).

The US Department of Justice also weighed in to support the lawsuit and urged the court to strike down, specifically, consumer protections for preexisting conditions (3). The effect of any successful lawsuit would be mitigated by whether your state government would step in to offer protections for consumers. States like California and New York have a record of legislating consumer protections into state laws. However, other states like those whose Attorneys General are involved in a lawsuit against the ACA, have not adopted many consumer protections and people in those states are a risk of losing coverage for preexisting conditions if the lawsuit succeeds.

“Lean” and Short-term Insurance Plans

The Trump administration issued guidance that allows states to use ACA subsidies for plans that fail to protect people with preexisting conditions. The argument is that these plans are cheaper,  but experts agree that they are poor-quality and do not comply with previous protections under the ACA. In addition, the Trump administration extended short-term insurance plans that were previously limited to 3 months and used as a stop-gap for people between jobs. Now, these so-called short-term plans can last up to 3 years. The plans are less expensive because they don’t cover pre-existing conditions. Even big, well-known insurers are participating in these flimsy offerings. UnitedHealth offers a low cost plan but, in the fine print of the plan, it notes frankly that “short-term health insurance is medically underwritten and does not cover pre-existing conditions.”(4)

Legislation

Earlier this year, the Trump Administration proposed a budget for fiscal year 2019 that includes eliminating the ACA’s Medicaid expansion which has been responsible for covering low-income adults. The idea is that the government would force states to come up with a way to cover some 12 million people who, without assistance, would have no health insurance. More shockingly, they proposed limiting the amount of federal funding for Medicaid for people with disabilities, seniors and children, regardless of need.

Finally, it is worth remembering the Republicans in Congress have spent years trying to repeal the health care bill, voting to undo provisions like coverage for pre-existing conditions over 50 times, most recently in 2017. Though no politician currently running for office would like you to do so, you can check on your local officials actual voting record on protecting consumer health plans that protect pre-existing conditions. Go to www.healthreformvotes.org to check. This non profit organization tracks voting records on healthcare issues nationwide. Select your state by clicking on it and navigate to either your Senator or Representative.

References

(1) Kaiser Health Tracking Poll - Late Summer 2018: The Election, Pre-Existing Conditions, and Surprises on Medical Bill. Ashley Kirzinger; Bryan We; and Mollyann Brodie (Sep 05, 2018).

(2) “A New Lawsuit Threatens Obamacare. Here’s What’s at Stake and What to Expect in Oral Arguments” The New York Times online. Goodnough,Abby’ Hoffman, Jan (Sept. 4, 2018).

(3) “Lawsuit Threatens Affordable Care Act Preexisting Condition Protections But Impact Will Depend on Where You Live” commonwealthfund.org . Corlette, Maasnasa; Giovannelli, Justin (Aug 29, 2018).

(4) “‘Short Term’ Health Insurance?’ Up to 3 years Under New Trump Policy." New York Times online. Pear, Robert (Aug. 1, 2018).

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New MHAIP Staff

Meet the newest members of our team

Hilary Cox

Hilary assists families in appealing denied claims for medically necessary mental health treatment. Hilary’s background is in healthcare privacy compliance working for a wide variety of organizations such as a county health and hospital system, the federal government, a health insurer, and a law firm. She lives in the Bay Area with her husband, daughter, and dog-son. Hilary obtained her law degree from Stanford University and her Bachelors from UC Davis.

 

Sarah Jones

I started working young at the age of 15 in many different field ranging from Food Service, Customer Service, Administrative & Bookkeeping. It was just over two years ago shortly before I found out I was pregnant with my son Mason I wanted to get in the field of Medical Coding & Billing. As I continued my job as an administrator for New Leaf Community Markets during my pregnancy, I left for maternity leave and after a long leave I decided to put in my resignation to peruse being a full time mom & start my career. Shortly after my resignation, I enrolled in school to receive a Certified Medical Coding & Billing Certification. Days after enrolling I sent in my resume for a part time job in the field and was hired. I was beyond grateful & blessed with the amazing opportunity. The path I’ve chosen allows me to raise my son, participate in my online schooling & provide for my family. ______________________

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Thank you for your continuing support!
Sincerely,
Karen Fessel
Executive Director & Founder
Mental Health & Autism Insurance Project