Television reporters often compress complex issues into short sound bites because they fear getting “into the weeds” of details. Sometimes, however, they go too far. The result can be confusion at best and misunderstanding at worst.
When talking about health care insurance reform, for example, many reporters have adopted a shorthand explanation of the proposal to guarantee health insurance coverage to everyone. The reporters say the new law is designed to “end the health insurance companies’ practice of denying coverage to those with preexisting conditions.” This oversimplification is extremely misleading. It suggests that anyone with a preexisting condition is uninsurable. This, of course is nonsense.
As a matter of fact, the vast majority of people with preexisting conditions are insured with no waiting period for their preexisting condition. That’s because most people get their health insurance through a group plan, and it is against the law to deny or delay coverage for preexisting conditions to people enrolling in a group plan.
Nor can health insurance providers deny coverage to someone seeking individual health insurance, provided they have had “continuous coverage” as outlined by HIPPA (Health Insurance Portability and Accountability Act). If you lose your group health insurance, you have a 63-day window to obtain new coverage to maintain your continuous coverage. Another significant portion of those with pre-existing conditions remain covered through HIPPA.
The only people really at risk of having their health insurance denied are those who are seeking individual coverage without HIPPA protection. Even in these cases, however, the health insurance providers do not deny coverage for most preexisting conditions; they merely postpone it for a waiting period. In the meantime, the health insurance company will cover all other illnesses and injuries.
Finally, those who are aged 65 and above—a large percentage of those with preexisting conditions—are covered in full by Medicare. The very poor and those with disabilities are eligible for coverage through Medicaid, regardless of preexisting conditions.
The number of people who are denied coverage outright because of preexisting conditions is very small. Keep in mind, however, that such individuals can make use of a flexible spending account (FSA), a savings account specifically create for paying medical costs. The beauty of an FSA is that the funds can be deposited before federal and state taxes are withheld, increasing the account holder’s buying power by 30 to 50 percent.
Should the unfortunate few denied health insurance beyond a waiting period because of preexisting conditions receive more help from the federal government? Perhaps, but the entire health insurance system does not have to be overhauled to do so. A targeted solution would be to provide outright grants to FSAs. This would preserve the actuarial integrity of private health insurance while covering those who need it. Such a program also would be more transparent, because its true cost would be known, rather than hidden in the cost of health insurance.
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