The TRUTH about Preexisting Conditions

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TruthAboutPreexistingConditions.com

On Thursday November 7, 2013 my new friend Bill Elliott appeared on “The Kelly File” with Megyn Kelly on the Fox News channel. I say “new friend” because immediately after I watched his heart breaking interview I ‘friended’ Bill on Facebook. I wanted him to know that even though his insurer was being forced to terminate his health insurance policy due to regulations posted by HHS and referred to in the Federal Register in June 2010. Three months after the PPACA – Patient Protection & Affordable Care Act (Obamacare) was signed into law. Such a posting in the Federal Register that has not been passed by Congress does not trump an existing Federal law. I will explain what law I am referring to in a moment but first please watch Bill’s testimony:

The following day Bill was interviewed by radio host Rocky D on AM1340 WQSC in South Carolina. In that interview Bill goes into detail about the type of illness he suffers from and how hopeless he felt after the president’s Obamacare took away his health insurance policy in the middle of ongoing treatment for Stage 4 Cancer. Click the MP3 logo below to hear the replay:

This is the worst time to cancel someone’s coverage. And, that is precisely why Public Law 104-191 was written and passed by Congress in 1997. It was written to protect Americans from such a situation. I am writing this article not just to help Bill but to help all Americans who are suffering from an ongoing preexisting condition.

If you are one of the 5 million Americans who have already received a policy termination letter or one of the 14 million Americans who will soon receive a letter, you need to print out Public Law 104-191 and highlight section 2742 and then contact an attorney. Or, if you have access to your governor – as Bill does – (his governor is the awesome Nikki Haley) contact your governor or state Attorney General’s office because your health insurer is violating a Federal law based on a posting in the Federal register that was not passed by Congress and as such does not trump an existing Federal law.

Since Bill did nothing wrong. No fraud was committed. His health insurer is not leaving the state and they charged him more based on a preexisting condition they are in violation of Public Law 104-191 section 2742. As such, they have no legal right to terminate his coverage, regardless of a posting in the Federal register.

Want to know the best part? I just heard from Bill and after contacting Governor Nikki Haley and his insurance company and reading to them section 2742 of Public Law 104-191 his insurer has decided to keep his policy in force because he has a chronic illness. Bill just told me the following: “Steve, the company decided to keep me active. Since it is a chronic illness. Until this illness kills me. Battle #1 is won. Now the hard part. You literally saved me. Thank you so much.” Those are the greatest words I have ever heard in my 20 year career as a licensed health insurance broker. I couldn’t be a happier man today!

UPDATE #1)  On November 15, 2013 Bill Elliott joined Sara Marie Brenner who covered this story in the Washington Times on November 14, 2013 to discuss how he was able to use HIPAA – Public Law 104-191 – section 2742 to require his insurer to reinstate his cancelled policy without increasing his premium or his deductible. Click the MP3 icon below to listen to the replay:

UPDATE #2)  On November 13, 2013 Rocky D had me on his show on AM1340 WQSC for a follow up to explain how Bill was able to keep his policy. Click the MP3 logo below to listen to the replay:

UPDATE #3)  On November 15, 2013 I joined the Chicks On The Right on 93.1 FM WIBC to discuss the latest Obamacare disaster created by the president and Bill Elliott’s policy reinstatement. Click the MP3 logo below to hear the replay:

 

Barack Obama is the greatest liar since the father of the lie

Now let me address a lie that president Obama and other members of the Democrat party have been repeating ad nauseum since 2008. President Obama said over and over again “health insurance companies can raise your premiums when you get sick” and “health insurance companies can cancel your coverage when you get sick”?

The truth is that Public Law 104-191 – has prohibited such actions by any insurer for more than 17 years. Long before Obamacare was ever written. To add insult to injury, the president told the following lies during a joint session of congress. Watch what he said below:

Really Mr. president? Here’s the truth from Politifact the Chicago Sun Times and Fox News. Watch their coverage below:

Then there was the LIE the president told about his own mother. In 2008 and again in the film created for Barack Obama entitled “The Road We’ve Traveled” – narrated by Tom Hanks. Watch him tell this lie in the video below:

In the book A Singular Woman: The Untold Story of Barack Obama’s mother, by journalist Janny Scott. Scott reviewed letters from the president’s mother – Anne Dunham – to CIGNA (the insurance company), and revealed the dispute was over disability coverage, not health insurance coverage. Disability coverage helps replace lost wages due to an illness. This story had absolutely nothing to do with her health insurer refusing to pay her medical bills. In fact, she had excellent health insurance, the hospital billed her health insurer directly and her health insurer paid her medical bills, less her deductible and applicable co pays.

Worse yet, the president described his mother as an indigent woman who was ‘pretty much drained of her resources.’ The truth is Anne Dunham received a base pay in 1995 of $82,500, plus a housing allowance and a car, to work in Indonesia for Development Alternatives Inc. of Bethesda. Today, adjusting for inflation, that salary would be equivalent to $123,500. This is far from indigent. Today, the Washington Post rightfully gives this story ‘Three Pinocchios”

What about the women who the president said had her cancer treatment denied because of acne? Well, as you may have guessed by now. That too is a lie. According to ABC News, “President Obama’s description that Beaton’s ‘insurance company canceled her policy because she forgot to declare a case of acne’ is not accurate.

As Robin Lynn Beaton’s congressman, Rep. Joe Barton, R-Texas, testified, the Blue Cross/Blue Shield letter ‘informed Ms. Beaton that an investigation into her claims for benefits resulted in the company reviewing her medical records in which they discovered that she has misinformed them on several pieces of information. One of them was that she did not list her weight accurately, and the other, that she had failed to disclose some medication she had taken for a preexisting heart condition.”

Blue Cross discovered the previous condition after her visit to the dermatologist for acne but her insurance was not canceled because she didn’t declare a case of acne.”

By now, you may be asking. ‘Who are you to call the president of the United States a liar?’ Let me answer that. I have been a multi-state licensed health and life insurance broker for more nearly 20 years now. I have also served as a Subject Matter Expert for multiple business journals around our great country.

One of the biggest challenges I’ve had to deal with throughout the years has been trying to secure coverage for people with preexisting conditions who obtain their health insurance on the individual market. They represent 10% of the American insured.

I’ve never had to worry about preexisting conditions with the other 90% of American insured’s who get their health insurance through an Employer Sponsored Group plan. Why? Because the same Public Law 104-191 “HIPAA” has protected them against being denied health insurance because of preexisting conditions for more than 17 years

Because government legislators did not apply this law to individual health insurance policies, you can be labeled as “uninsurable” when you apply for an individual health insurance policy if you have one or more preexisting conditions. That being said, who should we truly blame for the fact that you can be denied coverage for a preexisting condition? Is it the insurance company’s fault? Or are they simply following a law that was written by government law makers who did not include HIPAA portability protection for the millions of American’s who purchase health insurance on their own in the individual market?

Because there are no HIPAA portability protections for individual policy holders , this uninsurable status can last for many years and sometimes for life depending on the specific preexisting condition you have been diagnosed with. Some of the preexisting medical conditions that render an applicant uninsurable on an individual policy are: Heart Attack, Stroke, Diabetes, Cancer, Lupus, Multiple Sclerosis, Muscular Dystrophy, Degenerative Arthritis and a host of other preexisting conditions. In addition, there are applicants who have a combination of controlled preexisting conditions but since they have more than three “ratable conditions” they are also labeled uninsurable.

Does this mean then that there was some truth in the stories the president told about preexisting conditions? No, he is still a liar. In fact, during the last 2 decades of my career as a health insurance broker I have never been unable to offer someone health insurance coverage, regardless of the severity of their preexisting conditions. In fact, I once secured legitimate major medical health insurance for a woman who was dying of cancer in the hospital. How did I do it? Simple, I am an informed American. I know the laws that were already in place to protect consumers. Laws that were passed long before the president’s health care ‘reform’ law was passed in 2010.

The truth is even if you have lost your employer sponsored group health insurance coverage and/or have exhausted a COBRA continuation plan you too can obtain guaranteed issue health insurance on an individual basis that will provide coverage for your preexisting conditions seamlessly from day one. Your options are as follows:

1.) If you have a Corporate tax i.d. number you can purchase a small group health insurance policy from most insurance carriers. With this scenario, a minimum of 2 people (often husband & wife) who work for the same corporation can apply for a small group health insurance policy. Those who are HIPAA qualified will receive coverage for their preexisting conditions immediately. Even those who are not HIPAA qualified will receive coverage for their preexisting conditions after a maximum period of 12 months. Be sure to read the outline of coverage for the Small Group plan you are applying for to make sure it provides coverage for your preexisting condition before you apply.

2.) Some States, like Colorado, provide what is known as a “Self Employed Group of One”. In these States, you do not even need to have another person to comprise a “Group Health Insurance Plan”. To find out how your state defines Small Group health insurance visit this site: http://www.statehealthfacts.org/comparetable.jsp?cat=7&ind=350

3.) Enroll in your states High Risk Health Insurance Pool. 35 States provide them. Click here to see if your state does. In our home state of Illinois the risk pool is called the Illinois Comprehensive Health Insurance Plan (ICHIP). ICHIP is a state health benefits program and not an insurance company. Persons must qualify for coverage, but in most cases if the applicant is coming off an exhausted qualified COBRA continuation plan from a prior employer sponsored group, their preexisting conditions will be covered from day one (provided again that those conditions are a covered expense on the ICHIP policy). ICHIP (and all insurance risk pools) are by no means entitlement programs. They do indeed require you to pay a monthly premium. Nothing in this life is free. To find out if your State has a State Sponsored High Risk Pool visit http://www.naschip.org/states_pools.htm

2014 UPDATE  Thanks to Obamacare, state High Risk Pool insured members are also losing their coverage all over the country and will be forced into the Obamacare exchanges where many of them will pay much more for coverage and be exposed to much more out of pocket. Most especially if they do not qualify for a subsidy.

4.) If you live in one of the 10 States that have an “Individual Market Guaranteed Issue Mandate” you are guaranteed Health Insurance coverage for preexisting conditions from a variety of Health Insurance carriers that operate within that state. For example, in the state of Ohio, there are 20 Health Insurance carriers that must by law “Guarantee Issue” 4% of their block of business to people with preexisting conditions during an annual ‘Open Enrollment’ period. During this annual period, each health insurance carrier must report to the Ohio Department of Insurance as to whether or not they have “met their 4% Guaranteed Issue quota”. Once they have met their 4% quota, any future applicants with preexisting conditions are then referred to one of the other health insurers operating in Ohio who have not met their 4% quota and are then guaranteed coverage from that carrier. Did you know that Ohio has never maxed out the 4% quota for all carriers? Never. And, everyone has access to coverage for preexisting conditions in the state of Ohio.

2014 UPDATE  This concept is such a good idea that HHS – the Health & Human Services department – rewrote the Obamacare law regarding preexisting conditions in June of 2011 and adopted this concept for 2014. Beginning in 2014 there will be two national “Open Enrollment” periods for all Americans to obtain guaranteed issue coverage regardless of preexisting conditions. Those two periods are from January 1st of 2014 to March 31st of 2014 and from October 15th – December 7th 2014. Outside of those two “Open Enrollment” periods you will not be able to obtain coverage for a preexisting conditions unless you qualify for ‘Special Enrollment” period.

Whilst adopting Ohio’s plan will help to inhibit ‘Adverse Selection’ and provide an impetus for consumers to maintain health insurance between “Open Enrollment” periods. Make no mistake. ‘Adverse Selection’ will still exist because the fine for not purchasing health insurance is far less expensive than actually purchasing health insurance. If this fine amount is not increased, ‘Adverse Selection’ will still continue. This coupled with ‘Community Rating’ – charging young people much more for health insurance will lead to what we in the industry call a “Death Spiral. And, since there is nothing in the PPACA that states health insurance must continue to offer products within the PPACA “Health Insurance Exchange Marketplace” 2015 could end up being a very bad year for the health insurance industry and most importantly for their policy holders.

5.) Even if you are totally disabled and no longer able to work because of a debilitating medical condition, you can apply for one of our country’s MANY safety nets called SSDI (Social Security Disability Income) and with it early Medicare benefits. Learn more at www.disabilitysecrets.com

In case you missed that information, let me reiterate. Forty-five (45) States in our Union provide guaranteed insurability to individual health insurance applicants, regardless of preexisting conditions for decades before the ‘Patient Protection and Affordable Care Act’, a.k.a. “Obamacare”. This is not what we were told by the president.

In addition to the aforementioned existing legal options to pursue Guaranteed Issue Health Insurance for those with preexisting conditions. There are also over 1,200 “free” (subsidized by taxpayers and philanthropists) health clinics around the United States. Click “free” clinics in your State to find more information. If your situation is dire, Federal EMTALA law mandates that you must be treated without discrimination at your local emergency room.

If your child has a preexisting condition and you are at or below the Federal Poverty Level you are further entitled to the Federal SCHIP program, which is an extension of our Medicaid system. To find out if you qualify click here. If you do qualify be sure to see if your State has any money left. Some States like Arizona recently terminated their SCHIP program because the entitlement rendered them bankrupt.

Many States like Illinois have already dramatically expanded their Medicaid programs to include Tax Payer funded health insurance for low income adults , women who are currently pregnant and women who have been diagnosed with Breast or Cervical cancer. All of these benefits are provided to those without health insurance. In fact, in the state of Illinois, our All Kids Covered plan quite literally provides “free” health insurance to ALL indigent kids including the 75% of recipients who are illegal aliens. Thanks to Obamacare Medicaid Expansion we are about to drive our Illinois Medicaid system into a fiscal death spiral by adding on and expected 800,000 new recipients and being forced as state taxpayers to cover half of the cost of the ‘Woodwork” population. Those who were always eligible for Medicaid but never bothered to enroll. They will be forced to enroll via the Federal health insurance purchase mandate beginning on 1/1/14. On January 30, 2012, the Civic Federation released its “Budget Roadmap”. In it, they highlight the fact that Illinois state officials now believe that the Illinois Medicaid program will have between $21 and $23 billion in UNPAID bills by 2017.

The President’s “Patient Protection and Affordable Care Act’ will make that Medicaid debt exponentially worse. Not just in Illinois but around the country in states that choose to further expand Medicaid. Medicaid is the worst and most dangerous health care program ever devised by man. Without reform, I truly fear for the lives of the 17 million Americans that the CBO predicts will be auto enrolled onto this program beginning in 2014.

Back in 2010 I spoke the truth about preexisting conditions at the 2010 Chicago Tax Day Tea Party rally:

Please Note:  The vast majority of health insurance carriers that underwrite Individual Health Insurance plans do indeed provide coverage for many preexisting medical conditions (such as Hypertension, Hyperlipidimia, Gastric Reflux, Asthma, etc.) and have done so for many year. Providing of course that these conditions are well controlled by diet or medication AND you duly disclose these preexisting conditions on your health insurance application. This is important to know now because the president’s temporary PCIP – ‘Preexisting Condition Insurance Plan’ already ran out of money and has ceased further enrollment as of March 5, 2013.

EDIT: Posted also at C.Steven Tucker’s blog, where it includes updates