Health insurance coverage has since been a plaguing issue in the USA. But thanks to former President Barack Obama’s healthcare law (Obamacare), anyone with pre-existing health issues or a chronic illness can get affordable healthcare. Since the implementation of Obamacare, more than 16 million formerly uninsured Americans now have healthcare.
With such strong and immediate positives that the Affordable Care Act showed, anyone can see that before 2010, millions of American families desperately needed a new healthcare plan.
Despite the increasing number of people who have received healthcare coverage under Obamacare, some still criticize it. One major concern is that it requires individuals to have health insurance, and failure to do so comes with tax penalties.
Many argue that requiring the purchase of insurance is unconstitutional, and as such, it has been one of the main arguments for the act going before the Supreme Court.
Understanding health insurance policies and their political affiliations can be a daunting task. However, what ultimately matters is how they impact our families and ourselves. Even if you are currently young and healthy, it’s important to consider that as you age, you may have to shoulder the medical bills of your parents or grandparents who may require healthcare coverage presently or in the future.
It’s always important to understand all the different aspects of healthcare, regardless of your current health status or healthcare coverage. It’s never too early to ask questions and educate yourself on things like whether you can obtain life insurance if you have a stroke, develop cancer, or switch jobs. This knowledge can benefit not only you but also your friends and family.
That’s right. Healthy young people, don’t tune out. With talk of Obamacare possibly being repealed, you should know how the outcome of health care debates will affect you now or in the future.
Your Physical Health Isn’t the Only Considered Risk
What could become more apparent if Obamacare’s current policies are repealed is higher health insurance premiums based on external factors other than pre-existing health conditions. This is in addition to the following listed below
1) Job Lock
Are you considering switching job positions, offices, companies, or starting your own business? It turns out that the decision could have a negative impact on your health insurance coverage. Under private health insurance regulations, many Americans are trapped in jobs solely to keep their health insurance. We can see how this reliance is problematic in retrospect of the health insurance premiums and plans before Obamacare and the COVID-19 pandemic.
2) Age is More Than a Number
It’s important to acknowledge that aging is a fact of life. Even under Obamacare, it is legal and common practice for health care premiums to increase based on age. This means that as you get older, you may have to pay more for health insurance.
The reason for this is that as you age, your body becomes more susceptible to health conditions such as back pain, hearing and vision loss, depression, dementia, high blood pressure, and diabetes. To get a better idea of what kind of health issues you may face in the future, it’s a good idea to look into your family history.
It’s also important to consider the health insurance needs of your parents and grandparents, especially if you’re on a shared plan or under 26 and using your parents’ healthcare for coverage. Even if they are healthy, they may still face higher insurance rates as they get older.
In fact, my 56-year-old mother, who has always been active and healthy, saw a significant increase in her health insurance rates due to her age. This is because insurance companies are allowed to factor in the increased health care costs associated with aging after 55 years of age.
3) Decoding ZIP Code Bias
Healthcare stereotyping is a significant issue within our healthcare system, even though it may not be directly stated. These biases can have a massive impact on the quality of healthcare and can affect anyone, regardless of where they live. ZIP code biases have been a problem even before Obamacare, hindering the quality of healthcare and creating additional financial burdens for those living in certain areas.
Insurance companies often stereotype and exploit where you live when measuring someone’s health. They consider the health factors of your region despite the individual’s physical health and medical history. Before moving to a new area, it is a smart idea to look at the common health issues of that region, as healthcare providers gauge the cost of coverage based on the common procedures doctors in your area are more likely to perform.
Healthcare redlining can significantly affect anyone needing health insurance, regardless of whether they live in a poor neighborhood or are considering moving to a city with poor air quality. Insurance premium rates are generated based on a city’s population size, environment, and socioeconomic factors. These are just a few of the factors that contribute to what public health professionals call the social determinants of health.
The social determinants of health affect a wide variety of Americans, including those living in low-income areas, large cities, or rural areas, and even those in states with more severe weather conditions.
4) The Sexuality Bias
Suppose you are a part of the LGBTQIA+ community, especially if you identify as transgender. In that case, you are also at a disadvantage for health insurance coverage. Outside of Obamacare, gender dysphoria will be considered a pre-existing health condition, regardless of surgical history or intent.
Though the sociocultural structures surrounding the various gender identities are becoming more normalized and less stigmatized, our healthcare system has only recently begun not to view sexuality and gender identity as a psychiatric disability.
With society’s growth in understanding sexuality and a broader spectrum of gender identity, there’s no telling where healthcare could go in reference to bettering the lives of those within the LGBTQIA+ community.
5) Balancing Mind, Body, and Spirit is Everything, but Priceless
You guessed it. Being diagnosed with any sort of mental health illness such as depression, anxiety, addiction, or bipolar disorder puts your health insurance plan at risk under the “Repeal and Replace” plan for Obamacare. The fear with Repeal and Replace and the Trumpcare health insurance plan is that mental health and substance abuse care is almost wholly ignored.
The political commotion of 2016-2020 has caused many to forget the number of those left with no healthcare coverage because of their history of addiction or mental illness diagnosis. In 1996 and 2008, the country shortened the gaps between those with mental illness, substance abuse history, and those uninsured by creating the Mental Health Parity Act (MHPA) and the Addiction Equity Act (AEA).
These federal laws eliminated the legalities used by healthcare providers to increase premiums or differ coverage for any psychiatrically disabled or substance abuse addicts.
Both the MHPA and AEA made efforts and produced positive results; however, mental health inclusion still did not correlate with proper support and affordable coverage until Obamacare. In 2018, 47.6 million insured Americans, or 19 percent of the population claimed to be suffering from a mental illness. This data has helped gauge the disparities in mental health coverage and inaccessibility.
Shopping in a Deserted Marketplace
Millions of Americans who were previously unable to obtain insurance coverage were able to do so with the creation of an insurance marketplace under Obamacare, which ensured that pre-existing conditions would no longer be a barrier to coverage.
As the debate on repealing and amending Obamacare continues, those who have pre-existing conditions or have loved ones with pre-existing conditions should consider private insurance coverage as a backup plan in case Obamacare is ever repealed.
1) Obesity / Diabetes
An astonishing two-thirds of the American population is considered obese, one in three are prediabetic, and one in 10 have a diagnosed form of diabetes. Someone with diabetes will accumulate roughly $16,000 in direct costs of medical expenses per year.
The risk of diabetes increases due to genetic and environmental factors, making more impoverished Americans more likely to develop the condition. Both obesity and diabetes are considered pre-existing conditions that, thanks to Obamacare, cannot be the cause for healthcare coverage denial. But even with those protections, people who are diagnosed with diabetes tend to pay more than two times the healthcare costs than those without the preexisting condition of a diabetes diagnosis.
Obesity and diabetes affect everyone of all ages, races, and economic and social classes, making these illnesses two of America’s leading healthcare issues. Accounting for $245 billion in national medical costs makes diabetes one of the largest contributors to the healthcare financial burdens.
Obesity and diabetes’ dependence on environmental influence shines a light on how the disparities caused by the social determinants of health are exploited within the healthcare system.
2) Lupus and Chronic Illnesses
Lupus is a chronic autoimmune disease that causes damage to the joints, skin, kidneys, heart, and other internal organs. Most commonly diagnosed in African-American women aged 15 to 25, a lupus diagnosis comes with needing continuous life-long treatment that, if left untreated, can cause fatal health complications such as heart attack and stroke, making the medication and treatments vital.
Before Obamacare, lupus was considered a pre-existing condition that made it a death sentence for many diagnosed because they either didn’t qualify for quality healthcare insurance, or they needed multiple forms of coverage that weren’t accessible.
The most commonly prescribed drugs to treat lupus symptoms are hydroxychloroquine (Plaquenil®), chloroquine (Aralen®), and Restasis (Teva-Cyclosporine ophthalmic emulsion). All of these drugs have become less expensive under Obamacare, given that the patient has at least one form of health insurance.
The cost of medication for lupus patients can be quite expensive. For instance, both generic and branded prescriptions such as Teva-Cyclosporine ophthalmic emulsion can cost an average of $375 per month with insurance. However, a patient without insurance will have to pay $1,000 per bottle. It is important to note that there is no cure for lupus, and within the chronic illness are four subtypes that widely vary. As a result, the average lupus patient requires four or more daily prescriptions.
Something Obamacare got right concerning those with chronic illnesses like lupus is that it created more affordable coverage for up to 96 percent of most lupus prescriptions. Though insurance providers are no longer allowed to discriminate against pre-existing conditions, our current healthcare system still has fallen short in preventing private practice and specialty offices from turning away patients who can’t afford the doctor’s preferred treatment method.
When doctors decide on a course of treatment, they are forced by the healthcare marketplace to consider a patient’s external non-medical factors such as income and geographical location. This turns doctors’ visits into a double jeopardy of non-medical factors that have already played a role in the individual’s qualification for healthcare coverage.
It is impossible to deny that marginalized Americans continue to be negatively impacted by social determinants of health, which are also used to determine healthcare coverage eligibility.
For those with lupus and chronic illnesses, getting coverage is only the first leg of the healthcare race. Making their triangled health insurance coverage fit into the square pegs that will get them to their needed treatment are the issues still overshadowed by Obamacare’s promise of affordability.
The disparities in the quality of healthcare coverage and in-patient care lead to both badly cared for patients and an increase in the coverage gap of uninsured citizens, leaving them stuck between defective healthcare options.
This is an endlessly problematic cycle for anyone who pays toward our healthcare system because it makes patients rely on emergency room care which results in non-specialized care and massive hospital bills. Access to healthcare providers that specialize in areas further than primary care and the daily medications needed are equally vital for lupus patients’ health and overall quality of life.
3) Cardiovascular Diseases and Stroke
What would you do if you had $317 billion? If your answer is to cover the medical costs of those suffering from cardiovascular diseases, you would be able to eliminate the national financial burden caused by this condition in the United States for a whole year. Which didn’t go as far as you thought it would, right!?
The most common cardiovascular diseases include:
a) Coronary artery disease
b) Heart attack
c) Arrhythmias
d) Heart failure
e) Peripheral artery disease
According to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), an adult dies from a cardiovascular-related health complication every 40 seconds. It is globally the number one cause of death. Thirty-one percent of deaths in America are due to cardiovascular diseases and tend to be found more in males.
The main reason cardiovascular diseases are listed as pre-existing conditions is that you are almost twice as likely to suffer from another form of a cardiovascular complication and are now considered high risk. Patients who have suffered from any variation of cardiovascular disease have an increased risk of stroke, heart failure, speech disorders, chronic headaches, and blood clots, to name a few.
Heart attacks and strokes may seem frightening, but the good news is that many of the factors that contribute to them are within our control. By making healthier lifestyle choices such as adopting a more balanced diet and increasing physical activity, we can significantly reduce our risk of these conditions. It’s important to note that while natural healing practices and non-medical holistic methods can be beneficial, they should always be used in conjunction with prescribed medical treatment. Doing so can make a significant difference in preventing and treating life-threatening illnesses.
Two of the most popular prescriptions used to treat cardiovascular diseases are Corlanor and Entresto, whose annual pinch comes out to $4,500, an average of $375 per month. Other medications such as Digoxin, Lisinopril, and Carvedilol can cost patients up to $400 a month, which is as much as a car payment for most American households.
Are you and your loved ones worth insuring?
The fact is that everyone needs insurance. In the enlightenment of the COVID-19 pandemic, we have seen that value, importance, and unity often get overlooked when speaking about healthcare personally, nationally, and globally.
Healthcare and medical industry breakthroughs are happening every day, from hospitals to political movements such as the Mental Health Parity Act, the Addiction Equity Act, and most recently, Obamacare. Being critical of our current healthcare policies and products is a productive way to expose the cracks in the system and examine new ones that may have been created.
“When there is a genuine intention to create a system that focuses on benefiting a nation beyond profits, there are no opposing sides. Healthcare topics can become heated debates because the well-being of our families is a passionate subject matter.”
With political election pressure, new plans and acts will hopefully continue to expose the current divisions that contribute to the social determinants of health and cause the most significant issues contributing to healthcare disparities. The healthcare system has many positives and for now, having to fret over a pre-existing condition that is keeping you from obtaining insurance is a thing of the past.
With much work still to be done to close coverage gaps, increase affordability, and access to medications, broaden the ability to provide quality healthcare, and end biased medical prescribing, the discussion of what the American public needs from our healthcare system is loud and clear.
Tags: chronic condition health care Health insurance Health Issues healthcare cost Obamacare Pre existing conditions us healthcare
