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Insurance insider on Pre-Existing Conditions and Health Insurance

Post  sc4ram on Fri Dec 03, 2010 2:36 am

This is a transcript of a talk-radio exchange with a Health Insurance insider, thought it had some good insite.



RUSH: Stacy, our insurance agent somewhere in Georgia weighing in with an update. How are you, Stace?

CALLER: I'm well, thanks, how are you?

RUSH: Very nice, thank you.

CALLER: Well, listen, I can answer the lady from Florida's question, but that's not why I called.

RUSH: Well, wait a minute, let's stick there. Her question was, she doesn't like being called a welfare recipient, she wanted to know how a kid gets insurance after leaving home with an affliction known as type 1 diabetes.

CALLER: Correct. And she specifically mentioned how would an 18-year-old handle that. And I can answer that question.

RUSH: Go ahead, answer it.

CALLER: Okay. Promise you'll let me talk about Canada? Because that's the big one.

RUSH: Yeah, of course, yeah, yeah.

CALLER: You're sweet. Anyway, an 18-year-old is covered up until the 19th birthday. Any dependent who is registered as a full time student in a college, vocational school, or junior college can be covered by their parents' insurance today without Obamacare up to the age of 22 --

RUSH: Yeah.

CALLER: -- as long as they are enrolled and full time. At that point, then the, quote, unquote, child would be expected to get a job and join a health plan just like everybody else.

RUSH: Right. That's where the problem comes in.

CALLER: Well, no, it's not, because -- and we're gonna have to split up group insurance provided by an employer versus individual coverage.

RUSH: No, we're talking two different things.

CALLER: Okay.

RUSH: What I mean is the problem comes in when somebody has to start providing for themselves, that's the foreign concept here. "You mean I gotta start paying for it myself when I leave home? Oh, that's not fair."

CALLER: Well, you know how kids are.

RUSH: Kids? Kids? Try the president. Try the freaking Democrat population of this country!

CALLER: Well, Rush, it's funny, you know, talking about the 18-year-old with type 1 diabetes, the preexisting condition plan that was one of the supposed first benefits of Obamacare --

RUSH: Yeah.

CALLER: -- the Wall Street Journal reported and confirmed what we've been hearing in the industry.

RUSH: Yeah.

CALLER: On the 5th of November that this urgently needed federal insurance plan has enrolled nationally 8,011 people.

RUSH: What does that mean?


CALLER: Well, they were expecting enrollment of 375,000 nationwide. They got 8,011 people to buy this coverage.

RUSH: Yeah?

CALLER: For the preexisting condition plan.

RUSH: Yeah?

CALLER: If preexisting conditions are such a freaking emergency, why is their enrollment 8,011? South Dakota has --

RUSH: Oh, yeah, I see your point.

CALLER: -- two.

RUSH: So we've been sold a bill of goods again.

CALLER: And listening to Eric Cantor, I heard that on the podcast this morning and I had to rearrange my schedule 'cause I just had to tell you this. Please, Mr. Cantor, go talk to the HHS, and if she won't talk to you, please go talk to the Wall Street Journal. Another thing that they instituted on September 23rd is requiring --

RUSH: Wait, wait, wait, wait, wait, wait. Who is "they"?

CALLER: HHS. Sorry. Another of the Obamacare provisions --

RUSH: The government, okay.

CALLER: -- another of those was that for individual, child-only policies, which is a small market, to be sure, they could not deny coverage for preexisting conditions for anybody under 18 who buys one of these policies.

RUSH: Yeah.

CALLER: Guess what? As of September 23rd, there are no more policies being written anywhere in Georgia, and I'm hearing throughout the country. It's gone. That market has collapsed completely.

RUSH: Are you surprised?

CALLER: I'm not. But here we're gonna go back to the 8,011 enrollees.

RUSH: Could not deny coverage preexisting condition anybody under 18 who buys one of these policies, meaning they're not buying the policies.

CALLER: It's not that they're not buying the policies. The policies aren't being written. There's no insurance company who's offering those policies anymore.

RUSH: Wait. I thought Obama was mandating them to do that.

CALLER: No. Obama mandated that if they offer child-only policies, that they accept everybody regardless.

RUSH: Obama doesn't even know what's in this bill, he doesn't care, all he knows is it's gonna screw it all up.

CALLER: The insurance companies basically told Obama and Kathleen Sebelius to take a hike, and they just quit writing 'em. They said we're out of the child-only insurance business. We're gone. Now, when the rest of this kicks in you're gonna see the same thing happen with the individual, the general individual, which is about 20% of the health care market. They're just gonna go away.

RUSH: Why?

CALLER: Nobody's gonna write that because you can't cover the costs. You're just gonna lose money out your nose.

RUSH: Well, that's the design, I hate to tell you. You know it better than I do.

CALLER: Well, I know, but they've already collapsed part of the US health insurance system, and nobody's reporting it.

RUSH: Well, you just did.

CALLER: I mean, it's just frustrating, and listening to Mr. Cantor go on and on about the preex, you know, do you read the Wall Street Journal? It was right there. It's not the great emergency everybody thinks it is.

RUSH: Well, whether it is or isn't doesn't matter. The way it polls is how it matters.

CALLER: But that's where they're failing in education, Rush, you know, you keep talking that they need to be educating the public as they go along. They are so totally failing in that.

RUSH: I know, 'cause it's easier to poll and figure out what people want and go through the motions of making 'em think you're gonna give it to them.

CALLER: And, Rush, I hate to do this to you, sweetie, but I gotta correct you on one thing. You said that 36 states have laws on the books that mandate coverage for preexisting?

RUSH: Yes. That's what a staffer told me.

CALLER: Well, the staffer is mistaken. Starting in 1996, federal law requires all insurance companies for group plans, not individual, but group plans you have to accept everybody, regardless. Now, there is a waiting period for preex of a year maximum, and that's reduced based on how long you had coverage prior to enrolling.

RUSH: Well, that's HIPAA, isn't it?


CALLER: It is. That's the HIPAA law.

RUSH: All right.

CALLER: And that's been in effect since 1996. And, you know, your group, your employer-provided coverage is 80% of your insurance market.

RUSH: But I was talking about high-risk pools since 1996.

CALLER: Some states do have high-risk pools --

RUSH: That's what I was --

CALLER: -- most states got out.

RUSH: -- saying, 36 of them, I think.

CALLER: Well, most states got out of the high risk business, one, because it really wasn't needed, and two, the folks who do go into it are the folks with the catastrophic illnesses that you just can't put enough money into it.

RUSH: All right, could somebody with diabetes get coverage under HIPAA?

CALLER: Oh, yeah.

RUSH: Well, what are we talking about here?

CALLER: Well, that's why I wanted to tell the lady in Florida, you know, if you had an 18-year-old who didn't go to college, she just went to work as a secretary for some company --

RUSH: Yeah?

CALLER: -- okay, she would go in under their group plan. If her parents covered her up until the point that she went to work, that person, that 18-year-old would have no waiting period whatsoever for coverage for her type 1 diabetes. If the parents did not have that coverage, if she went at work and had not had insurance for 12 months, the maximum amount of time she would have to wait for coverage for the diabetes is a year, but everything else, if she broke her leg, it would be covered.

RUSH: Whose regulations are these? Did you guys write these yourselves or the government make you write this stuff?

CALLER: This is the HIPAA. This is the government.

RUSH: Okay.

CALLER: This, incidentally, was a Republican Congress that did that.

RUSH: Well, it's supposed provide medical care privacy, medical record privacy, but --

CALLER: Oh, there's much more in there than that.

RUSH: I know, but it doesn't even do that, is my point.

CALLER: Oh, yeah. Well, you know, it's kind of funny, if the Pentagon's computers aren't protected, then who thinks that their health records that are now gonna be electronic are gonna be protected? I want to see that.

RUSH: It's not. But, look, I want to talk about high-risk pools because I'm pretty sure that more than half the states have these high-risk pools.

CALLER: And they may. I mean I know where I am that it was tried and it was dropped. Like I said, there wasn't the need, and for the few enrollees that you had, the costs were through the ceiling.

RUSH: Okay, so what's the difference between HIPAA and what Obamacare does? Why do we even need Obamacare, this precondition stuff, if we got HIPAA?

CALLER: I think they're doing it because the public is generally ignorant of preex laws that are on the book --

RUSH: It's not ignorant, it's impossible. I can't keep up with this stuff as you're telling me about it.

CALLER: Oh, I'm sorry.

RUSH: No, no, it's not you. I'm supposed to know that my kid has 12 months variance to go get coverage if my parents covered me but he didn't get covered under my parents, my grandparents were covered here under this law in 1874, if it contrives with what was written here in 2009, maybe I can get coverage for six weeks of my type 1 diabetes provided it doesn't offend a Democrat. I mean that's what all this stuff sounds like to me. What in the world just happened to walking into an insurance office and saying, "Look, I want to buy a policy. I got type 1 diabetes, will you cover me?" "Yes, here's what it's gonna cost you." "Fine, I'm not gonna buy, I can't afford it," or, "Here's a check." This is worse than hieroglyphics. This is worse than trying to learn a foreign language. This is like trying to learn every dialect of the Chinese lingo.

CALLER: Well, Rush, that's why we gotta get the government out of it. They've created this monstrosity.

RUSH: Yeah.

CALLER: And, you know, we understand it 'cause we have to work in it every day. And if people paid half as much attention to their health insurance as they do to NBA scores on a weekly basis they'd understand it, too. It's really not that complicated.

RUSH: They think they are. People are obsessed with their health care coverage. They're obsessed with it. They're more obsessed with their health care coverage than they are with getting food, for crying out loud. Their health care coverage is a daily emergency. They don't think they can get out of bed without it.

CALLER: Well, Rush, I got the biggest kick out of reading that two South Dakotans signed up for Obama's wonderful preexisting condition fix, you know, the maximum number of enrollees in a state is in Pennsylvania. They have almost 2,000. But the reason for that is that they cut the prices. So for year two of Obama's great fix for preexisting conditions, DHS is doing three things: they're reducing the premium costs by 20%; they are gonna add two more tiers to the coverage and vary the premiums based on your coverage level --

RUSH: This is getting even more ridiculous. Two more tiers of coverage, I'm crying a river here just trying to understand what you've said in one ten-minute phone call.

CALLER: I'm sorry. I'm trying so hard to explain it where it makes sense.

RUSH: You could explain it perfectly and, look, I'm not a dumb guy. Can you imagine somebody in Rio Linda trying to keep up with all this?

CALLER: (laughing) Well, Rush, you know, the SEIU who bumped off their dependent coverage, you know why they did it?

RUSH: You mean for their kids?

CALLER: Yeah. You know why they did it?

RUSH: Yeah, they're a bunch of heartless SOBs.

CALLER: Beyond the obvious.

RUSH: They could have bailed out the -- they coulda done any number of things that they're making us do to cover their kids but, no, their kids are gonna go without coverage.

CALLER: No, they're not. They're gonna go to the preex plan because another way they're gonna spend that $5 billion that was allocated is open it up to children.

RUSH: Oh.

CALLER: The theory floating around the industry is that Kathleen Sebelius is gonna allow children with preexisting conditions to go to the government plan, and that's gonna entice these companies to start up again for child only.

RUSH: You know what? They ought to make prisoners try to pass a course in this stuff. That would keep people out of jail. If you had to pass a course in this stuff to get out of prison, nobody would ever commit another crime.

CALLER: Oh, Rush, I'm sorry.

RUSH: It's not you. Look, I gotta take a break here 'cause you wanted to talk about Canada, right? And we haven't even gotten there.

CALLER: Sure.

RUSH: All right, hang on.


BREAK TRANSCRIPT

RUSH: All right, back to Stacy. All right, I got two minutes. No, sorry, got a minute and a half. What's Canada?

CALLER: Okay, Obamacare came within 5% of making the US health care system Canada's system.

RUSH: Yeah?

CALLER: And now the CBO on December 13th before the Senate pushed through the bill on Christmas Eve --

RUSH: Yeah.

CALLER: -- the CBO released a memo about the medical loss ratio. Remember I told you about how much they were gonna make us pay out in claims versus what we get to spend on administration?

RUSH: Yeah, I remember every penny of it.

CALLER: Okay, the CBO said Harry Reid initially wanted that to be 90% of claims and 10% for admin. The CBO came back and told Harry Reid that if they did that, the CBO would assume all health insurance, private and public, to be part of the federal budget. I am going to e-mail Mr. Snerdley the link to this document, the last paragraph is where it is 'cause I know how you hate people reading.

RUSH: Well, it's only because most people aren't highly trained professionals.

CALLER: I understand.

RUSH: But, look, again, this is the government telling a private business how to run itself. You know, what it can spend on profits, what it can spend on coverage. It's just asinine. It's absurd. Send it to Snerdley. I'm sure he's got your e-mail address and vice-versa. Stacy, thanks much.
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Sorry Small Businesses, No 1099 Repeal This Time...But Soon!

Post  sc4ram on Sat Dec 04, 2010 1:30 pm




http://politics.blogs.foxnews.com/2010/11/29/sorry-small-businesses-no-1099-repeal-timebut-soon
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Health Care Reform: How Companies Need To Worry

Post  sc4ram on Sun Dec 05, 2010 2:18 am



http://www.forbes.com/2010/11/29/health-care-reform-employee-retention-leadership-managing-costs.html?feed=rss_home
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Unions, Companies Win Health-Reform Exemptions

Post  sc4ram on Thu Dec 09, 2010 2:01 am




http://video.foxbusiness.com/v/4452401/unions-companies-win-health-reform-exemptions
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Congress Does a 'Doc Fix'

Post  sc4ram on Fri Dec 10, 2010 2:54 am



http://www.theatlantic.com/business/archive/2010/12/congress-does-a-doc-fix/67772/
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Florida Republicans Want Out of Federal Health Reform

Post  sc4ram on Sat Dec 11, 2010 2:25 am



http://www.wtvy.com/home/headlines/Florida_Republicans_Want_Out_of_Federal_Health_Reform_111569484.html
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Side Effects: Number of Waivers Grows As a Result of Obamacare Authors’ Sloppy Handiwork

Post  sc4ram on Sun Dec 12, 2010 1:28 pm



http://blog.heritage.org/2010/12/10/side-effects-number-of-waivers-grows-as-a-result-of-obamacare-authors%e2%80%99-sloppy-handiwork/
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Treasure Coast doctors happy with reprieve from Medicare reimbursement cuts

Post  sc4ram on Mon Dec 13, 2010 12:48 pm



http://www.tcoasttalk.com/2010/12/11/local-doctors-happy-with-reprieve-from-medicare-reimbursement-cuts/
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Federal judge in Va. rules against Obama-care

Post  sc4ram on Mon Dec 13, 2010 2:26 pm




http://southflorida.sun-sentinel.com/news/sns-ap-us-health-care-overhaul-virginia,0,3069161.story
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From Landmark Legal Foundation on ObamaCare

Post  sc4ram on Tue Dec 14, 2010 2:31 am



http://www.facebook.com/notes/mark-levin/from-landmark-legal-foundation-on-obamacare/470155410945
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Disney, Universal win insurance waivers

Post  sc4ram on Fri Dec 17, 2010 2:18 am



http://www.orlandosentinel.com/the-daily-disney/os-disney-universal-waivers-20101215,0,1272961.story
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Health insurance mandate like broccoli? Judge wants to know

Post  sc4ram on Sat Dec 18, 2010 2:11 am



http://www.postonpolitics.com/2010/12/health-insurance-mandate-like-broccoli-judge-wants-to-know/
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Health-care reform law outlook is hardly promising

Post  sc4ram on Mon Dec 20, 2010 2:40 am



http://www.marconews.com/news/2010/dec/16/guest-commentary/?partner=yahoo_feeds
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WikiLeaks cables: Michael Moore film Sicko was 'not banned' in Cuba

Post  sc4ram on Tue Dec 21, 2010 3:06 am

This is rich, Mr. Moore was a contributor to the bail money for Julian Assange in the UK (the Wicki Leaks guy that leaked these cables in the first place), a action which has been praised in may lefty circles as "showing us what our government is doing". Now that the cables say something Mr. More finds objectionable, they are suddenly not credible. Besides looking like he lives in his parent's basement, I think Michael Moore is the sicco here............

As for seeing a doctor (for medical purposes) in Cuba, I will right after Michael Moore does.


http://www.guardian.co.uk/world/2010/dec/18/wikileaks-us-diplomats-story-cuba-banned-sicko-film
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Health Care Reform faces fresh Legal and Political Hurdles

Post  sc4ram on Wed Dec 22, 2010 12:20 pm




http://www.pbs.org/newshour/video/module.html?s=news01s4666q1009
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Obama Health Law Should Be Completely Thrown Out, States Argue

Post  sc4ram on Thu Dec 23, 2010 2:35 am



http://www.businessweek.com/news/2010-12-22/obama-health-law-should-be-completely-thrown-out-states-argue.html
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Revelations from Obamacare

Post  sc4ram on Fri Dec 24, 2010 4:06 am


AARP gets preferential treatment in exchange for its support:

http://www.foxnews.com/on-air/special-report/index.html#/v/4473262/big-break-for-aarp/?playlist_id=86927
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Medicaid tightens its grip on funding

Post  sc4ram on Sun Dec 26, 2010 1:00 pm



http://www.floridatoday.com/article/20101226/NEWS01/12260335/Medicaid-tightens-its-grip-on-funding
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Obamacare: The Price Controls Begin

Post  sc4ram on Mon Dec 27, 2010 2:07 am



http://blog.heritage.org/2010/12/24/obamacare-the-price-controls-begin/
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Death Panels are back

Post  sc4ram on Wed Dec 29, 2010 1:15 pm


http://www.nypost.com/p/news/opinion/opedcolumnists/here_come_death_panels_rOgtOinGhJgRdmCYR9JtcK?CMP=OTC-rss&FEEDNAME=



http://www.nytimes.com/2010/12/26/us/politics/26death.html?pagewanted=1&_r=2
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Health care changes that may affect you start January 1

Post  sc4ram on Mon Jan 03, 2011 2:03 am



http://www.orlandosentinel.com/health/os-pg-2011-health-care-changes,0,6465264.photogallery
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Healthcare Showdown

Post  sc4ram on Tue Jan 04, 2011 2:27 am




http://www.cnbc.com/id/15840232?video=1720050846&play=1
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Cantor's Obamacare repeal bill goes online

Post  sc4ram on Wed Jan 05, 2011 2:04 am

I like this, a 2 page bill that I can easily read, (2 pages beats 2000 any day)

http://washingtonexaminer.com/blogs/beltway-confidential/2011/01/cantors-obamacare-repeal-bill-goes-online
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Boehner fires back at Dem senators with vow to push forward with repeal

Post  sc4ram on Thu Jan 06, 2011 2:40 am

Short and sweet...................


http://thehill.com/blogs/blog-briefing-room/news/135895-boehner-fires-back-at-dem-senators-with-vow-to-push-forward-with-repeal
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Reality Check: Repeal of Obamacare Would Not Increase the Deficit

Post  sc4ram on Fri Jan 07, 2011 2:05 am



http://blog.heritage.org/?p=49568
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Re: Health Care initiatives in the world of the unemployed

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