Obamacare Covers Pre-Existing Conditions at Unaffordable Costs
By Dave Jolly
Feb 20, 2014
One of the major selling points of Obamacare was its promise to cover pre-existing illnesses and conditions. No one would be denied coverage regardless of what they had previously. But what they didn’t tell anyone was that the cost of covering pre-existing conditions and illnesses would be too high for many patients to afford.
To begin with, just having a pre-existing condition automatically places one in a higher cost bracket. The more expensive the condition is to treat, the higher the cost for coverage. I’m overweight and have diabetes prior to Obamacare going into effect, I was deemed uninsurable when trying to obtain private health insurance. With Obamacare, I am guaranteed coverage but my pre-existing conditions double the cost of coverage I could get without them. In the end, it makes obtaining health insurance far too expensive for me to afford.
Emilie Lamb who suffers from lupus is another example of the higher cost for pre-existing conditions that is being used by the conservative group Americans for Prosperity in an ad. Lamb starts out saying:
“I voted for Barack Obama for president. I thought ObamaCare was going to be a good thing.”
Then she explains how she received a letter telling her that her insurance plan had been cancelled due to Obamacare. Through the exchange, her monthly premiums increased from $52 a month to $373 a month. Lamb goes on to say:
“I’m having to work a second job, to pay for ObamaCare. For somebody with lupus, that’s not an easy thing. If I can’t afford to continue to pay for ObamaCare, I don’t get my medicine. I don’t get to see my doctors.”
For those who are fortunate enough to be able to obtain health insurance for pre-exiting conditions, they may face a second financial hurdle and that is the cost of their medications. People with diseases deemed expensive to treat such as lupus and multiple sclerosis face the dreaded ‘closed drug formulary.’
What does that mean? Dr. Scott Gottlieb, a practicing physician and Resident Fellow at the American Enterprise Institute (AEI) explains:
“If the medicine that you need isn’t on that list, it’s not covered at all. You have to pay completely out of pocket to get that medicine, and the money you spend doesn’t count against your deductible, and it doesn’t count against your out of pocket limits, so you’re basically on your own.”
Dr. Daniel Kantor, a neurologist in Ponte Vedra Beach, Florida treats a number of patients suffering from MS and other neurological diseases. He explained further what his patients face under Obamacare:
“So it could be that a MS patient could be expected to pay $62,000 just for one medication. That’s a possibility under the new ObamaCare going on right now.”
Emilie Lamb not only is facing a huge increase in her monthly health insurance premiums, but the medications for lupus are like those for MS and could end up costing her many thousands of dollars out of pocket which Lamb cannot afford.
Dr. Kantor says he and other doctors are worried that patients with lupus, MS and other pre-existing conditions won’t be able to afford their medications under Obamacare. Some of them may only buy some of the medications instead of all of them or they may take them sparingly instead of regularly. He commented:
“We know MS can be a bad disease when you’re not treating it. When you’re treating it, for most people they handle it pretty well, but we know when you don’t treat (it), it’s the kind of disease where people end up in wheel chairs potentially.”
Obama promised coverage for pre-existing conditions. He didn’t promise that this coverage would be affordable . It seems that Obamacare and insurance companies have gone out of their way to make pre-existing conditions so expensive to cover that many people will opt not to purchase coverage. That was my only option.
By Dave Jolly
Feb 20, 2014
One of the major selling points of Obamacare was its promise to cover pre-existing illnesses and conditions. No one would be denied coverage regardless of what they had previously. But what they didn’t tell anyone was that the cost of covering pre-existing conditions and illnesses would be too high for many patients to afford.
To begin with, just having a pre-existing condition automatically places one in a higher cost bracket. The more expensive the condition is to treat, the higher the cost for coverage. I’m overweight and have diabetes prior to Obamacare going into effect, I was deemed uninsurable when trying to obtain private health insurance. With Obamacare, I am guaranteed coverage but my pre-existing conditions double the cost of coverage I could get without them. In the end, it makes obtaining health insurance far too expensive for me to afford.
Emilie Lamb who suffers from lupus is another example of the higher cost for pre-existing conditions that is being used by the conservative group Americans for Prosperity in an ad. Lamb starts out saying:
“I voted for Barack Obama for president. I thought ObamaCare was going to be a good thing.”
Then she explains how she received a letter telling her that her insurance plan had been cancelled due to Obamacare. Through the exchange, her monthly premiums increased from $52 a month to $373 a month. Lamb goes on to say:
“I’m having to work a second job, to pay for ObamaCare. For somebody with lupus, that’s not an easy thing. If I can’t afford to continue to pay for ObamaCare, I don’t get my medicine. I don’t get to see my doctors.”
For those who are fortunate enough to be able to obtain health insurance for pre-exiting conditions, they may face a second financial hurdle and that is the cost of their medications. People with diseases deemed expensive to treat such as lupus and multiple sclerosis face the dreaded ‘closed drug formulary.’
What does that mean? Dr. Scott Gottlieb, a practicing physician and Resident Fellow at the American Enterprise Institute (AEI) explains:
“If the medicine that you need isn’t on that list, it’s not covered at all. You have to pay completely out of pocket to get that medicine, and the money you spend doesn’t count against your deductible, and it doesn’t count against your out of pocket limits, so you’re basically on your own.”
Dr. Daniel Kantor, a neurologist in Ponte Vedra Beach, Florida treats a number of patients suffering from MS and other neurological diseases. He explained further what his patients face under Obamacare:
“So it could be that a MS patient could be expected to pay $62,000 just for one medication. That’s a possibility under the new ObamaCare going on right now.”
Emilie Lamb not only is facing a huge increase in her monthly health insurance premiums, but the medications for lupus are like those for MS and could end up costing her many thousands of dollars out of pocket which Lamb cannot afford.
Dr. Kantor says he and other doctors are worried that patients with lupus, MS and other pre-existing conditions won’t be able to afford their medications under Obamacare. Some of them may only buy some of the medications instead of all of them or they may take them sparingly instead of regularly. He commented:
“We know MS can be a bad disease when you’re not treating it. When you’re treating it, for most people they handle it pretty well, but we know when you don’t treat (it), it’s the kind of disease where people end up in wheel chairs potentially.”
Obama promised coverage for pre-existing conditions. He didn’t promise that this coverage would be affordable . It seems that Obamacare and insurance companies have gone out of their way to make pre-existing conditions so expensive to cover that many people will opt not to purchase coverage. That was my only option.
