Ending medical underwriting: The popular part of Obamacare

Polls showing that few people understand the intricacies of the Affordable Care Act (aka Obamacare)–things like health insurance exchanges, minimum medical loss ratios, and the like– don’t surprise me. It’s pretty wonky stuff and frankly it’s not critical to most people.

But I’m a little more surprised and concerned that people are unaware that Obamacare addresses head-on an issue that lots of people care about: the ability for people with pre-existing conditions to get coverage at reasonable rates, and to avoid losing their health insurance or seeing rates jump when they get sick.

This is a topic people care about. About half of non-elderly people surveyed by Kaiser Family Foundation indicated that either they or a family member had a pre-existing condition. One-quarter said they or someone in their household had their premium raised or coverage denied as a result. One-third are worried about having to stay in a job they don’t like or putting off retirement due to this issue.

The relatively unpopular mandate to buy insurance coverage under Obamacare must be looked at in the context of the popular mandate to offer coverage at regular prices without regard to pre-existing conditions. Getting rid of medical underwriting only works if everyone is in the insurance pool. If only the sick are covered then affordability goes away.

As the benefits of the Affordable Care Act are publicized, I’d suggest reinforcing the value of not worrying about pre-existing conditions and link it to the mandate.

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By David E. Williams of the Health Business Group.

2 thoughts on “Ending medical underwriting: The popular part of Obamacare

  1. Nate Ogden

    “One-quarter said they or someone in their household had their premium raised or coverage denied as a result.”

    We either have a very small world or KFF poll is deeply flawed. Group insurance does not have individual underwriting. That would mean this could only apply to people buying coverage in the individual market. About 15% of the market.

    “the popular mandate to offer coverage at regular prices without regard to pre-existing conditions.”

    How are you defining regular prices? I suspect your going to be greatly disappointed, along with most of the bills supporters, to find out not only do the sick not get insurance at “regular” prices but now even the healthy don’t. Unless you consider 88% increase(Ohio) regular price, no one is paying it any more. Common suffrage, was that the purpose of the bill?

    Reply
  2. David E. Williams of the Health business blog Post author

    Thanks for your comment.

    On your first point, there are a couple reasons the number could be higher than the 15% market penetration:
    — Even if only 15% of market is individual at any given time, people shift over time and so more than 15% have had individual coverage at some point in the past
    — Household could include people on different plans
    — Some uninsured people could answer “yes” to the question and would not be part of the 15%

    On the second point:
    — I’m in MA, which bans medical underwriting and merged the individual and small group markets as part of RomneyCare
    — “Regular” prices are high and they went up when the law was enacted, but they’re not unaffordable thanks to subsidies, Medicaid availability, and high wages in the state
    — You can point to anecdotes like the 88% Ohio price jump. I can also point out that our premium went down in 2013 and we were not alone

    Reply

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