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prior to the ACA she was previously unable to purchase health insurance on the private market due to a food allergy (a precondition). This is a common misunder

prior to the ACA she was previously unable to purchase health insurance on the private market due to a food allergy (a precondition). This is a common misunderstanding. For most people in this situation, the laws on the books already took care of the problem. If she already had healthcare insurance at her previous employer, if she could show continuous coverage, she would be able to continue to purchase healthcare insurance privately, despite her preexisting condition. Whether the private insurance would be affordable to you is a different question, but it's not true that a preexisting condition was, before Obamacare, a complete roadblock to acquiring coverage privately.

dragonwriter 13y ago
The two preconditions you state explain exactly why preexisting conditions often were complete roadblocks to insurance. If you didn't have previous employer-sponsored insurance, or you had ever become financially unable to afford to maintain continuous coverage, you were SOL.
scarecrowbob 13y ago
Yes, you are correct. Yes, she did have a lapse in coverage occurred. And you're right; I believe that there were options open to her, specifically our state's high risk pool, which wasn't a viable option due to price. But, heck, if price isn't a factor, why do we need insurance at all :D ? I mean, we always have the option to just purchase healthcare directly; whether that will be financially feasible, is, of course, "a different question".
tptacek 13y ago
I believe you may be oversimplifying the continuous coverage rules. Under HIPAA, continuous coverage ensures acceptance into group health care plans (for instance, employer-provided coverage) regardless of preexisting conditions. Further, continuous coverage ensures acceptance into some form of individual coverage, of a kind determined by the specific state you're in. I do not believe it is the case that continuous coverage guarantees acceptance into individual health care plans. In 19 years of working, and (more relevantly) 15 years of marriage, I have never had a lapse of health care coverage for myself or my family. When we started Matasano, I had just previously left a full-time, full-benefits job at a larger company where I'd been working for 4 years. I elected COBRA when I left, and started shopping for individual coverage. We were unable to get family coverage at any price in Illinois because of preexisting condition concerns for two members of my family. In both cases, the rejection cause was a total surprise, because the "condition" wasn't an ongoing health problem, but rather a piece of medical trivia that caused underwriters concern that there might have been more significant issues down the road. I shopped for insurance myself, and then with a professional broker who I paid to deal with the problem, and who could not find a way around it. We solved the problem first by my wife taking a full-time job outside Matasano, which got us group coverage, and then by starting group coverage at Matasano.

dragonwriter 13y ago

The two preconditions you state explain exactly why preexisting conditions often were complete roadblocks to insurance. If you didn't have previous employer-sponsored insurance, or you had ever become financially unable to afford to maintain continuous coverage, you were SOL.

scarecrowbob 13y ago

Yes, you are correct. Yes, she did have a lapse in coverage occurred. And you're right; I believe that there were options open to her, specifically our state's high risk pool, which wasn't a viable option due to price. But, heck, if price isn't a factor, why do we need insurance at all :D ? I mean, we always have the option to just purchase healthcare directly; whether that will be financially feasible, is, of course, "a different question".

tptacek 13y ago

I believe you may be oversimplifying the continuous coverage rules. Under HIPAA, continuous coverage ensures acceptance into group health care plans (for instance, employer-provided coverage) regardless of preexisting conditions. Further, continuous coverage ensures acceptance into some form of individual coverage, of a kind determined by the specific state you're in. I do not believe it is the case that continuous coverage guarantees acceptance into individual health care plans. In 19 years of working, and (more relevantly) 15 years of marriage, I have never had a lapse of health care coverage for myself or my family. When we started Matasano, I had just previously left a full-time, full-benefits job at a larger company where I'd been working for 4 years. I elected COBRA when I left, and started shopping for individual coverage. We were unable to get family coverage at any price in Illinois because of preexisting condition concerns for two members of my family. In both cases, the rejection cause was a total surprise, because the "condition" wasn't an ongoing health problem, but rather a piece of medical trivia that caused underwriters concern that there might have been more significant issues down the road. I shopped for insurance myself, and then with a professional broker who I paid to deal with the problem, and who could not find a way around it. We solved the problem first by my wife taking a full-time job outside Matasano, which got us group coverage, and then by starting group coverage at Matasano.