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 conditions 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 health care plan.
The number of people that were in need and that have now received coverage hasn’t stopped others from criticizing Obamacare. A primary concern that some people have with it is that it makes health insurance a requirement that comes with tax penalties if one chooses to opt out of having healthcare coverage.
Many argue that requiring the purchase of insurance is unconstitutional, and that has been one of the main arguments for the act coming before the Supreme Court.
Health insurance policies and each proposal’s political alignments can be hard to follow. Still, we mainly want to know how it affects our loved ones and us. Even if you are young and healthy now, eventually you will age and could take on medical bill debt from your parents and grandparents who may have health conditions that need coverage now or in the future.
No matter where you are with your health and healthcare coverage, it’s never too early to ask questions and better understand all of the various topics surrounding healthcare. For yourself, friends, and family, know whether you can get life insurance if you have a stroke, develop cancer, or even get a new job.
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 With talk of Obamacare possibly being repealed, you should know how the outcome of health care debates will affect you now or in the future.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What we could see more of if Obamacare’s current policies are repealed are higher health insurance premiums based on external factors other than pre-existing health conditions.
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 were 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
Sorry to keep adding weight to the shoulders of the young and healthy, but a fact of life is that you’ll age. Even under Obamacare, increasing health care premiums based on age are still legal and practiced.
Now it makes sense that older people would pay more because as they age, their bodies are at a higher risk of health conditions like back pain, hearing and vision loss, depression, dementia, high blood pressure, and diabetes.
Looking into your family history will be a better indicator of what you may need your insurance to cover in the future. Still, these examples are just a few health issues that commonly affect the American public.
Besides yourself, you should also think about your parents and grandparents, especially if you’re on a shared plan or under 26 and use your parents’ healthcare for coverage. At 56 years young, my overall healthy all-American athlete mother saw a massive increase in her health insurance rates as a birthday present.
This happened because, after 55 years of age, insurance companies are allowed to factor in the possibilities of your age, generating more health care costs.
3) Decoding ZIP Code Bias
You probably won’t find the words “healthcare stereotyping” being directly stated. But that doesn’t mean that it’s not a massive issue within our healthcare system and that these biases aren’t affecting you.
Now and before Obamacare, ZIP code biases have continued to hinder the quality of healthcare while creating additional financial burdens for those living in undesirable ZIP code areas.
When measuring someone’s health, insurance companies often stereotype and exploit where you live because they consider the health factors of that region despite the physical health and medical history of the individual.
Looking at an area’s common health issues before moving is a smart idea considering that health insurance companies gauge your cost of coverage on the common procedures doctors in your area are more likely to perform. How the healthcare system and government choose to redline each state significantly affects anyone needing health insurance.
Healthcare redlining can affect you no matter if you live in a poor neighborhood or are merely thinking of moving to a city with poor air quality.
A city’s population size, environment, and socioeconomic factors play an essential role in generating insurance premium rates. These factors are only three that contribute to what public health professionals call the social determinants of health.
Social determinants of health affect a wide variety of Americans, including those living in low-income areas, large city or rural areas, and even those in states with more severe weather conditions.
4) The Sexuality Bias
Suppose you are apart 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 as 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 are almost wholly ignored.
The political commotion of 2016-2020 has caused many to forget the quantity of those left with no healthcare coverage because of their addiction history 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 for substance abuse addicts.
Both the MHPA and AEA made efforts and produced positive results; mental health inclusion still had not correlated with proper support and affordable coverage until Obamacare. In 2018, 47.6 million of 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
For millions of Americans, Obamacare picked them up when no private insurance companies would. Since 2014, pre-existing conditions have had a safe haven of sorts under Obamacare by creating an insurance marketplace that wouldn’t turn them away.
With the ongoing debate of repealing and amending Obamacare, those with pre-existing conditions or who have loved ones with pre-existing conditions should look at private insurance coverage as a backup plan if Obamacare is 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 indirect 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 person has at least one form of health insurance.
Generic Restasis and branded prescriptions such as Teva-Cyclosporine ophthalmic emulsion with insurance can run patients an average of $375 per month. A patient without insurance will be coughing up $1,000 per bottle. There is no cure for lupus, and within the chronic illness are four subtypes that widely vary, which result in the average lupus patient needing four or more daily prescriptions.
Something Obamacare got right in favor of 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 has still 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 to healthcare coverage.
There’s no way around concluding that the social determinants of health continue to negatively affect marginalized Americans and the determinants used for healthcare coverage qualifications.
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 that 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 with $317 billion? If your answer is to cover the medical costs for those suffering from cardiovascular diseases, you would be erasing this condition’s national financial burden in the United States for one whole year. Which didn’t go as far as you’d think?
The most common cardiovascular diseases include:
a) Coronary artery disease
b) Heart attack
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 that 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 can sound scary, but the bright side in most of these cases is that a large part of the healing and prevention are controllable lifestyle changes such as eating a more balanced diet and increasing exercise. Natural healing practices such as healthy lifestyle changes and non-medical holistic methods can make a life-and-death difference but it is strongly urged to do so in addition to prescribed medical treatment.
Two of the most popular prescriptions used to treat cardiovascular diseases are Corlanor and Entresto, whose annual pinch comes out to be $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 it to insure?
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 where cracks in the system still lie and examine new ones that may have been created.
When there’s a genuine intention for creating a system that can focus on how it can benefit a nation in other ways than profit, there are no opposing sides. Healthcare topics can become heated debates because our family’s well-being 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 keeping you from obtaining insurance is a thing of the past.
With much work still to be done to close coverage gaps, increase affordability, 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: Health insurance Health Issues Obamacare Pre existing conditions