[B][U]Romney Plan for Pre-Existing Conditions Draws Dem Fire[/U][/B]
By Devin Dwyer
Mitt Romney this week has been highlighting his opposition to Obamacare, telling voters and donors of his eagerness to see the U.S. Supreme Court strike the law down and a willingness to do the deed from the White House if the court does not.
"You know, regardless of what they do, it's going to be up to the next president to either repeal and replace Obamacare or to replace Obamacare," Romney told a crowd in Orlando on Tuesday.
But it's Romney's unabashed public opposition to one of the law's most popular provisions - a ban on health insurance company discrimination against people with pre-existing conditions - that is once again stirring the political pot.
The former governor said this week, reiterating a position he's articulated in the past, that only Americans who have had constant, uninterrupted insurance coverage should be guaranteed access to a health plan, regardless of any pre-existing conditions.
Asked to clarify his position on Wednesday, Romney campaign spokeswoman Andrea Saul confirmed that the former governor does not support the across-the-board consumer protections for pre-existing conditions as written into Democrats' health care law.
"Governor Romney supports reforms to protect those with pre-existing conditions from being denied access to a health plan while they have continuous coverage," she said first in a statement to the Huffington Post later obtained by ABC News.
As for Americans with pre-existing conditions who may not have had continuous insurance coverage or spent a period of time without, Saul said Romney "supports reforms that empower states to make high risk pools more accessible by using cost reducing methods like risk adjustment and reinsurance," but suggested there would be no guarantees.
"Beginning on his first day in office, Governor Romney is committed to working with Congress to enact polices like these that protect Americans' access to the care they need," she added.
Democrats have seized on the position to cast the former Massachusetts governor, who authored a landmark state health law that mandated individual insurance coverage, as grossly out of touch. A New York Times/CBS News poll in March found that 85 percent of Americans support the law's pre-existing conditions protections.
"Mitt Romney just clarified the choice in this election - he'd put insurance companies back in charge," said deputy Obama campaign manager Stephanie Cutter. "People living with pre-existing conditions from asthma to breast cancer are on their own if Mitt Romney is elected president and millions more would lose their health insurance."
Romney's position - protecting people with pre-existing conditions so long as they've always had insurance - has been law since 1996, experts say. It does not immediately address people who have never had private health insurance, or who have had insurance but spent some time without, often because of financial circumstances and unemployment.
The governor believes in an incremental, market-based solution to boosting coverage and helping states develop ways to help those with difficulty obtaining insurance or care.
Romney's comments this week are not the first time he's publicly defended his approach. In March, the candidate had a lengthy exchange with "Tonight Show" host Jay Leno on the topic of pre-existing conditions.
LENO: "What about pre-existing conditions in children? That - I mean, I know people who could not get insurance up until this Obamacare and now they're covered. Their pre-existing condition is covered. …It seems like children and people with pre-existing conditions should be covered."
ROMNEY: "Yeah. Well, people who have been continuously insured, let's say someone's had a job for a while but insured, then they get real sick and they happen to lose a job, or change jobs, they find, gosh, I've got a pre-existing condition, I can't get insured. I'd say, no, no no. As long as you've been continuously insured, you ought to be able to get insurance going forward. See, you have to take that problem away. You have to make sure the legislation doesn't allow insurance companies to reject people."
LENO: "So you would make the law stand for children and people with pre-existing conditions?"
ROMNEY: "Well, people with pre-existing as long as they'd been insured before, they're going to be able to continue to have insurance."
LENO: "Well, suppose they were never insured before?"
ROMNEY: "Well, if they're 45 years old, and they show up and they say 'I want insurance because I've got a heart disease,' it's like, hey, guys, we can't play the game like that. You've got to get insurance when you are well. And so and then if you get ill, then you're going to be covered."
LENO: "Yeah, but there a lot people that - see I only mention it because I know guys that work in auto industry and they're just not covered because they work in brake dust and could get it - so they've just never been able to get insurance. And they get to be 30, 35, they were never able to get insurance before, now they have it. That seems like a good thing."
ROMNEY: "Well, we'll look at circumstance where someone was ill, and hasn't been insured so far. But people have had the chance to be insured. If you're working at an auto business, for instance."
ROMNEY: "The companies carry insurance. They insure all their employees. You look at the circumstances that exist. But people who have done their best to get insured are going to be able to be covered. But you don't want everyone saying, 'I'm going to get back until I get sick,' and then go buy insurance."
LENO: "No, of course not. Of course. Of course."
ROMNEY: "That doesn't make sense. But you have to find rules that get people in that are playing by the rules."
Romney is correct. Without a mandate it is not possible to force insurance companies to take on folks with pre-existing conditions. If it were no one would purchase the insurance up front. they would wait until they got sick then buy insurance. It is a problem within Obamacare as well in that folks can just pay the fine each year, save the cash, then jump on a plan when they get sick.
The Romney plan guarantees that folks with coverage can't be dropped when they get sick as it should be (New York State already has that mandate on the books). Romney also called for portability of insurance from State to State (good concept but difficult to implement due to States rights) and allowing small businesses to pool together to purchase insurance like the big guys. That is perhaps the single best idea in terms of common sense. My company pays twice what large companies pay for family coverage. If small businesses could pay half of what their paying now many more would offer insurance to their employees. That concept alone will cover more people and reduce the cost drastically without the government having to spend a dime. Common sense.
[QUOTE=Buster;4492212]From what I understand the mandate part of 'Obamacare' paid for covering the pre-existing condition folks.
So, if the Supreme Court strikes down only the mandate part of the law there will be trouble in the insurance industry.[/QUOTE]
The mandate is what ensures people don't game the system by refusing to purchase insurance until they are actually sick. That would change it from "insurance" (i.e. I pay you $10 and if I get sick it's a good deal for me, and a bad deal for you, if I stay healthy you profit) to "I pay you $10 so you cover my $100 medical bill" (i.e. no chance for insurance companies to make a profit).
But yes, coverage for preexisting conditions should only be mandatory if the person with the preexisting condition can prove that he was uninsured despite attempting to procure insurance, not just because he chose not to purchase it.
But yes, coverage for preexisting conditions should only be mandatory if the person with the preexisting condition can prove that he was uninsured despite attempting to procure insurance, not just because he chose not to purchase it.[/QUOTE]
How would that be any different than the person who can't get car insurance because of their lousy driving record, but then gets in an accident and "demands" insurance because they tried to get it but was refused? Or perhaps he could get insurance, but the rates were so high he couldn't afford it? Would that be a valid excuse?
Is there anyone out there who CAN'T get health insurance? Or is it just a question of being able to pay for it? And if it's the latter, is that fair? Should someone who you KNOW is going to be a drain on the system pay more than someone who potentially won't be?
I completely agree with not being dropped if you already have insurance -- that's WHY they call it "insurance". But I just don't see how you can feasibly force companies to insure people they know from the start are going to take out substantially more than they put in . . .
[QUOTE=OCCH;4492574]How would that be any different than the person who can't get car insurance because of their lousy driving record, but then gets in an accident and "demands" insurance because they tried to get it but was refused? Or perhaps he could get insurance, but the rates were so high he couldn't afford it? Would that be a valid excuse?
Is there anyone out there who CAN'T get health insurance? Or is it just a question of being able to pay for it? And if it's the latter, is that fair? Should someone who you KNOW is going to be a drain on the system pay more than someone who potentially won't be?[/quote]
Yes: Children whose parents did not provide them with coverage or sign them up for state plans.
[QUOTE=doggin94it;4492589]Yes: Children whose parents did not provide them with coverage or sign them up for state plans.[/QUOTE]
In this circumstance I could see the States setting up a specific plan for those children. I would be surprised if there are 50,000 kids that fall in to that category nationwide. You can't base a healthcare plan designed for 400 million people around 20,000 or so that fall in to an unfair category. The impoverished poor are already covered in our system through the safety net. It is the working poor that get the shaft right now.
The families with 35-50K income where the employer does not provide coverage and because insurance is so damn expansive they choose not to purchase it.
The solution? Bring down the cost and offer less expensive catastrophic/preventive coverage plans. Employers would likely add insurance if it wasn't so expensive. That along with Romney's plan to allow small businesses to pool together and reduce the pricing to the levels that larger companies pay would go a longer way toward covering the 30 million working poor families that lack coverage today.
My company pays $27,000 per year for each family health plan we buy(up from $17,000 before Obamacare). A friend of mine runs a similarly small company but they have an association which pools companies together (not offered in my area). They pay $11,000 per family for a similar plan. The difference is beyond dramatic. Quite frankly is pisses me off.
Take the working poor example from before. If I offer them insurance with a 50/50 company match what will they do? Well at 27K per year the employee match is $13,500 per year. Ouch. Even worse if as an employer I know I'm on the hook for the other $13,500 I will lower the salary I offer for the position. When hiring we look at "total compensation" as the primary consideration. The higher cost of insurance ensures that everyone loses.
Redo the example but reduce the cost of the plan to $10,000. The employee gets paid more because the total comp picture has changed. They therefore can afford the $400 per month for the insurance plan. Millions would insure their families if we could just get the cost down.
I believe everyone should be able to buy insurance. If a comapny provides it - fine.
Extraordinary (Cadillac ) plans should be taxed as income if provided free.
No insurance. No service. Want it? Go to a free clinic.
Pre-existing conditions. These should be covered after a WAITING period. A fair period is perhaps two years. When I decided to stop working I purchased my own plan. My wife had a minor problem with her esophogus. She had coverage EXCEPT for any problem involving that. After two years it was covered. Fair.
If we lied on the application - no coverage plus we would be on a national published list and NEVER get any coverage.
There can also be types of plans. The gov for Medicare SUPPLEMENTS has about a dozen standared plans created. These are offered thru insurance companies. Every insurance company has the same plans (perhaps not all of them) at the price they charge. Good idea. You buy the coverage you need. Like car insurance. To be safe you have lots of liability coverage. No money you go bare bones. Makes sense.
[QUOTE=chiefst2000;4492642]In this circumstance I could see the States setting up a specific plan for those children. I would be surprised if there are 50,000 kids that fall in to that category nationwide. You can't base a healthcare plan designed for 400 million people around 20,000 or so that fall in to an unfair category. The impoverished poor are already covered in our system through the safety net. It is the working poor that get the shaft right now.
There are more than a million kids in this country that are diagnosed with autism alone, almost all of who do not have their condition recognized by insurance companies. Recently many states have passed (weak) legislation that requires insurance companies to provide coverage, mainly because it is viewed as discriminatory to not, but also to move them off the specific plan already in place on the part of the States, Medicaid.
I won't even get into the "legality" of the Rommey plan as it applies to autism as this is a disorder whose etiology is unknown and furiously debated by all sides, insurers included. Really, if you want to get down to the scientific brass tacks, we all have pre-existing conditions on some level, it's just a matter of when/if the manifest themselves. How they do (environment, lifestyle etc) may provide some defining verbiage for coverage, but really it's mostly splitting hairs. Genetically speaking.