This page was last updated on October 10, 2012.
Health care act works; Michael J. Komlos; Beaver County Times; October 10, 2012.
Below is a detailed critique of the subject letter.
“I’ve been fortunate and grateful for excellent health care insurance provided as part of my wife’s family plan paid as part of her college’s benefits package.
“Recently, I reached the age of 65 and had to seek a supplemental insurance plan to add to Medicare coverage.”
[RWC] Mr. Komlos appears to refer to Medigap insurance. According to a Forbes article, “Medigap plans are private insurance plans that seniors buy to cover the things that traditional, government-run Medicare doesn’t, like catastrophic coverage. Medigap plans also help seniors eliminate the co-pays and deductibles that are designed to restrain wasteful Medicare spending.”
“Previously, I viewed this transition with ominous and troubling concern. In past years my status was the same as millions of ‘uninsurable.’ I would have been ostracized arbitrarily because I had pre-existing medical conditions.”
[RWC] This claim appears to be untrue. My research indicates Obamacare had no effect on Medigap insurance and pre-existing conditions.
Even before Obamacare, all Medigap plans were required to cover pre-existing conditions. According to “Choosing a Medigap Policy” for 2009 written by the Centers for Medicare & Medicaid Services, “While the insurance company can’t make you wait for your coverage to start, it may be able to make you wait for coverage of a pre-existing condition. A pre-existing condition is a health problem you have before the date a new insurance policy starts. In some cases, the Medigap insurance company can refuse to cover your out-of-pocket costs for these pre-existing health problems for up to 6 months. This is called a ‘pre-existing condition waiting period.’” “Choosing a Medigap Policy” for 2012 says the same thing.
There are a bunch of exceptions that grant immediate coverage of pre-existing conditions, however. One of those exceptions is “coverage from [Private health insurance] for at least six months prior to purchasing the Medigap and have had this prior coverage within the last 63 days.” This appears to have been Mr. Komlos’ situation (coverage by his “wife’s family plan”).
Medicare issues aside, let’s look at Mr. Komlos’ comment that he “would have been ostracized arbitrarily because I had pre-existing medical conditions.” There’s nothing “arbitrary” about not covering pre-existing conditions. Forcing medical insurance companies to cover pre-existing conditions is the same as forcing a company to issue a fire insurance policy on a house that’s already burning down. That’s not insurance; it’s a handout and forces up the rates paid by everyone else.
“Yet a provision from what is called disaffectionately by some as Obamacare prevents exclusion from health care plans because of such discrimination.”
[RWC] Except for Medigap insurance as discussed above.
President Obama himself refers to Obamacare as Obamacare.
“Because of this act, I had no difficulty becoming insured, enabling me the opportunity to receive much-needed health care with relative ease.”
[RWC] Again, Obamacare did nothing with respect to Medigap coverage of pre-existing conditions. For the sake of argument, what if Obamacare increased coverage of pre-existing conditions? There ain’t no free lunch; someone has to pay and this additional coverage forces up the rates paid by all policyholders.
“Also, we have nieces and nephews who graduated from college and are now fully employed. A major role in their success was being able to be included with their parents’ coverage until age 25 if needed.”
[RWC] How did “being able to be included with their parents’ coverage” play “A major role in their success?” I’m not a sociologist, but I suspect this “benefit” delays some adults from leaving the nest.
In any case, there ain’t no free lunch; someone has to pay and this additional coverage for adult dependent children forces up the rates paid by all policyholders.
“Might I suggest that citizens with doubts remaining study the provisions passed by our Congress instead of listening to the judgmental skewed rhetoric of critics with only a political agenda.”
[RWC] As you read above, just about everything Mr. Komlos wrote about Obamacare, Medigap insurance, and pre-existing conditions was false. Given that, if you think Mr. Komlos didn’t have a “political agenda” for writing this letter, I have a bridge to sell you.
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