Complaints about lack of access to insurance for preexisting conditions may be overstated
The recent spate of articles about how wonderful it is that this person or that person was able to quit a nasty job (or not take on a nasty job they thought they’d have to get) because of Obamacare includes this one by Diana Reese of Kansas:
Had the ACA not become law, I would have considered a job as a “lunch lady” in one of the nearby elementary schools — just to get health insurance.
My inspiration was an out-of-work accountant I met at a social event a couple of years ago. When asked what he did for a living, he laughed and said, “lunch lady.” Then he explained that he’d been laid off during the recession, and though his wife worked at a job she loved, she had no benefits. So he took a job at his children’s school, working a few hours a day to qualify for health insurance for his family…
Because of my own pre-existing condition, I couldn’t buy health insurance — at any price — before the ACA.
She goes on to add that her husband had been employed and she was actually covered under his health insurance, but they both knew the coverage would end because it was a time-limited contract position. At that point, since she was uninsurable any other way, she was considering that lunch lady route.
Only thing is that Kansas was a state that had a high-risk pool even prior to Obamacare, as did most states.
The following excerpt is taken from a piece on the subject that appeared in April of 2010 and describes the high-risk pool in Kansas right around the time that Obamacare was passed, before Obamacare’s provisions had ever been implemented:
Kansas is among about 35 states that already have a high-risk pool…High-risk pools provide health insurance for people whose medical history makes it difficult or impossible for them to otherwise find affordable coverage.
In Kansas, about 1,800 people are enrolled in the state’s existing plan, which is managed by the Kansas Health Insurance Association…
Kansas law governing the existing high-risk pool here allows for premiums up 150 percent the cost of a standard, non-group policy, though that has been held to 128 percent by decision of the risk-pool’s governing board.
So there was a high-risk pool in Kansas that covered people with pre-existing conditions. It was somewhat more expensive than regular insurance, to be sure, but not so very very much more expensive. Many pre-Obamacare state high-risk pools also provided subsidies for those with low incomes.
So, if Diana Reese had lived in Kansas when all of her insurance woes (or prospective insurance woes) occurred—and the focus on Kansas in her article implies that she did—then she could have purchased insurance, and the price would not have been so extraordinarily much higher than standard insurance either; the premium price would have been capped at 128% of a healthy person’s premium cost.
If you look at the chart about two-thirds down this page, you’ll see that 35 states ran high-risk pools prior to Obamacare, and most of them had been in operation for many many years (for example, Kansas had started its high-risk pool in 1993).
The 15 states that didn’t have high-risk pools didn’t necessarily leave their high-risk individual health insurance customers in the lurch, either. Some were guaranteed issue states, which meant that pre-existing conditions could not be excluded at all: New Jersey, New York, Maine, Massachusetts, and Vermont had straight guaranteed issue, with Ohio, Oregon, Rhode Island, and Idaho having guaranteed issue with some restrictions involving previous continuous coverage.
There were indeed some states where people were in a situation much like the one Reese describes, but it would appear that Reese (if she had lived in Kansas immediately prior to Obamacare) would not have been considered one of those people, even potentially.
So I really, really wonder what Reese is talking about when she said she could not get health insurance “at any price.” Did she live in some other state? Did the Kansas high-risk pool function in some unusual manner that excluded her? Or did she just assume she couldn’t get coverage rather than actually checking it out?
[Neo-neocon is a writer with degrees in law and family therapy, who blogs at neo-neocon.]