See Comments on 2017 ObamaCare Repeal Efforts and Consequences here

(The rest of the page is older, from before the 2016 election, going back several years.)

SEARCH TERMS WHICH HAVE GOTTEN PEOPLE TO THIS SITE AS REPORTED BY SEARCH ENGINES BEFORE THE OBAMACARE ROLLOUT (any personal identifying information and internet address have been removed)

"alabama law on reporting pre-existing conditions" "paying medical bills with a pre-existing condition" "Is there a way around the high risk pool waiting period"

"insurance denied emergency treatment pre-existing condition"

"can insurance plans still have pre-existing condition exclusions in ma" "what happens to people with pre existing issues under obama care"

(Site editor note: last two questions answered here.)

More recent search terms here



For those looking up the meaning of pre-existing-condition, I have put it on the seperate page here.

(11/2013) Back in November of 2012, Obama Won Reelection and the Senate stayed Democratic. The last obstacle (Romney and a Republican Senate) to enactment of Obamacare (=The Affordable Care Act) was taken away. (Well, actually just this month, Oct 2013, the Republicans did a surprise action "Repeal Obamacare or We'll Destroy the Country" by shutting down the government for two weeks (minor) and then threatening worse by not raising the debt ceiling, and knocking out 5% of consumption to the U.S. economy and really making the already bad jobs situation much worse). The Republicans seem to have lost this battle, (though they may do it again in 3 months) and Obamacare goes into effect in January, with exchanges already open. (The internet-site version of the exchanges to find and buy insurance used in many states got messed up technically, and this could be so for a while, but that's a pretty minor problem in the scheme of things: there is maybe 20 hours of time on the site wasted for some, but that's small compared to millions of people going broke in medical bankruptcy, and, of course, dying from lack of health insurance. I live in Massachusetts, the only state that already has its own version Obamacare, and last time, on the first day of enrollment time, the MA internet site was overloaded with users, and kicked me out, but I just enrolled on paper, and 7 days later I had my proof of enrollment back in the mail.)

The main provisions of the Obamacare law for people reliant on their own non-employer (="individual") insurance are that health insurers may no longer deny coverage or charge more for people with pre-existing conditions, or exclude coverage of pre-existing conditions. Further, people with lower incomes get partial or complete subsidies (on a sliding scale according to income and family size) so they can afford to buy the health insurance (with major exception (1), as below).
There will also be a modest tax penalty on people who can afford insurance, but do not pick it up. This is important to keep people who can afford insurance from freeloading on us all by not having insurance and just going to the emergency room whenever they get sick. (Under a Reagan-era law, the hospital has to stabilize a person if they are sick and show up at the emergency room, even without insurance. The person at the emergency room in that case is legally responsible for charges to the extent of all the assets they have. However, in many cases, the hospital isn't sure if it is worth their while to spend money on lawyers to go after those assets, which they are after all not sure how much you might have. And in some cases people don't use their real names at the emergency room, so this makes it harder for the hospital to recover. So the hospitals just raise prices for everyone to compensate for the money they can't collect for the emergency room services. The tax penalty under ObamaCare, for people who can afford insurance but choose not to buy it, is designed to discourage that freeloading.)

There are some real potential problems ahead, which are overwhelmingly, I am sorry to say, due to Republicans.

(1)MAJOR EXCEPTION TO AFFORDABILITY: in 26 Republican states the state's Republican governor and/or legislatures have exercised their option, given in the (unexpected) June 2012 Supreme Court decision on ObamaCare, not to extend coverage to a large group of low-income people (the group being people not so extremely poor as to be covered under pre-Obamacare-extended Medicaid but still very low income: income to about 130% of the poverty line -- the extension of Medicaid is how those particular people were supposed to have gotten their full subsidies in the enacted ObamaCare law). (See the state-by-state Obamacare-Medicare-Extension status here.) The state Republicans are choosing to not extend Medicaid even though 90% of the cost of covering those people would be paid for by the Federal Government as a provision of ObamaCare. And even though most of those people don't now get Medicaid simply because they work and make a little too much to be dirt-poor to qualify under pre-extension rules for Medicaid. (These people who will be denied health insurance in those Red States are often called the "working poor", and may be about 10% of the population in those states. Thus, those folks can keep getting whatever care they can get at the emergency room, and accept not being able to save any money if the emergency-room and hospital sends them humongous bills.) Those Red States' health care coverage will not be 98% (as in MA where I live, now, with its own version of ObamaCare in effect for several years) but maybe only 88% without those working poor having coverage.

(2)REPUBLICANS HAVE THE POWER TO, AND WILL, BLOCK ANY NEEDED ADJUSTMENTS TO THE LAW: Until at least 2016, and possibly for many years longer, the majority of members of the House of Representatives will be Republicans. They will undoubtedly block any changes to Obamacare, instead saying "tough luck, no changes, you must just repeal it".

They indeed might do it, particuraly if by not allowing changes they can force it to mess up. Thus, I plan to stay here in Massachusetts, the only state where we have already our own version of Obamacare, at least until the results of the November 2024 election.

(4)There are indeed cases of individuals for whom insurance costs will go up under ObamaCare.
These are generally people who had individual insurance in the 45 states that allowed screening for pre-existing conditions prior to ObamaCare (all states except MA, NY, NJ, VT, ME) and got relatively low cost insurance because they were in good health when they got their policies. (That is, the cost of those policies is low because the insurers threw all of the expensive sick people who applied for insurance under the bus and left them with no insurance.) Now, generally, the coverage that people with those pre-existing-condition-screened policies had is not that great over the long-term: what happens is that
(a) when some people with the same policy get sick, the insurers sell new low-cost policies to only the healthy people, making the costs rise rapidly for the sick people, who can not get new policies and are stuck with their old policies which get very high premiums to cover the medical costs of just the expensive sick people who have to keep those old policies. This happened to me once when I lived in Connecticut -- costs rose to 5 times in only about 5 years.
Also, with those old pre-existing-condition screened policies, the insurance could be cancelled, (b)this varies by state, but virtually always if the insurer decided to stop offering policies in the state.
What also happened in the past in many cases is (c) that the insurer issued a policy, and if you got expensively sick, they reviewed all of your medical records and said something like "look--you had such and such a blood test result 6 years ago that makes you more likely to get cancer and that is a pre-existing condition. Sorry, you left a relevant pre-existing condition off your application, policy cancelled." I posted examples of this a while back here on this page . Now, even with those old pre-existing-condition-screened plans, it has fortunately become more difficult for the insurance company to cancel a policy this way, but that is only due to a provision of ObamaCare itself that went into effect soon after the law was passed a few years ago.
It is the above-described case, people who passed prior pre-existing-condition-screens (which they call "medical underwriting") is the case where people are now facing higher prices. In some of those cases, the premium price, or premium price plus out-of-pocket, is up to a few thousand dollars more per year, and if the person is above the 400% of poverty income level (and therefore does not get the new Federal subsidy), that extra few thousand dollars can hurt. For people who the few thousand dollars does not particularly hurt, we would hope they would understand the system well enough to know that in the long term, if they got sick, their old policy premiums could rapidly escalate, and in most states, they could have even had their policy cancelled -- that is, the insurance they had was kind of crummy And we would also hope that they have some sense of solidarity with the umpteen million people who were uninsured under the old system, and would be running a high risk of medical bankruptcy and death all the time, so that they would happily pay the extra premium. I point out that any hope of helping out the people in tight squeezes with a tuning of the law is wrecked because Republicans will not go along (and just want ObamaCare to fail, no matter how many people die and go bankrupt), and at this point in time, their House of Representatives majority gives them the power to prevent any changes.

(4b)By the way, the people "thrown under the bus" by the insurer (people denied coverage because of a pre-existing condition)
in the (expiring unless the Republicans have their way) pre-ObamaCare system did, in some states only, at least have access to a state-run "high risk pool". There were problems with these, one of them being that in many states, the high risk pool had a waiting period, was closed altogether, or had some eligibility design problem that could let you go broke from hundreds of thousands of dollars in medical bills between the time you lost your old insurance and the time you actually were allowed to get the high-risk-pool coverage. Another problem was straight expensiveness: if you look at the example of Connecticut's high risk pool, the best available deal, for a 60-year-old male without a very low income, is $27,668.40 a year in premiums (=2305.70x12) (verify here) plus up to $7500. in out of-pocket-costs (verify here on p. 3) (total $35,168.40) for one person only per year. (If you don't trust my numbers, and think that people with pre-existing conditions may have had a better deal to pick than the ones I chose, here is the CT high-risk-pool website. You might stumble upon the lower-out-of-pocket option, which, unfortunately, for one 60 year old male without a very low income, would run $52,300.68 a year.)

(5)And, oh yes, the President spoke sloppily in an oversimplification when he said "you can keep your policy if you like it".
He would have been precise if he said, "if you had an individual policy at the time the law passed several years ago and it didn't change substantially, then it would not have to be cancelled under ObamaCare". But we can't really blame him for this over-simplicification. The Republicans have been blatantly many times more deceptive than he has, frightening people with "Death Panels", "rationing", and numerous other things that quantitatively minded people like me can pick up on. Since the people are not well informed, innumerate, have a poor understanding of economic mechanisms, etc., and since the Republicans were taking advantage of this and being so horribly deceptive, I believe the President was justified. I would hope for straght-for-the-truth non-deceptiveness in American politics, but it seems pretty far off for the time being.

Due to Pre-Existing-Conditions Issues (People Under 65):

(These risks on health insurance obtainability to those moving to a new state, losing or changing jobs, changing insurance companies, or having massively rising rates as other health insurers cherry pick just the healthy people out of the group of people with your current policy) remain until the passed-in-2010 Obama/Democratic reform provisions kick in in 2014, at which time they go away. If Republican efforts to repeal (as here with House Member voting record here) the Obama law succeed, the risks remain beyond 2014, (including post-issuance policy recision and claim non-payment when the insurance company decides or pretends you must had a pre-existing-condition that you did not tell them about). If the Republican proposed "Ryan plan" succeeds, or some similar Republican plan passes in the future, the risks to people under 65 remain, and similar pre-existing-conditions medical/financial wipeout risks extend to people over 65 starting in 2021.)

To: By-State information and DANGERS


10/4/2012 debate 1: Chameleon Romney Introduces New Deceptions on Pre-existing Conditions at Debate 1

As somewhat referenced here, Romney, realizing that more middle class people than he would like are realizing that they're gonna get completely wiped out financially if they wind up with a pre-existing health condition at the wrong time (if they don't live is Massachusetts, which has RomneyCare), has just sprinkled in some new assertions in the debate about "his health plan", whatever that completely unspecified thing in his mind might be. In any case, he seems to be asserting that he would force insurance companies to give health insurance to people holding health insurance continuously, either with no new law (and thus in the limited case as provided by the 1996 Kennedy-Kassebaum law of people losing employer coverage), or possibly by some new extension to Kennedy-Kassebaum (imagining that somehow the radical antigovernment Republicans in Congress would allow him to get it passed), which would be a Federal law to force insurance companies to give coverage to people with pre-existing conditions even if the prior insurance was not from a job.

As a quantitative person, a statistician, who has looked at the details of Kennedy-Kassebaum, let me point out that it involves a big trick. The big trick is that the insurance company (under Kennedy Kassebaum) has to offer you coverage if you have a pre-existing condition, but they can charge you whatever they want or need to to cover how expensive you are with that pre-existing condition. Thus, you might have had a pretty bad heart attack recently, so they can charge you $108,000 a year for your policy. There is, in Kennedy Kassebaum, a provision that, if the state you live in has chosen to set up a high risk pool to cover the people with pre-existing conditons losing job-based insurance, then, rather than the insurance company insurance with the unlimited rate, you get that state high risk pool insurance. But even in those states, the issue is how expensive it is -- that high risk pool insurance is much more expensive than insurance for people without pre-existing conditions, and may typically in the financial wipeout zone for older people, say in their 50s or 60s. I exhibit the case for the Insurance Capital of America State Of CT where the rates are here, as well as the brochure for the plan here, where we find out that you will likely have to toss in $7500 per person in addition to the high premium, which high premium itself is over $25,000 for a male in his early 60s. So this is one version of the no-details-available plan that Romney might have going on in his head. It is also just the status quo, with a small extension of Kennedy Kassebaum.

There is another possibility that the plan that Romney has going on in his head and has not given details on is to force insurance companies, via a new Federal law, to give coverage to people who have maintained continuous health insurance prior which is actually at the same rate whether or not they have pre-existing conditions, but without a mandate on people to carry coverage. This is precisely to make national what New York State has already done. For New York State now, rates are here. If you click on, say, the non-wealthy St. Lawrence County, you see that you've got $1200. a month for any adult on the cheapest plan. This is better than the CT high-risk option (up to $2700/mo), but it's still unduly expensive. That's because there is no mandate to carry coverage in New York State. People tend to not pick up insurance until they get sick. And there's also a constant possibility of a "death spiral", which is, as the problem of only the more expensive, sicker people buying insurance worsens, the rates go up and up rapidly, and soon maybe rates hit $60,000 a year. (This had started to happen in New York State when I lived there several years ago. Monthly rates on the cheapest available policy went from about $650. a month per adult to about $1150. a month per adult over the three years I lived there. This was around the time of the financial meltdown, when all of a sudden many people who weren't really, really sick decided they just couldn't afford insurance. So, at that time, anticipating the start of a death spiral where rates might hit $2000 or $3000 or $5000 a month, I rapidly left the state, and moved to Massachusetts, which had just enacted Romneycare. That insurance has served me well -- rates are much lower, the insurance company can't charge more if you have a pre-existing condition, and it's all made possible by penalizing people who don't carry insurance, that is, by keeping them from freeloading on the nonfreeloaders. And, it is well recognized by experts that the mandate is the only way to get reasonable rates without tossing people under bus once they get a pre-existing condition, without also having much more government involvement (like the government-only-insurance of Canada, or the fully run-by-government health care delivery of Great Britain).

Thus, the chameleon Romney, having said he'll repeal National RomneyCare = ObamaCare on day one of his taking office, can only have something in his mind like the current Kennedy Kassebaum / high risk pool system (very expensive if you get a pre-existing condition and you don't have humongo savings, and will throw you under the bus completely if the state you live hasn't chosen to set up a high risk pool to implement Kennedy Kassebaum), or the New York State Community-Rated but No Mandate system, where the insurance costs maybe double what it costs in MA, and further, where you can get a death spiral at any moment, and the insurance might start costing $10,000 a month or so for everyone.

P.S. I, personally, have moved from state to state kind of a lot in the last few years, completely to be in a state where the health insurance is, at the moment, safe. Since the states I have to move to for the insurance don't happen to be the same states where the work that I am most productive at, and get paid much more at, are, I no longer work. This is done because of my calculation that the, say, $600,000 I might lose in a year in one of the numerous states with unsafe health insurance is more important than the considerable but smaller amount of money I might earn by doing something productive in the economy. I'm having a really good time not working, since I have a lot of interests, so don't worry about me. But what I was producing has been lost to the economy, and, well, a pretty good amount of tax revenue paid be me has been lost that would reduce our humongous debt that we are burdening everone's children with. (This is what Romney's leave it to each state has yielded for the economy in my case.)

P.P.S. Yet another issue I can foresee with "leave it to each state" is that people can easily move between states. For Massachusetts itself, the Presidential campaign coverage has let the cat out of the bag that a person with no insurance living in State A which is not Massachusetts, where he or she may be accumulating say $200,000 a year in uncovered medical bills, or otherwise perhaps may have a serious pre-existing condition and be paying $50,000 a year for health insurance, can move to Massachusetts and immediately or almost immediately get complete health insurance for between $0. a year and $5,000 a year (depending on his/her income) under our MA RomneyCare. Well, then, we have a problem here in Massachusetts, with a big load of sick and poor and sick but not poor people from the other states flocking to Massachusetts. Then the people of Massachusetts have to pay humongous state taxes to support the subsidies needed for the new poor-sick, and rates skyrocket in non-subsidized policies with all the high proportion of non-poor sick now in the state. Thus we have a new kind of health insurance "death spiral" for Massachusetts with "leave it to each state". Massachusetts might be able to break this death spiral by rapidly enacting a law requiring say 5 years prior Massachusetts residency in order to get health insurance, but we can foresee that this might violate the U.S. Constitution for some reason, and even if it doesn't, we have to wait maybe 4 years for that to get decided by the U.S. Supreme Court. I expect some residents with foresight hear in MA are anticipating that possibility, and have an eye on an eventual relocation to some place where you don't need health insurance at all, but rather costs are low enough so you can just pay cash for care. Perhaps Panama, Costa Rica, Argentina, or Chile.

P.P.P.S. Not to mention in all of this what happens if Romney dies in office, and radical antigovernment Vice-President Paul Ryan becomes president.

10/16/2012 Romney/Obama debate 2: Romney, in his response to the final question, cites our Massachusetts 98% health insured rate (vs 85% elsewhere) as his success as MA governor, but leaves off that what he did in the state is virtually identical to what ObamaCare does nationally, including the mandate to carry coverage. Further, as Romney indicated in debate #1 and #2 both, he has pledged to repeal ObamaCare, but what most people who are not experts on health insurance don't know is that ObamaCare=National RomneyCare is, of the workable systems for healthcare, the one with least government involvement. Other workable alternatives are the full government-run paid-for-by-taxes insurance like Canada, and the fully socialized governmen-run-and-paid-for-by-taxes hospitals and doctors of Great Britain. (As discussed in comments above on the first debate, any other set of laws with less government involvement, which would keep health insurance and hospitals private, and keeping it optional for people to have insurance, fail, as health insurance under them is really expensive, because people game the system and pick up health insurance just when they get sick, and otherwise freeload by going to the emergency room for care with disguised identities so the hospital can't collect when it bills them. This is why, all of the other industrialized countries, which by now have for a long-time (20 to 100 years) had universal health insurance coverage, use either the ObamaCare=MA RomneyCare system, or the Canadian system, or the British fully socialized system -- nothing else can work.)

Republican challenges to the passed Obama Reform at the state level did go to the Supreme Court. FORTUNATELY (6/28/2012) the court UPHELD the law, including the key mandate-to-carry-insurance provision that makes the law work (by preventing freeloading). However, it's still very scary that the vote was only 5-to-4, with anti-government appointees to the court, by George W. ("just go to an emergency room", see below) Bush, almost making the bill get rejected. I am afraid that if Mitt Romney becomes President, there will be more redically right wing appointees, making it impossible to have laws that get a country working in the future. (Note: one negative on the court's decision--they did strike down one aspect of the law -- and thus now it is up to each state to decide whether to extend completely free of charge Medicaid to a certain large group of struggling low-income people who do not get it now because their incomes or assets are a little too high (this group is sometimes called the "working poor"). This extension of coverage of Medicaid to the working poor will be 90% paid for by the Federal government, but nonetheless some very Republican states may in fact choose not to, in order that their politicians may save face, and to avoid having to kick in the 10% of the extension of Medicaid not covered by the Federal Government. It would be pretty mean-spirited to leave the working poor uncovered and with just the emergency room and charity as the back up just for thae sake of that 10% of cost, but some states probably will choose not to extend Medicaid to the working poor.)

However, even after the approving Supreme Court decisionTHE OBAMA REFORM IS STILL AT EXTREME RISK depending on the outcome of the 2012 Presidential and Congressional Elections. Republicans have vowed repeal, if they can, including Mitt Romney. Thus, either Romney as President, or enough Republicans in the House and Senate, could get the bill repealed even before the main provisions go into effect in 2014.

Don't be fooled by assertions by the Republicans that they want to "replace" (with something better) the Obama Reform. Everything the Republicans have proposed since before the 2008 elections has been at best to continue the 35-year-old Republican-favored system of states crafting their own high-risk-pools for people with substantial pre-existing conditions (with just a teensie bit of additional Federal aid). The high risk pools have miscellaneous eligibility traps, and varying rates. Here is an example of the rates of one, rates listed here, in the insurance industry headquarters of Connecticut, where a 60 year old male, at a time he has pre-existing conditions, pays $46,896.24 a year just to insure himself (=3908.02x12). (There is quite a substantial low-income discount, which we point out would make working not pay, but in any case that doesn't apply if the man is single, and makes a dollar over $32,760. a year, or has a wife, and their total income is a dollar over $44,130. a year. In the wife case, that $46,896. doesn't cover her. If she is 60 as well, and has substantial pre-existing conditions, we'll have to add another $39,726.48 for her insurance. This makes both working and being married really not pay. So much for conservative work-ethic and family values.)

[Further, actually, the Republican insistence that Federal override of state laws to allow insurance to be sold "across state lines" is just a trick to allow certain less-scrupulous health insurance companies to continue sell highly profitable insurance that pays out as little as 55% to 60% of premium in medical claims to just very healthy people. It also wipes-out the in-state mechanism that funds the state high risk pools in many states. If interested, I have some information on this on my policy technical details page (here)].

In June 2011, Mitt Romney promised to direct all members of his Presidential administration to ignore the Obama Reform (by granting waivers to all states) starting in the first day of his administration (YouTube video here).

After the 6/28/12 Supreme Court decision, Mitt Romney is still promising to Repeal the Obama Reform (as here). Despite the fact that the provisions of Obama's reform are pretty much the same, including the mandate to carry coverage, as the one Romney, as governor, brought to Massachusetts. (Did I mention: I live in Massachusetts, and feel the reform makes me much more secure. Most of the people in the state are happy with the reform.)

Examine Mitt-Romney's-Championed-as-Governor Massachusetts State Tax Schedule HC (=Health Care) penalty/mandate/tax forms here:

Form, at Mass Revenue Department / Instructions (non-coverage penalty worksheet next-to-last page), at Mass Revenue Department

Form, backup copy up at my site / Instructions (non-coverage penalty worksheet next-to-last page), backup copy up at my site

Throwing a monkey wrench into any reputatiotion of truthfulness for Romney, on 4/12/2012 the Obama campaign celebrates the 6th Anniversary of Massachusetts RomneyCare, and points out that Romney was proud of that Massachusetts plan, which is the model for the main provisions of the Obama plan (video here).

More Championing by Romney here.

Paul Ryan: Honest, Committed Leader?? Try Paul Ryan, Sneak. (People with a good grasp on the English Language, verify here.)

(7/2/12) My Own Personal MA Romney-Care Activity Log: As a Massachusetts Resident not dependent on employers for health insurance (due to frequently changing self-employment arrangements further with down periods), I availed myself today of the online web MA Health Connector and the July 1-Aug 15 Open Enrollment period, where people can shop to easily change their insurance without worrying about serious or minor pre-existing conditions causing very high rates from the insurance company or state high-risk-pool (like these already cited above), policy denial, heart-related claim exclusion for people with prior heart conditions, closed high-risk-pools, non-existent high-risk-pools, or an insurer refusing to pay a big claim on "unreported"-pre-existing-conditions-grounds after they've been cashing your premium check month after month.

(My experience of today is how it will be under ObamaCare (ObamaCare=pretty exactly MA RomneyCare for all 50 states) starting in 2014 -- for people without employer-provided insurance -- people with employer insurance or traditional over-age-65-Medicare are unaffected. That is, this is how it will be in the other 49 states + DC starting in 2014 if the Obama reform manages not to be repealed by the Republicans and, ironically, Romney himself. Romney, though I think not really a natural smooth-talking decesptive-and-manipulative-without-conscience politician, is following his political advisors, and trying to appear to match the mood of the people--who mostly don't understand the Obama Reform and are in an angry mood. He also knows that, if he becomes a Republican President, he will have to play along, and have played along, with the now radically anti-government Republican party.)

In any case, on the online MA Health Connector, I found a policy with the same coverage for $30. less a month than my current BCBS policy in about 5. I did find, that being the second day of open enrollment, the MA server was a little too busy, and so rather than getting and paying for the new plan in 12 minutes online and with a credit card, I had to print the 2 page application and 3 page agreement. The applications asks nothing about pre-existing conditions--the rate you pay depends on the plan and deductibles and copays you choose, whether you live in an expensive or cheaper health-care part of the state, and your age, with the higher premiums for being older bounded by a 2:1 rate ratio rule to keep the higher premium for older age in contol (which age-dependent rate ratio will be at most 3:1 in any state under the Obama Reform). Once I filled out the application, I wrote out a check, and mailed it. Reading carefully, copying the sent documents, etc., and going to the mailbox took me an hour and a half. A person would have to be pretty damned foolish to complain about the hour and a half delay due to the MA website overload, as I am able to tell from the search terms that people from other states hit my web-site with, that they have much bigger headaches and often actual catastrophes. I find search terms in my website logs passed on from Google, Yahoo, and Bing like "what to do insurance says pre-existing condition won't pay", "insurance lawyer pre-existing condition denied claim", "can I get any insurance pre-existing condition", "any help for not going bankrupt--no insurance pre-existing condition", "am sick -- no insurance -- will emergency room see me", "can the insurance company find out if I leave off my pre-existing conditions". Really, I'm not kidding -- about a third of the search terms I get are people in obvious physical and/or financial distress, similar to those I've listed.

My own worry is that, although Mitt Romney claims it is good policy not to extend RomneyCare to all states (i.e. the already-passed effective-in-2014 Obama Reform), and rather let each state so inclined (blue state) do it if and when it feels like it, and if it can get the state politicians and special interests aligned, and if it can manage to craft an adequately competent law. I myself wonder about that. Any state acting without all other states, like MA did, has some risk of, having, among those from other states with assets to lose, the sickest people (with major pre-existing conditions) flocking to it -- an inter-state adverse selection. I kind of expect this may eventually happen here in MA if the Obama Reform is repealed. So we in MA will have to deal with it then. (Perhaps some kind of protection locking out from our insurance people coming from other states with pre-existing conditions for five years could be put in our insurance laws. Though then it may become a major legal struggle up to the Federal Supreme Court again whether those MA state laws -- which would the only way to have single-state RomneyCare continue to work -- is Constitutional.

(7/14/12) My Own Personal MA Romney-Care Activity Log Part 2: Despite the little glitch enrolling directly on the site on day 2 of open enrollment (above), got my notice in the mail yesterday telling me I'm all enrolled in the new plan. Sorry, BCBS of MA, the MA Connector site made it easy to see you were $30. a month more than this other company for pretty identical coverage, so I switched. (Mitt Romneyspeak version: "I fired my insurance company. But if I become President and you have a pre-existing condition, we'll keep firing your insurance company for Massachusetts residents only.")

(9/27/12) My Own Personal MA Romney-Care Activity Log Part 3: To give people the evidence to look at, let me post the page of the text of my insurance policy that says all pre-existing conditions are covered, for this insurance that I got a few weeks ago from the RomneyCare Massachusetts Exchange. (What the heck -- let me also give you the whole policy text here so you can really look it over. ) I got this insurance here in Massachusetts without answering any questions about pre-existing conditions, and without rates being different based on pre-existing conditions. I didn't have to be a government worker to get it, or in any kind of union, or a member of Congress, or have a special job or any job. I got it simply based on that I was a legal U.S. resident and resident of Massachusetts. (I assume, like anyone in their mid-50s, I have tons of pre-existing conditons -- essentially any time any of the new lab tests that they keep coming up with and automatically do on you nowadays flags as possibly questionable, you have a new pre-existing condition that in all of the other states without ObamaCare, could be grounds for claim denial and your policy being revoked when the insurance company gets a big claim to pay, even after they've been cashing your premium checks for months or years before that big claim.)

(The particular plan I chose has a high deductible of around $2000, with a stoploss of $5000, meaning I might have to pay up to $5000 total in ang given year for copays and deductible. I have enough money to handle this outlay, and I chose it because the policy is cheaper, and as well the higher amounts you have to pay out keep people from being wasteful in a situation of what many Republicans refer to as "an open bar of free medical services". Also, the particular plan I chose runs as an HMO, which means in this case that some physicians in the area are not available, and some more-expensive services require pre-approval. Many of the plans I had a choice of are not HMOs, including the one I had last year, a Blue Cross of MA one. This year I chose the HMO, basically to save a few bucks.)

I should point out that I live life very independently, almost like a Marlboro Man riding on a horse across the terrain in a red state. I didn't choose in my life to play the trick of taking a Federal Government or State Government job for 10 years in order to get free health insurance paid for by the government for life. Instead, most of the money I have earned has been doing very efficient technical computer and science work, through my own small business private corporation. While doing this work, I, and my corporation, averaged paying about 45% in taxes, not the meager 13%-20% that the fatcats who dodge taxes in Switzerland and the Cayman Islands pay and then complain about. And, the Massachusetts RomneyCare policy I have has no government subsidy (though the ones for people with lower incomes than mine do have a subsidy), and in fact I have never had health insurance with a government subsidy of any kind.

(Because I have a lot of math and science reasoning skill, I am able to trace the mechanisms and figure out that here in Massachusetts, RomneyCare, as will be ObamaCare, is a good thing. It takes people who freeload on the rest of us by not carrying health insurance, go to the emergency room to get treatment, and successfully evade the emergency room bills from the hosptial by using a false name at the hospital, or by hiding assets from the hospital, or by just arranging a "see--I'm poor and you can't get blood from a rock" assetless hippielike freeloading financial life, and makes those people pay a money penalty back to us to offset some of the cost to us of that loose, morally lax, irreesponsible freeloading. (Mitt himself said this when he worked together with liberal Democrats in Massachusetts on RomneyCare=MA ObamaCare) a few years ago. Since he needs to attract radical anti-government Republicans to win for President, he reversed himself and now wants to repeal ObamaCare=National RomneyCare.) Anyway, I see that here in MA, RomneyCare lets me live a very independent, non-government dependent life, also independent of having to hang on to a fixed job that you might hate just for the health insurance.

March 20, 2012: Republicans are still creating uncertainty and danger for everyone by going after the repeal as a part of the brand new Mar 2012 Ryan Budget proposal. (The timing of this new attempt is more than two years after the law was passed, and more than half way through the period when the major provisions kick in at the start of 2014, for Pete's sake.) (Source: US News and World Report here). March 29, 2012:Ryan Budget proposal passed by House Republicans, as indicated here

Early July, 2012:Yet again, just in case the almost-brain-dead, who do often vote for them, missed the Republicans in the House of Representatives again passed a Repeal of Obamacare (It has no chance of becoming law right now, since the Senate and President will block it, but the repeal could become actual in January if the November election puts in Mitt Romney as President.) I'm tired of looking up links for all these Republican repeal attempts. If you don't believe me, Google it on Google news.

"By the time I am sworn in, [Congress] will have repealed Obamacare," [former Republican Presidential Candidate Newt] Gingrich said,
explaining that he would ask Congress to get to work on the repeal beginning January 3, 2012, after its Christmas recess.

(Source: CBS News here).

"I mean, people have access to health care in America. After all, you just go to an emergency room.".
-G.W.Bush, 7/10/07.

(Quote Source: Official Bush White House U.S. Government Archives, Paragraph 16, here).

NOTE: Some problems with the emergency-room approach that Republicans are trying to keep in place forever:

--My undersanding is the hospital can go after you for the cost unless you have no money or assets to lose

--It makes people who do have any money to lose and manage to get away with it freeloaders

--My understanding is the emergency room only has to stabilize you

--The care is given when you become really sick and could have been much cheaper for the country if you got treated earlier.

(Some sources for this info below on this page.)

The Republican Ryan Medicare Plan (click here). Full privatization of Medicare (for people over 65), where seniors have to worry about not being able to afford health insurance if they have pre-existing medical conditions.

[U.S. Government Debt-Spiral Note: The author of this site is aware of the looming government debt crisis, and wants to be clear that he supports the tough, painful decisions that need to be made (a la Bowles-Simpson) and which indeed the special-interest-infested political system and electorate are not making.

My objection to the Ryan Medicare plan is not that it inflicts pain, is austere, etc., but rather that it supplies pre-existing-condition-screened insurance to people over 65. (You observe this if you read the bill--here--carefully. The pages about Medicare are 255-337, and I guide you to more specific details within those pages on my Ryan Plan page here.) Pre-existing-condition-screened insurance is just lousy insurance, which leaves people who have worked and saved to go bankrupt if they get sick for a long time. I would accept austerity of a "premium-support" plan like the Ryan plan if the associated insurance is not pre-existing-condition dependent. Indeed, there needs to be pain in the measures necessary to control the U.S. debt, but the point is to act sensibly, and not have the pain be mainly by personally bankrupting say 10% of people over 65. The author of this site is not opposed to the necessary austerity -- indeed there will need to be some extra physical discomfort and a bit of earlier death and cutting back on luxuries for the over-65-crowd, but the author wishes to avoid excessive risk volatility amd punishments on people who work and save. This is the apparent consequence of much in our current health care system and state/Federal financing, and many of the Republican proposals, including much of the means-testing (only when such means testing is poorly crafted).]

To Understand Why The Reform Was Needed, and Get a Grip on the Economic Mechanisms Surrounding Pre-Existing-Health-Conditions (In Particular: Why the Mandate to Carry Coverage is Critical to Make the Pre-Existing-Health-Conditions-OK Insurance Work without an increasing-without-bound Coverage Cost Death-Spiral), You Can Click here for my explanations.

ANOTHER GOOD SOURCE OF SIMPLE EXPLANATIONS ABOUT THE PLAN: (graphic book form) from an MIT health economist who helped create of the Federal Obama Law (and a person who advised Mitt Romney on his construction of the Massachusetts blueprint for the Federal Obama law--the Massachusetts "RomneyCare" blueprint being very close to the Obama law including in the mandate to purchase coverage that all the Republicans are now complaining about: for example, Rick Santorum and Newt Gingrich in this video of debate confrontations of Romney.

Republican Senator expresses contentment with the emergency-room system:

"People have -- people got health care before. They had to go to emergency rooms, but they got it."

-Republican Senator Orrin Hatch 2/28/11.

(Source: PBS Newshour Transcript, Last "Sen. Orrin Hatch" section, here).

INSURANCE RECISION Based On Known or Unknown Pre-Existing Condition

(Recision problem temporarily relieved under temporary in-effect provisions of the Obama reform, and go away completely when the full law kicks in in 2014. But, recision problems come back full scale if the law is repealed or rejected by the court. Further, I see no reason why post-claim insurance recision based on comments about feeling sick or emotionally down you made on publically available Facebook and Twitter posts can't happen after the Obama law is repealed. Recision perhaps even decades after your internet post was made, with that post having hung around on Facebook, Twitter, or somewhere else on the internet, or on insurance industry magnetic archive disks, for all of those decades.)

Is Employer Coverage Secure if the Obama Reform Gets Repealed or Rejected by the Supreme Court? No, Not In This Age of Corporate Cost-Cutting Pressures. See The Walmart Memo

General Information on Health Insurance and Pre-Existing Conditions

Another Brazen Republican Deception on their Health Insurance Proposals

"BENEFIT PARITY WITH MEMBERS OF CONGRESS" as a bold heading in their bill, to trick you.

But read just a little farther, and read carefully.
Bottom on this Page

Yes, indeed, honesty forces me to admit that Barack is a Pol and thus no Angel of Truth. One of his most flagrant cases of not going straight for the truth is his proposed "Buffet Rule" proposed by billionaire Warren Buffet -- taxing incomes over a million dollars at the 30% rate (instead of say the 16% that say Romney pays on his huge income because it is mostly dividends and capital gains from investments which are now-- due to the 2001 and 2003 George W. Bush tax cuts -- taxed for the very wealthy at a much lower rate than salary-income from jobs -- those rates for capital gains and dividends for the wealthy were 28% and 35% or so before those GW Bush tax cuts brought them down to 15%). The Buffet Rule is reasonable and probably increases the fairness of the system to make it more like the fairness before GW Bush was President, but Barack's deception is in trying to let the less quantitative of the people believe it will help in a large way with our budget problems, when it's only about $5 billion a year out of a $500 billion dollar a year problem. Though I'd rather see more courage to be truthful with the bad news on his part, it seems all of the current bunch of Pols are massively deceptive -- Romney asserts Obama has wrecked the country in his 3 years in office, when in fact Obama seems to have been able to keep us out of a full depression that might have been the consequence of the 2007 financial meltdown, and Obama's health care reform is very similar to what Romney did in Massachusetts (where I live) as Governor. That Massachusetts health insurance reform is working out well for me, and I a feel noticeably more financially secure here due to it than I would in any other state. In fact, I won't move out of the state until and unless the Obama Reform goes into effect in the other 49 states.

Oy, oy, oy. Scientists and doctors have created a Monster of Resource Consumption (e.g.) that the country is having real problems coming to grips with. The better of the politicians pander (e.g. Obama asserting no sacrifice at all in his healthcare plan or that raising taxes only on the rich will solve our problems), while the Republicans seem unable to think of any solution more effective than the fully market-based one of having us all pay cash for all medical and hospital services, like we do now at the dentist. The Republicans organize an orgy of deception geared at manipulating the least mentally able ("rationing" cries, etc.). It's enough to make me drag out my dismal Walter Lippmann quotes.


"I mean, people have access to health care in America. After all, you just go to an emergency room.".
-G.W.Bush, 7/10/07.

(Quote Source: Official Bush White House U.S. Government Archives, Paragraph 16, here).

One thing the former president didn't mention is that, if you're not low enough in both assets and income to qualify for Medicaid-for-the-poor (and in some states, even just being a childless adult can disqualify you no matter how poor you are), the emergency room
can bill you for full cost of services, and you are legally responsible. (To check me on this, see here or especially here.)

So, if you are and want to stay middle class, Mr. Bush's emergency room system may not work out so well for you. But if you don't mind dropping to having no wealth or savings, and if you don't mind getting all of your treatment only in emergencies, from the emergency room, then it would seem to work, based on the
"the hospital can't get blood from a rock" principle.

And, of course, people who do "just go to an emergency room" and manage not to pay for their care, wind up freeloading on people with and without insurance who do pay, because of cause the hospital has to pass the cost on of that unpaid for care to people who do pay.

For some other information on the "just go to an emergency-room system", including the Federal Government ENTALA law, which makes that system possible by forcing emergency rooms to treat people who it knows can not pay, click here.



If the complexity of the economic mechanisms involved has had you missing the outrageousness of Republican efforts to undermine secure health insurance for Americans, you should be able to catch it here if you read carefully, in this particular instance from the text of the Paul Ryan Medicare bill.

I have extracted the relevant page of the Ryan Bill here. (It is page 11 of the full Ryan bill, verify my link from Ryan's own page here).

Now, on the extracted page we have this:

"BENEFIT PARITY WITH MEMBERS OF CONGRESS.óWith respect to health insurance issuers offering health insurance coverage through the State Exchange, the State shall not impose any requirement that such issuers provide coverage that includes benefits different than requirements on plans offered to Members of Congress under chapter 89 of title 5, United States Code." .

Certainly the heading "BENEFIT PARITY WITH MEMBERS OF CONGRESS" will satisfy those taking a superficial look at the bill, but those reading carefully will see that what it says means only that the government can't prohibit an insurance company from giving you the same coverage as members of Congress get if the insurance company is so inclined. (Well, since the Ryan plan offers seniors insurance where insurance companies can charge more for seniors with pre-existing-medical conditions, I'm pretty damned sure the insurance companies won't be inclined to offer people with serious medical conditions the same benefits as members of Congress get, unless they charge them a humongous unaffordable premium to cover costs and profit on those medically expensive people.)

To accompany the deceptive language of the bill, in promotions of it such as this PBS Newshour interview, Ryan misleadingly indicates that seniors on Medicare will be getting coverage like "Members of Congress" under his plan. (In case the less cynical reader of "Members of Congress" language in the bill think it is not intended for deception, the use in the Newshour interview makes the purpose clear. Perhaps he and his Republican friends are also privately mocking the people by crafting the deceptive language right into the law, knowing they know how to make the people eat up deceptive language.)

(Besides the section quoted above being intended to mislead people into feeling they will be privelege to have the same coverage he has, I suspect it might be fulfil an additional purpose of actually limiting requirements on the quality of the Medicare insurance. For those interested in going through these details, here is a link to Chapter 89 of title 5.)