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It’s Only My Health


#1

It’s Only My Health

Olivia Alperstein

I’m one of the 27 percent of Americans with a pre-existing medical condition.

Pre-existing conditions range from life-threatening illnesses like cancer or multiple sclerosis to chronic conditions like diabetes or cerebral palsy. They can also include life events like pregnancy or having broken bones.

Before the Affordable Care Act — aka Obamacare — pre-existing medical conditions made it incredibly expensive to get health insurance, or even impossible. Yet Republicans are dead set on repealing it.


#2

To be fair, it is "taxpayer subsidized" in the same way a (usually union) Safeway employee's medical coverage is "grocery-shopper-subsidized". To frame my and my co-worker's employee benefits (the same benefits the politicians get) as something unfairly "taxpayer subsidized" (only partly so, I pay almost $500/month employee share) is to parrot the right-wing propaganda frame regarding government employees.


#3

It's not even actually that, "taxpayer-subsidized." Yes, you may pay a contribution, but what the members of Congress (and now djt) have is mostly like Medicare, and for life, even when they leave office.

And please, please, don't downplay the problem of preexisting conditions. I'm one of those like Alperstein, insured since before I was diagnosed with diabetes through the employer of my husband, who is 8 years older than I am. He's now in his 70s and still working, in part to keep me insured. His is now Medicare supplemental. If I could still work, I could get my own insurance on the ACA exchange and Ed could retire. But I contracted a tick-borne infection 6 years ago, that went undiagnosed until just recently, and I'm waiting for the judge's decision on my next-to-last chance for SS Disability. But between preventive care (such as I can get) and the reassurance that, should Ed die, I could still get insurance, I'm wearing a bumper sticker that reads
Don't tread on my Obamacare


#4

Actually, they don't. It's an urban myth. Members of Congress are under the same FEHB system as ordinary federal employees. When a member of Congress leaves office, their health coverage ends like any employee.

My comment was simply one trying to correct a major misconception. A "pre-existing condition" is just another one of those unique and strange USAn concepts, like people getting fired for getting sick or pregnant, that leaves people in the civilized world scratching their head in befuddlement at how a country that claims it is so "great" can be so dog-eat-dog-barbaric.


#5

Actually as of January 1, 2014, they get their health insurance through the DC Health Exchange under the ACA, unless they buy a policy directly in the individual market or somewhere else (perhaps as the spouse of someone covered by an employer plan).


#6

Interesting. I didn't know that the ACA mandates that congress members and staff not be eligible for the FEHB and instead have to buy their insurance from the ACA. So, the misconception that all members of congress get full coverage for life ("We want the coverage you have!") is even greater now...


#7

If you read the report I linked, to, you'll see that they can buy into the FEHB system when they retire. So, in a sense, they do get coverage for life. Also,this report doesn't generally address Congressional retirement benefits. Maybe that's part of their retirement program, which, I assume, is a defined benefits programs, not a defined contributions program.


#8

There's another FAS report that lays out their retirement situation.

But the major point of this topic is that members of congress and those in the other two branches, especially before they were beaten into the ACA compromise for the rest of us, didn't have to worry about preexisting conditions. Dick Cheney, for one, would never have gotten health insurance of any kind under the insurance market in place when he was VP. Yet Olivia Alperstein and I were holding our breath lest that one little thing happen that we lost the coverage in place when we were diagnosed.


#9

And here's another piece of it: Get sick when you're poor, and you're more likely to get poorer.

There's a link to the actual study, and references to other studies on poverty and medical bankruptcy, as well as anecdotal information from those working on the issues and trying to support sick, poor people.


#10

Yes, but the FEHB continuation is expensive - basically like COBRA - $1500 a month or more. They would just get medicare with the supplements.

Also, I do believe that congressional retirement is same as federal employee retirement (just checked) called FERS - a 401(k)-like TSP with 5% matching, a fairly stingy defined benefit portion based on years of service and the top 3 years earning amount, plus Social Security.

Sure congressional salary is very good ($175K) and most congress members are already rich to begin with. But the idea that the government provides lavish fringe benefits in congress members (compared to, say, union auto workers, union construction trades or federal government workers) is a very durable myth which seems to reflect the enormously lowered expectations of US workers regarding job, healthcare and retirement security since the wholesale busting of unions over the past three-plus decades.

(Disclosure - I am a federal worker)


#11

The FEHB, as selection of group policies never had a "pre-existing condition" clause even before ACA. But then, I have never heard of "pre-existing conditions" clauses in any other private-employer group insurance I have had since my 20s. The "pre-existing condition" crap was always an aspect of only individual policies.


#12

Actually, I believe a number of the employer-based plans had a pre-existing condition clause that had a six or twelve month waiting period, after which the pre-existing condition clause went away.


#13

This article was great. It's also why I, as someone with a preexisting condition, have no truck for progressives who want to crap on the ACA without recognizing the achievement it was. Could it be better? Sure. But right now, in the world as it is, there are two easy fixes that could be done without new legislation, one political, one legislative, that would make a huge difference in improving it. On the political side, progressives could work to get new governors elected in states that didn't expand Medicaid. Many of the horror stories we read are from the non-Medicaid expansion states. Just doing that would go a long way to stabilizing markets and give millions health insurance.

The second thing is to increase the subsidies for insurance. This could be done through reconciliation since the law is written. Of course, that would take a new congress. However, that would also stabilize the insurance market and make it more affordable.

Single payer is my preference. There are things we could do now though, with the law we have, that would vastly improve the lives of millions.


#14

I wanted to submit this story to CD, but this site uses some kind of weird system. (Here's an idea, put an email address out there.)

www.sacurrent.com/the-daily/archives/2017/02/27/texas-lawmakers-advance-bill-that-would-allow-doctors-to-lie-to-pregnant-women

Just something for Women's History Month (y'know, the month that gets completely ignored by liberals).


#15

Yeah, you are right. I must admit that I have been blessed with near perfect (physical) health until a arthritic knee starting about a year ago - so I really have ignored what is actually in my insurance coverage over the years.


#16

Actually, if you pay attention, more of the horror stories of rising deductibles and premiums, and can't keep my doctor, are about people who already had insurance and choices they could make. They're not about people first getting insurance and preventive care. And you never hear anything about the out-of-pocket cap if you're getting a subsidy and buy a silver plan on an exchange (I looked into it just in case). The complaints are from the already privileged. That's everybody the moaners and groaners care about.


#17

It's reading stuff like that reminds me of how stupid it is to cede power to the other side in the hopes of a "people's revolution." Once the other side controls the levers of power, they make the laws and the rules. Wait until the new Court seat is filled and stuff like this will be going national.


#18

Most complaining comes from the already privileged class.

I have yet to meet an indignant complaining Trump supporter who is poor in the least. They may look and dress like poor WV rednecks until you see their late model deluxe huge pickup and their collections of "quads" for the whole family...big screen home theater TV in their not at all shabby ranch house - the old mobile home with the tires on the roof abandoned at least a generation ago and long grown over with weeds...


#19

This is Trumps idea of adhering to the preamble to the constitution, "and promote the general welfare"