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Obama setting up a temporary insurance pool for uninsured with medical problems

Discussion in 'General ME/CFS News' started by shrewsbury, Apr 3, 2010.

  1. shrewsbury

    shrewsbury member

    Messages:
    1,540
    Likes:
    55
    Insurance Pool to Offer Reduced-Rate Coverage
    By ROBERT PEAR Published: April 2, 2010

    WASHINGTON In one of its first steps to carry out the new health care law, the Obama administration announced Friday that it was establishing a temporary insurance pool where uninsured people with medical problems could buy coverage at reduced rates.

    Kathleen Sebelius, the secretary of health and human services, said the program would help provide affordable insurance for Americans who have been locked out of the insurance market.

    Federal health officials said the program would be available from late June of this year to Jan. 1, 2014, when private insurers will be required to accept all applicants without varying premiums on account of a persons medical condition.

    Under the new law, Ms. Sebelius can sign contracts with states to operate insurance pools meeting federal standards. The federal government can operate the pool directly or hire a nonprofit organization to run it in any state that does not want to do so.

    To qualify for the high-risk pool, a consumer must have a pre-existing condition and must have been uninsured for the six months before filing an application.

    Premiums in the new program will be set at standard rates, based on the average premiums charged by private insurers for similar coverage in the individual market.

    If I have cancer, my rate cannot vary based on my having cancer, said Jeanne M. Lambrew, director of the Office of Health Reform at the Department of Health and Human Services.


    Ms. Sebelius may establish a minimum set of benefits. The law specifies a limit on out-of-pocket medical costs, which cannot exceed $5,950 a year for an individual in the pool.

    Dr. Lambrew said the new program would build on what works.

    A recent study published by the Kaiser Family Foundation says that 35 states have high-risk pools with enrollment that totaled 200,000 at the end of 2008. States with the largest enrollment include Illinois, Maryland, Minnesota, Oregon, Texas and Wisconsin.

    State insurance pools often have waiting periods of three months to a year, during which they will not cover pre-existing conditions like cancer or diabetes.

    With some changes, many of the state insurance pools could probably meet the federal criteria.

    The Kaiser study, by Professor Karen L. Pollitz of Georgetown University, said: Currently, state high-risk pools set premiums at a multiple of standard rates, ranging from 125 percent to 200 percent. As a result, pool coverage is often unaffordable for individuals.

    Ms. Sebelius sent letters to governors and state insurance commissioners on Friday asking if they wanted to participate in the new program. The law provides $5 billion to help pay claims for people in the risk pool.

    That may not be enough to provide coverage for all the people who want to enroll in the next three years. Ms. Sebelius said the high-risk pool could provide immediate relief to potentially millions of people.

    Beyond the minimum statutory requirements, Ms. Sebelius said, federal officials will give states a large degree of discretion in devising their programs.

    State high-risk pools, all of which operate at a loss, paid a total of $1.9 billion in claims in 2008, according to a recent report by the Government Accountability Office, an investigative arm of Congress. The average claims per person totaled $9,437 in that year. Premiums paid by beneficiaries accounted for 54 percent of the money used to operate the existing high-risk pools. Assessments collected from insurance companies accounted for 23 percent of the total, while state general revenues and other taxes accounted for most of the remainder.
     
  2. Martlet

    Martlet Senior Member

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    Near St Louis, MO
    Actually, I do find it offensive to see a politician portrayed with a Hitler mustache. It sounds like tea-party stuff to me. It might make some of your members laugh, but our members are often just struggling to get out of bed, let alone find a job in construction - or anywhere else, for that matter.
     
  3. Lesley

    Lesley Senior Member

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    Southeastern US
    Shrewsbury, thanks for posting this. I'm sure this will be helpful to some on this forum.
     
  4. calzy

    calzy Senior Member

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    Naples Florida
    :Retro mad:Thank you Marlet......Im trying not to say something that isnt as respectful as your post!
     
  5. ggingues

    ggingues $10 gift code at iHerb GAS343 of $40

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    Concord, NH
    Offensive?

    Tea Partiers rock!
     
  6. shiso

    shiso Senior Member

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    Thanks shrewsbury for posting this. Very relevant for many ME/CFS patients who are facing no health insurance (no spouse with health insurance through job, no Medicare, other options prohibitively expensive).
     
  7. sarahg

    sarahg Admin Assistant

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    Pennsylvania
    I don't think the content of this spam is the problem here. I don't think it matters what the message is, or whether or not any one person agrees or disagrees with it. The problem here is that we have a spammer who joined to make one post that has nothing to do with this forum. It has nothing to do with us at all. If this problem is not dealt with by deleting the message and deleting the user, all we can hope for is that this will happen all the time and no one wants that.

    This is not a forum for unemployed construction workers to share political videos(well, unless they find themselves disabled by this illness, but in this situation that is not the case) Just as this is not a forum for wedding planners, sellers of miracle herbals supplements, sexual performance enhancers, or shoes at rock bottom prices.

    The message does not matter. Anyone who joins here with the sole purpose of adding spam to this community needs to have all posts and membership deleted every time, we don't have to put up with it.
     
  8. JillBohr

    JillBohr Senior Member

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    Columbus, OH
    Great comment SarahG. The spammer is obviously trying to divert from the topic at hand in which it looks like people will be helped if they come down with an illness and do not have health insurance. I have two coworkers that came down with cancer in the last two years and they lost their jobs because they were too sick to work. They both lost their homes as well and are now living with relatives. Although I think this is a decent attempt on Obama's part, I do not think it is enough. I am not sure how a person will be able to make health insurance premium payments if they are too sick to work and have no income. This is why I have always supported a universal health care plan.
     
  9. flybro

    flybro Senior Member

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    pluto
    I agree SarahG

    There should be no place here for this. It is irrelevant to the discussion, and irrelevant to the forum.

    Could MODS please delete it.
     
  10. ggingues

    ggingues $10 gift code at iHerb GAS343 of $40

    Messages:
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    Concord, NH
    I am not a spammer, not sure if this was addressed at me? Doesn't sound like anything that Tea Parties I know support either. After all Nazi's were Socialist which is totally opposite of Tea Party principles. Tea Partiers do rock and are patriots which is what the US is based upon!
     
  11. Mark

    Mark Acting CEO

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    4,528
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    Sofa, UK
    I've deleted the spam post. Suggest everyone delete their responses to it to clean up the thread as best you can, and return to the subject of shrewsbury's thread. I do have sympathy with the plight of these particular spammers, but it doesn't seem to have anything to do with our forum. Members should really be here out of interest in ME/CFS. It doesn't appear this user is.
     
  12. Mark

    Mark Acting CEO

    Messages:
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    Sofa, UK
    "Nazi's"

    Misplaced apostrophe. Dead giveaway. Learn grammar first, then move on to the more advanced stuff, else somebody will be able to turn reality upside down and fill your head with goo.

    Can we please return to the subject in question, in relation to ME/CFS, this isn't fair to Shrewsbury.
     
  13. Mark

    Mark Acting CEO

    Messages:
    4,528
    Likes:
    2,004
    Sofa, UK
    Obama setting up a temporary insurance pool for uninsured with medical problems

    Insurance Pool to Offer Reduced-Rate Coverage
    By ROBERT PEAR Published: April 2, 2010

    WASHINGTON In one of its first steps to carry out the new health care law, the Obama administration announced Friday that it was establishing a temporary insurance pool where uninsured people with medical problems could buy coverage at reduced rates.

    Kathleen Sebelius, the secretary of health and human services, said the program would help provide affordable insurance for Americans who have been locked out of the insurance market.

    Federal health officials said the program would be available from late June of this year to Jan. 1, 2014, when private insurers will be required to accept all applicants without varying premiums on account of a persons medical condition.

    Under the new law, Ms. Sebelius can sign contracts with states to operate insurance pools meeting federal standards. The federal government can operate the pool directly or hire a nonprofit organization to run it in any state that does not want to do so.

    To qualify for the high-risk pool, a consumer must have a pre-existing condition and must have been uninsured for the six months before filing an application.

    Premiums in the new program will be set at standard rates, based on the average premiums charged by private insurers for similar coverage in the individual market.

    If I have cancer, my rate cannot vary based on my having cancer, said Jeanne M. Lambrew, director of the Office of Health Reform at the Department of Health and Human Services.


    Ms. Sebelius may establish a minimum set of benefits. The law specifies a limit on out-of-pocket medical costs, which cannot exceed $5,950 a year for an individual in the pool.

    Dr. Lambrew said the new program would build on what works.

    A recent study published by the Kaiser Family Foundation says that 35 states have high-risk pools with enrollment that totaled 200,000 at the end of 2008. States with the largest enrollment include Illinois, Maryland, Minnesota, Oregon, Texas and Wisconsin.

    State insurance pools often have waiting periods of three months to a year, during which they will not cover pre-existing conditions like cancer or diabetes.

    With some changes, many of the state insurance pools could probably meet the federal criteria.

    The Kaiser study, by Professor Karen L. Pollitz of Georgetown University, said: Currently, state high-risk pools set premiums at a multiple of standard rates, ranging from 125 percent to 200 percent. As a result, pool coverage is often unaffordable for individuals.

    Ms. Sebelius sent letters to governors and state insurance commissioners on Friday asking if they wanted to participate in the new program. The law provides $5 billion to help pay claims for people in the risk pool.

    That may not be enough to provide coverage for all the people who want to enroll in the next three years. Ms. Sebelius said the high-risk pool could provide immediate relief to potentially millions of people.

    Beyond the minimum statutory requirements, Ms. Sebelius said, federal officials will give states a large degree of discretion in devising their programs.

    State high-risk pools, all of which operate at a loss, paid a total of $1.9 billion in claims in 2008, according to a recent report by the Government Accountability Office, an investigative arm of Congress. The average claims per person totaled $9,437 in that year. Premiums paid by beneficiaries accounted for 54 percent of the money used to operate the existing high-risk pools. Assessments collected from insurance companies accounted for 23 percent of the total, while state general revenues and other taxes accounted for most of the remainder. ​
     
  14. ggingues

    ggingues $10 gift code at iHerb GAS343 of $40

    Messages:
    4,084
    Likes:
    909
    Concord, NH
    Sorry smarty pants, perhaps I will be at your level some day. I think you get my point, sorry I have cognitive dysfunction and English is my 2nd language.
     
  15. jshu43

    jshu43

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    19
    Likes:
    1
    Friendswood, TX
    I am on a High Risk Pool for Texas already. It is very expensive. Is this going to be a new High Risk Pool? Do you know any info on whether people on those programs would I have to get off of their High Risk Pool for six months to be able to get on it?
     

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