Health Care Reform is a three-legged stool: one leg is no denial of coverage, one leg is individual mandate and one leg is subsidies. Like a three-legged stool, HCR cannot stand if one of the legs is removed.
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In part one I shared something I wrote back in 2009. As I read through it, the common theme was, "What if we cannot get health insurance?" That was certainly our biggest issue then. Prior to Health Care Reform (HCR), because Bill has a pre-existing condition, if we lost our employer based health insurance, we may or may not have been able to get health insurance.
So let's talk about the main things HCR does:
1) Insurance companies cannot deny someone a health insurance policy ever.
No denial for pre-existing conditions. No rescission (where they deny and stop your coverage after you get sick). Now you cannot be denied a health insurance plan. Period. This is huge for our family, and many other families like ours where someone has an illness. Knowing that you cannot be denied a health insurance plan is a giant weight off your shoulders.
2) The individual mandate: Because insurance providers now cannot discriminate based on your health, all US citizens must purchase health insurance.
If you think about it, you cannot have 1) No denial for pre-existing conditions, without 2) mandating that people buy insurance. Otherwise everyone would wait until they got sick and then buy insurance. It's like saying you can buy car insurance after you've had an accident. Insurance companies would go out of business. Insurance is predicated on the fact that some people will not need the insurance they are paying for and so their premiums pay for the people who get sick. It's a classic statistical "pool," get enough people in and everything evens out.
3) If you cannot afford health insurance, the government will help subsidize you premiums.
This is the most difficult part of HCR. Some people simply can't afford to buy health insurance. What we do now is that we let them. We let them go without health insurance, saying "It's their choice." (It's not really a choice. No one goes without health insurance by choice, it's always by necessity.) The problem is what happens when they get sick? (Because they will. Everyone of us, will, at some point in our lives, get sick. We will get sick and die. This is a basic fact of human existence) If we have allowed them to "choose" to go without health insurance, who pays for their care?
I ask again, when someone without health insurance gets sick, who pays for their care?
The answer is we do. The costs of uninsured care are built in to the system and passed on to the rest of us via higher premiums, and higher doctor/hospital bills. So even if you don't want to subsidize someone else's health care expenses, you are already doing so. Right now those costs are "hidden," meaning we pay them in various ways that we aren't even aware of.
HCR puts those costs out in the open. It may not be pleasant. You may not want to help pay for some else's health care, but you are doing it already. We might as well get the costs out in the open so we can see what those costs are, and maybe, maybe get a handle on them so we can begin to lower them. It's like bank fees. You might pay any number of fees, but if you're not aware of them, or what they are for, you have no way of reducing them. So HCR says the government (meaning all of us) will subsidize health insurance premiums for people who cannot afford to buy them.