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> once that expires, through the public exchanges that are guaranteed to cover their existing condition. Thanks ACA. The ACA just states that insurers can't re

> once that expires, through the public exchanges that are guaranteed to cover their existing condition. Thanks ACA. The ACA just states that insurers can't refuse a customer who wants to purchase a plan just because they have a preexisting condition. It doesn't actually require that the plan cover treatment for said condition. In many states - including wealthier deep blue states - the marketplace plan options are actually quite terrible.

rcme 4y ago
The HHS disagrees with you: https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html https://www.hhs.gov/healthcare/about-the-aca/pre-existing-co... > Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either. Once you have insurance, they can't refuse to cover treatment for your pre-existing condition.
- notch656c 4y ago
  Doesn't this create a huge incentive for people to buy rolling "temporary" insurance plans which can consider pre-existing conditions, and then switch to subsidizing off the healthy once they actually get a condition and buy the regular ACA plans?
  - rcme 4y ago
    You can only switch plans during the open enrollment window or in cases of specific life events. You can't arbitrarily change plans whenever you want.
    - notch656c 4y ago
      "Temporary" plans are 1-12 months so you can buy ones that last until the next open enrollment, and if you're healthy you buy another (12 month) temporary plan. If you develop a condition you buy the regular plan.
  - vikingerik 4y ago
    Yes, and that's one reason why costs have ballooned so much, the need to subsidize people who didn't pay while they didn't have a condition and now do. The temporary plans aren't even necessary, if you can wait until the next regular enrollment period. The ACA originally tried to hide that vulnerability by making insurance mandatory, then it appeared when that forcible mandate was repealed. Edit to reply to the reply: Right, it's not insurance. Insurance is pooling risk. If you wait until the risk event has already happened, it's not insurance, it's just paying your own costs with extra steps.
    - notch656c 4y ago
      ... so we have the worst of both worlds. Insurers are forced to take pre-existing conditions, but you can wait until you have a condition before buying it. I don't think that's even "insurance" at that point.... America may quite possible have the absolute dumbest system humanly possible.
      - willcipriano 4y ago
        The best part? The US spends more per captia than any other OECD nation on socialized medicine. The United Kingdom's NHS costs around half, per capita and delivers universal coverage.
        notch656c 4y ago
        Yeah. As a a pretty hardcore ancap who hates socialized anything, I'll still take NHS over our current system. Anything is better than our current bastardized system.
- chimeracoder 4y ago
  No, you are misreading it. They cannot limit benefits due to your condition, but that doesn't mean that they have to cover treatment for your condition. If you have a disease or syndrome, the treatments for that condition (whether pharmaceutical, outpatient, or inpatient) may simply not be on the list of benefits provided by the insurance plans offered. It's legally distinct from, but analogous to, a nodiscrimination clause. They can't refuse to cover your mammogram (which they cover for everyone else) just because your initial diagnosis for Vamipiric Brain Syndrome occurred before your plan went into effect. But they can choose to say they they don't cover Nosferatudone for anyone (when Nosferatudone happens to be the only effective treatment for Vamipiric Brain Syndrome). (There are, separately, certain treatments that all insurance plans must cover by law, although that's separate from the ACA, and it's a very limited set).
  - rcme 4y ago
    Yes, you're always able to buy a bad health insurance plan. But you're also able to buy a good health insurance plan, and your pre-existing condition won't impact the price of the good insurance plan.
    - chimeracoder 4y ago
      > Yes, you're always able to buy a bad health insurance plan. But you're also able to buy a good health insurance plan, If one exists, and as I stated in the original post, in many states, even the best plans available on the marketplace are quite terrible. And that's a problem that's actually gotten worse in recent years, not better, as plans have left the exchange (and providers have dropped marketplace plans from their networks). > and your pre-existing condition won't impact the price of the good insurance plan. Your "pre-existing condition" won't impact the price of the insurance plan relative to others who are purchasing that same plan, but you quite likely will be in a situation where the "good" (eg, gold) plans are the only ones which will provide the coverage that you need, and those are the most expensive ones. This satisfies the letter of the law, but in practice it still means that often people with chronic health condition either are are forced to pay more for coverage or are literally unable to get coverage for their conditions at all (because none of the marketplace plans will cover it). The protections provided by the ACA are much more narrow than you're portraying them as, which is understandable because it's a common misconception about how the ACA operates, but it's unfortunately a very important distinction.

rcme 4y ago

The HHS disagrees with you: https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html https://www.hhs.gov/healthcare/about-the-aca/pre-existing-co... > Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either. Once you have insurance, they can't refuse to cover treatment for your pre-existing condition.

notch656c 4y ago
Doesn't this create a huge incentive for people to buy rolling "temporary" insurance plans which can consider pre-existing conditions, and then switch to subsidizing off the healthy once they actually get a condition and buy the regular ACA plans?
- rcme 4y ago
  You can only switch plans during the open enrollment window or in cases of specific life events. You can't arbitrarily change plans whenever you want.
  - notch656c 4y ago
    "Temporary" plans are 1-12 months so you can buy ones that last until the next open enrollment, and if you're healthy you buy another (12 month) temporary plan. If you develop a condition you buy the regular plan.
- vikingerik 4y ago
  Yes, and that's one reason why costs have ballooned so much, the need to subsidize people who didn't pay while they didn't have a condition and now do. The temporary plans aren't even necessary, if you can wait until the next regular enrollment period. The ACA originally tried to hide that vulnerability by making insurance mandatory, then it appeared when that forcible mandate was repealed. Edit to reply to the reply: Right, it's not insurance. Insurance is pooling risk. If you wait until the risk event has already happened, it's not insurance, it's just paying your own costs with extra steps.
  - notch656c 4y ago
    ... so we have the worst of both worlds. Insurers are forced to take pre-existing conditions, but you can wait until you have a condition before buying it. I don't think that's even "insurance" at that point.... America may quite possible have the absolute dumbest system humanly possible.
    - willcipriano 4y ago
      The best part? The US spends more per captia than any other OECD nation on socialized medicine. The United Kingdom's NHS costs around half, per capita and delivers universal coverage.
      - notch656c 4y ago
        Yeah. As a a pretty hardcore ancap who hates socialized anything, I'll still take NHS over our current system. Anything is better than our current bastardized system.
chimeracoder 4y ago
No, you are misreading it. They cannot limit benefits due to your condition, but that doesn't mean that they have to cover treatment for your condition. If you have a disease or syndrome, the treatments for that condition (whether pharmaceutical, outpatient, or inpatient) may simply not be on the list of benefits provided by the insurance plans offered. It's legally distinct from, but analogous to, a nodiscrimination clause. They can't refuse to cover your mammogram (which they cover for everyone else) just because your initial diagnosis for Vamipiric Brain Syndrome occurred before your plan went into effect. But they can choose to say they they don't cover Nosferatudone for anyone (when Nosferatudone happens to be the only effective treatment for Vamipiric Brain Syndrome). (There are, separately, certain treatments that all insurance plans must cover by law, although that's separate from the ACA, and it's a very limited set).
- rcme 4y ago
  Yes, you're always able to buy a bad health insurance plan. But you're also able to buy a good health insurance plan, and your pre-existing condition won't impact the price of the good insurance plan.
  - chimeracoder 4y ago
    > Yes, you're always able to buy a bad health insurance plan. But you're also able to buy a good health insurance plan, If one exists, and as I stated in the original post, in many states, even the best plans available on the marketplace are quite terrible. And that's a problem that's actually gotten worse in recent years, not better, as plans have left the exchange (and providers have dropped marketplace plans from their networks). > and your pre-existing condition won't impact the price of the good insurance plan. Your "pre-existing condition" won't impact the price of the insurance plan relative to others who are purchasing that same plan, but you quite likely will be in a situation where the "good" (eg, gold) plans are the only ones which will provide the coverage that you need, and those are the most expensive ones. This satisfies the letter of the law, but in practice it still means that often people with chronic health condition either are are forced to pay more for coverage or are literally unable to get coverage for their conditions at all (because none of the marketplace plans will cover it). The protections provided by the ACA are much more narrow than you're portraying them as, which is understandable because it's a common misconception about how the ACA operates, but it's unfortunately a very important distinction.