Thursday, May 19, 2011

Punishing the Good Guys

[Caution: long rant ahead]

Last week, a good friend and colleague called to ask for help on what had become a rather complicated case. His clients, a husband and wife, were about to lose their health insurance - through no fault of their own - and had asked him for help. While he dabbles in this area, he's really a (very, very good) P&C guy, and turned to me for advice.

Bill and Mary are in their sixties (he's 68, she's 61). Bill was recently (May 3rd) laid off from his long-time job, in anticipation of the company closing its doors. He'd received his COBRA election info, but was unsure of his next step. He called my friend, who then called me.

Bill's going to be okay: he can (and will) pick up a Medicare Supplement plan, as well as his Part D coverage, on the "open market."

But Mary has a problem: after a thorough pre-screen, we've determined that she's uninsurable.

You're probably thinking "okay, Henry, what's the big deal? They've got the COBRA info, she'll just glom onto that."

Would that it were so simple:

In its infinite wisdom, the CongressCritters who drafted the Consolidated Omnibus Budget Reconciliation Act made it very clear that COBRA was a continuation of one's existing group coverage. Implicit in that definition is a major problem: if there's no group, then there's no continuation of that coverage, and so there's no insurance.


Which leaves Mary with very few, mostly sub-optimal [ed: why not just say "crappy?"] choices:

■ Open enrollment with a local HMO (with a very high premium and some major limitations)
Applying - and being declined - for coverage (which gets her on a state-mandated Guaranteed Issue plan)
A conversion plan (very expensive, verry crappy)
The new ObamaPool©

None of these are really great choices, but it's that last one that has me seething:

The ObamaPool© plan has decent benefits, reasonably decent rates, is Guaranteed Issue, and will cover her (numerous) pre-existing conditions.

There's just one catch:

She'll have to be uninsured for (at least) six months before she's eligible.

That's correct: she and Bill have played by the rules, staying insured even when times were tough, and she can't access the same coverage that her no-goodnik neighbor - who's never bothered to buy insurance, even though she could well afford it - is free to waltz in this afternoon and buy with basically a signature and a (smallish) check.

This is outrageous. Unconscionable. Immoral.

We are punishing people for playing by the rules, for being responsible, productive citizens, for taking personal responsibility This isn't about politics, it's about something far more important: justice.
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