Be Careful What You Wish For

Some people wanted a change in the way health insurance is managed by carriers. They claim it was unfair that some are able to qualify for health insurance while others are not. They said no one should be denied health insurance.

They got their wish.

The Patient Protection and Affordable Health Care Act (Obamacare) is now law. But somewhere along the way it became clear that "affordable" did not belong.

(Of course those of us who have been in the health insurance business for a while knew that there was no way this plan was going to make health insurance . . . affordable. In fact, just the opposite is happening already.)

the law doesn't limit what the companies can charge, and the Thompsons fear that could leave them in the same predicament: still no insurance for two children because it costs too much.

"If that's the way it's going to shake out, it's not really that helpful," said Mary Thompson.

She checked with her insurer recently and was told Andrew probably would have to have his own policy. "I could be looking at a $500-a-month policy for just the two of them," she said.

Of course the law does not limit what a health insurance company can charge. If it did, you would be hard pressed to find a carrier willing to offer coverage. In fact, some carriers have already dropped out of the market completely, and at least one will no longer write coverage on children as a stand alone policy.

The ban on turning kids down goes into place this fall, a stepping stone to a full prohibition that will protect Americans of all ages in 2014, when new competitive insurance markets go into operation. At that point, insurers also will be barred from charging higher premiums to people in poor health.

Care to guess what happens to premiums in 2014?

ALL premiums will skyrocket.

Marathon runners will pay the same rate as 3 pack a day smokers with COPD. Olympic athletes will pay the same as those that weigh 400 pounds.

This makes as much sense as offering a mortgage to everyone and charging the deadbeat who just filed bankruptcy the same rate as someone with an 800 credit score.

The Thompson's have 3 of 5 family members covered by Humana. Two of their children were denied coverage.

Andrew has ADHD (attention deficit hyperactivity disorder), a common condition that most of the time is controlled with medication. Medication that can often run $100 - $300 per month.

Emily has spina bifida. Even though her condition is mild it is still a condition that many times can be expensive to treat.

They're now paying a little over $500 a month for a policy that leaves them with considerable out-of-pocket costs and doesn't cover two out of five family members. Mary Thompson says they could afford another $100 a month, but anything above that would be a stretch

There is no way a carrier can cover the risk associated with either of those conditions against a premium of $100 per month. So, under current guidelines, the children are denied coverage.

While the Thompson's will probably disagree, the $500 figure "quoted" to cover their two children is probably a bargain.

Perhaps we should refer to Obamacare by a more accurate name. The Patient Protection and Unaffordable Health Care Act.

So be careful what you wish for.