Affordable Health Care Law Upheld

[DaleDalbey]

Regarding neither hell or high water would stop someone from taking care of their kids, I agree. But, if every insurance company denies you, what do you do then? Quit your job so that you are eligible for Medicaid to get him the expensive services he needs? No, that would be taking a government hand out and make me a low-life living off of others. Rob a bank? No, that would be illegal.

I'd like some meaningful advice.

Until then, don't you dare lecture me about taking care of my child. You have no idea. Not all issues in life can be shortened to three words and put on a bumper sticker.

You think I need to put on my big girl pants...man up, bud.

 

[PearlSB4U]

Our family situation is the similar to Beach Runne'sr: our daughter has a pre-existing condition. She was kicked off our Blue Cross/Shield insurance at age 22. With Obamacare, she was reinstated on our insurance up to age 26, at which point the for-profit insurance companies can't deny her insurance coverage.
It's a ruse to say that Obamacare is a gov't takeover of health insurance; most insurance will still be provided by for-profit companies, that really only want to insure healthy people & don't want to pay claims because it hurts their bottom line. We never had the government standing between us & our doctor, but we've had Blue Cross/Shield standing between us & our doctor lots of times.

 

[jcpd2]

I'm not lecturing anyone. But if you don't think I would do something at all costs for my kids, you are sadly mistaken. I wish I could offer you some meaningful advice. I wish I could make it all go away for you. I'll offer you prayers if you aren't offended by them. I wish there was a magic wand we could all use. I hope your youngster will be fortunate that a private support group will take up his cause and help you raise funds to make your situation less stressful. And for the endowment, I said I contributed to it. I didn't say it was only $250,000. Please slow down and read the FACTS as you like to say. I live part-time in Kentucky and the costs are not the same. As I said before, there is no set solution to any of this and I think the politicians have simply added to all of our frustrations as evidenced by all of those weighing in on this topic. We have to hold them to accountability instead of dividing ourselves.

 

[DaleDalbey]

The only pre-existing illnesses that are protected by law are:

1. Pregancy.
2. Children with no lapse in coverage of more than 63 days.
3. Genetic markers in which the disease has not been diagnosed as active

All others can be subjected to up to a 12 month waiting period. Corporate group policies usually negotiate no preexisting illness waivers as long as the new employee had no break in coverage.

Individuals are at the whim of the insurance companies' underwriters. This is particularly true if they are moving from a corporate policy to an individual one. (Example, COBRA ends). These are facts, not opinions.

 

[NotDeadYet]

We never had the government standing between us & our doctor, but we've had Blue Cross/Shield standing between us & our doctor lots of times.

Unfortunately people don't get this one until they experience it for themselves. Unless you happen to be well off enough to afford to pay out of pocket for whatever you need, sooner or later you are quite likely to discover that your decisions are not as much in your own hands as you thought.
The ACA is an attempt to fix some of what is wrong with the way we pay for health care in this country. For profit insurance companies will not do it on their own; private support groups cannot possibly help more than a fraction of people who need assistance. That only leaves the govt.
Just about every other industrialized country in the world figured this out long ago.

 

[DaleDalbey]

I appreciate the tone of your last message. The point I was trying to make is this:

You stated ..."If they already had insurance, coverage for pre-existing is moot. Does it make any sense that I have paid for health insurance for 40 years in case I need it. Maybe I could wait until a hurricane is 24 hours out to buy a wind policy."

The truth is not on your side here. The only way adults can ensure a pre-existing illness is covered is by staying in the same job with the same insurance benefits. This is actually not good for the economy. It causes people to be unwilling to open their own businesses or start new endeavors for fear that they will lose their insurance. Or worse yet, become a government employee!

Your point about paying for insurance for 40 years in case you need it is exactly the reason the mandate is in place. So all people (especially when they are young and healthy) have insurance so that no one else has to pay for their care.

The wind policy argument holds no water.

If you do not have wind insurance, there is not a builder in the world who is required by law to fix your house for free, then pass the cost onto everyone else. There is a law, however, (Emergency Medical Treatment and Active Labor Act) passed in 1986 and signed by RONALD REAGAN, that requires hospitals to provide care regardless of the person's ability to pay.

Who pays for it in the end? You and I do through increased charges from the hospital to our insurance companies who in turn raise our premiums.

Regarding your post about the nursing home... in your first post you said, "I've raised over $250,000 for a nursing home that goes to an endowment to pay for their care after they have exhausted their funds." Then chastise me for calling you out on it by saying, "And for the endowment, I said I contributed to it."

By the way, the average nursing home cost per year is, in fact, less in KY. It is $83,000 per year. The interest amount you raised will pay for 22 days per year for one person in a nursing home. Commendable, but not a long-term solution.

 

[jcpd2]

Not to nitpick, but the average nursing home care in the largest metropolitan area in Kentucky is $60,000 because I'm paying it so I don't know how they arrive at the inflated numbers. The rest of the state is less. What my other worry is how many doctors will leave their practice when everything is implemented. I won't keep debating this further, but I wish the best for your family's future. Regarding the funds we raise, it is continuous. Fortunately, only a few residents are in the situation that funds are needed. Very few people understand Medicaid and its regulations. Just pray you never have to utilize it for nursing home care. In Kentucky, they can, and do, ship the patient out to Medicaid's choice of facilities and it can be 200 miles from a patient's home and family. Again, good luck to you and you'll be in my prayers whether you want them or not.

 

[jcpd2]

Actually, one more thing before I conclude. The endowment of which I spoke is several million which has generated enough until this year.

 

[Beach Runner]

Judy, your numbers are pretty close to what we've experienced. The cost of assisted living and nursing homes is just unbelievable. My Mom lives in a quite nice assisted-living facility south of ATL for $4000 a month, so that's costing $48,000 a year after taxes. Prior to that for a year she was in a nursing home with 4 people per room. We couldn't find a nicer one with any availability. That place was just awful -- the care was good, but the facility was run-down. It cost $8500 a month, so $102,000 a year. That was in 2009, so I'm sure they've increased their prices since then. We looked at hiring several CNAs to stay at her house with her 24/7 and rotate their hours. That was gonna be $130,000 a year. And if what if one of the CNAs did a no show for their shift? My brother and I both work, and our sister lives too far away to help.

After being stunned by the cost of elder care, I purchased a long-term-care insurance policy so I wouldn't have to burden my family or live in a nasty place.

But I don't think the Affordable Care Law addresses long-term care. Does anyone know? I hadn't even thought about that question until jcpd2 brought this up. Yikes!

I'd take care of her, but then I'd have to quit my job and lose my health insurance and our daughter's COBRA.

 

[Zebraspots]

The only pre-existing illnesses that are protected by law are:

1. Pregancy.
2. Children with no lapse in coverage of more than 63 days.
3. Genetic markers in which the disease has not been diagnosed as active

All others can be subjected to up to a 12 month waiting period. Corporate group policies usually negotiate no preexisting illness waivers as long as the new employee had no break in coverage.

Individuals are at the whim of the insurance companies' underwriters. This is particularly true if they are moving from a corporate policy to an individual one. (Example, COBRA ends). These are facts, not opinions.

I don't think these are facts. Maternity coverage for BCBS has to be added more than 30 days prior to conception for them to cover anything. Less than 30 and no coverage for anything related to pregnancy.