This post was written by Tiffany Wallace exclusively for WorkingWithChronicIllness. All content for informational and educational purposes only. I am not an expert in this area so I’m grateful for her effort and hope that the information is useful to you!
Affordable medical insurance is a major consideration for many people, particularly those who live with a chronic health condition. Some believe that recent legislation, often referred to as “Obamacare”, has fallen short of delivering on the promise of affordable healthcare for all citizens, and has instead placed the resources of the taxpayers at significant risk.
The Affordable Care Act aims to prevent insurance companies from the practice of rescission, which means that they will no longer have the authority to cancel someone’s insurance policy even though premiums have been paid. This will prevent those with chronic health problems from being burdened with the medical bills that should have been covered by the insurance companies. Children with preexisting conditions will no longer be denied coverage, and adults with preexisting conditions will not be denied coverage if they have been without insurance for at least six months.
Beginning in January of next year, insurance companies will not be permitted to charge higher premiums for those who are disabled or have a preexisting condition. Lifetime dollar amount limits will also be done away with in most policies so that there will no longer be a limit on the amount of coverage policy holders can use in their lives. This would be of note to those suffering from a chronic condition.
One caveat for those with a chronic condition is the cap that “Obamacare imposes on flexible spending accounts. Starting in 2013, there will be a limit of $2500 that can be saved in these accounts. The accumulated savings will no longer roll over from previous years. This could put pressure on account holders to schedule their care around a calendar rather than optimizing their doctor’s visits and medical procedures to their specific needs.
Another issue is the use of flex accounts or health savings accounts (HSA) to buy over-the-counter medication. In order to use these monies to purchase over-the-counter medications a prescription will now be required. This will use additional flex account savings if those savings are used to pay for the portion of the visit not covered by insurance. In effect, it will cost quite a lot to use flex account savings to buy cold medicine or a common pain reliever.
According to statistics, 35% of the people with a chronic health issue use 65% of the medical resources available. Changes in healthcare will have a national impact on the quality of care that these individuals may receive. There is significant risk that many businesses will be unable to maintain the cost of their plans, and the insured workers will be transferred to the individual state run exchanges. This might be problematic because the insurance companies are will not be required to cover preexisting conditions until 2014.
The cost of individual policies will increase significantly when coverage is mandated for those with chronic conditions. This has already happened in the states that have a guaranteed issue and require availability of insurance to everyone. The cost of an individual policy can be as much as four times higher in a state where they have a guaranteed issue mandate, and while this is good for those with chronic health conditions it increases the cost of care for healthy people.