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Progressive Politics in Minnesota, the Nation, and the World

About That Gap In Coverage

Category: Health Care
Posted: 05/19/17 10:48

by Dave Mindeman

As the GOP publicly defends the GOP Congress version of health care, the biggest item to keep in mind is their "promise" to maintain the mandate about pre-existing conditions.

The Kaiser Foundation examined this concept and stated publicly that this is what we face:

Using the most recent National Health Interview Survey (NHIS), we estimate that 27.4 million non-elderly adults nationally had a gap in coverage of at least several months in 2015. This includes 6.3 million people (or 23% of everyone with at least a several-month gap) who have a pre-existing condition that would have led to a denial of insurance in the pre-ACA individual market and would lead to a substantial premium surcharge under AHCA community rating waiver."

The reason the "gap" in coverage is important is that under a law that Ted Kennedy passed years ago, if a person has had continuous coverage under some form of insurance, they cannot be denied coverage, or have surcharges, via an insurer. In the AHCA bill, an opt out by a state can grant the insurers an option of significant surcharges for pre-existing conditions, making the coverage completely unaffordable.

We all know how life intervenes. People get laid off. Bills get overwhelming and health premiums get lower priority. Jobs change and coverages change. Coverage gaps happen. It is a fact of life and people in lower wage jobs are the first victims.

The ACA (Obamacare) understood this and ended the issue of pre-existing conditions. With the Republican bill, it is has been brought back for the sake of insurance profitability.

No matter how Jason Lewis and his cohorts try to spin this, the loop hole is there. And it was placed there intentionally so that insurers can find ways to opt out of coverage for the people with the most need.

It is cynical politics and we have to keep fighting this.
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