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Like many leftist causes, this issue of pre-existing conditions is based on a false understanding. We once thought that such misunderstandings were accidental or inadvertent. However, we see increasing evidence that this is actually purposeful deception, in order to advance an agenda.
This seems to be the case with today's article.
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Rep. Sean Duffy (R-WI) announced on Monday that he will soon resign his House seat, citing family reasons. He and his wife, Fox News contributor Rachel Campos-Duffy, said their soon-to-be born ninth child will require heart surgery soon after her birth.
On Tuesday, Duffy explained that he had made sure the child will have access to health insurance despite her pre-existing conditions. (The child does not have a "pre"-existing condition. A pre-existing condition is a status that can only exist if one has a condition, but does not have coverage.
If the person in question has insurance, then it is an existing condition, that is, a health issue is present and the person has coverage. "Pre" means a health issue "pre" coverage.)
It is laudable that the Duffy family is preparing to provide as much care as possible for a child with serious medical challenges. But as a congressman, Duffy voted to take away those same important protections for others with pre-existing conditions — directly contradicting his own campaign promises. (We don't know this is true, especially since it's a leftist stating it. We are unable to trust the honesty of leftists.)
The couple went on Fox News on Tuesday morning to explain their decision and situation. Both discussed the challenging schedule a member of Congress must endure and expressed their commitment to being present for their family.
On Tuesday, Duffy explained that he had made sure the child will have access to health insurance despite her pre-existing conditions. (The child does not have a "pre"-existing condition. A pre-existing condition is a status that can only exist if one has a condition, but does not have coverage.
If the person in question has insurance, then it is an existing condition, that is, a health issue is present and the person has coverage. "Pre" means a health issue "pre" coverage.)
It is laudable that the Duffy family is preparing to provide as much care as possible for a child with serious medical challenges. But as a congressman, Duffy voted to take away those same important protections for others with pre-existing conditions — directly contradicting his own campaign promises. (We don't know this is true, especially since it's a leftist stating it. We are unable to trust the honesty of leftists.)
The couple went on Fox News on Tuesday morning to explain their decision and situation. Both discussed the challenging schedule a member of Congress must endure and expressed their commitment to being present for their family.
Duffy was asked what he and his wife planned to do about healthcare in light of the pre-existing condition their daughter will be born with and his resignation from his job.
He noted that former members of Congress don’t get health insurance for life and explained he plans to get a COBRA plan for his family — utilizing a 1985 law that allows people to pay to stay on their employers’ health plans at their own expense for up to 18 months after leaving a job.
“We pay the full boat for that so we can transition and with the condition of the baby, we have that complete coverage,” Duffy said. “But, yeah, you are right. I had to look at that and make sure that with, open heart surgery, we had coverage to make sure that, you know, we could pay for that and we have got that worked out. So, thank God, that’s not a consideration as we look to the birth.”
While his daughter’s coverage will be protected for up to 18 months, after that in order to insure her the Duffys will need those pre-existing condition protections. (No, she will not. An existing condition currently insured will continue to be insured with any subsequent plan.)
While Duffy promised as a candidate that he would protect insurance coverage for those with pre-existing conditions and would not back any repeal of the Affordable Care Act (commonly known as Obamacare) that did not include a replacement with comparable protections, his record in Congress shows just the opposite. (Obamacare changed coverage for pre-existing conditions, it did not create it. Prior to Obamacare, a person with an existing condition [that is, they had a condition and had coverage] could not be denied coverage if they changed insurance companies. The new insurance company could not decline because of a currently covered condition.
With Obamacare the definition changed, so now the person doesn't have coverage and has a condition. This is what a *pre* existing condition is. the change means they can now buy coverage and be covered for it.
In other words, a sick person needing treatment could buy coverage and go in and get treated the next day. By comparison, this is like a homeowner buying property insurance while his house is on fire.
This is not insurance, by definition. Buying a policy when there is an existing condition that will immediately be covered is not insurance, it is welfare.
Insurance is based on certain principles, where the risk must
A 2011 PolitiFact examination of Duffy’s vote to fully repeal Obamacare with no replacement noted that as a 2010 candidate, he vowed he “would not vote to repeal the legislation unless a better proposal was in place.” Months later, he voted to repeal the legislation without any replacement. PolitiFact dubbed this vote “a Full Flop.”
During his eight years in Congress, Duffy repeatedly voted to destroy Obamacare and undermine the pre-existing condition protections. He enthusiastically voted for Trumpcare in 2017, which would have made insurance coverage significantly less affordable for those with pre-existing conditions, (In a world based on reality, a person who is not healthy and is being underwritten for coverage would be charged a higher premium. That is, an insurance company would evaluate the risk of a potential insured and charge an insurance premium commensurate with the possibility of loss.
It is quite proper to charge a less healthy person more for his coverage. But even then he still wouldn't bear the entire cost of a potential loss in his premiums. The pool of insureds must pay more for their coverage as well. They would pay based on the total losses in the pool. This is the real world.
But what the Left has achieved via Obamacare is the insurance company must pay for losses for people who come into the pool without having contributed to it and intend to use it immediately. That is, those who have a 100% chance of loss are be covered.
We have already acknowledged that a pool of insureds will pay more if the loss experience of the entire pool is higher. However, if we add into the cost to the pool those claims that have a 100% chance for loss, the cost of coverage would be prohibitive for everyone.
This is why the ACA created subsidies and mandatory participation. Premiums are manipulated, based not on loss potential, but on the insured's income [which is not a factor in insurance risk].
Therefore, a poor person with the pre-existing condition will not have to pay anywhere near the actual premium. He gets his coverage, with an immediate need to use it, without paying hardly anything for it. Therefore, costs are being shifted from very high risk individuals to the government, then to the taxpayer.
Mandatory participation eliminates, in theory, adverse selection. If a pool of insureds has a high loss experience, those insureds who can exit the pool will do so, leaving behind those who are unable to leave the pool. The loss experience increases, which in turn increases government intervention, until only the sickest people are in the pool.
The penalty for not having insurance was supposed to dissuade people from leaving the pool. However, though Obamacare was supposed to cover everyone, it has never achieved this.
Chart found here.
and just this May he voted against the Protecting Americans with Preexisting Conditions Act of 2019. (As is typical for the Left, their "solutions" never solve anything. More laws are always needed, more programs, more government control.)
While legislative Obamacare repeal efforts are unlikely to go anywhere as long as Democrats control the House of Representatives, a Trump administration-backed lawsuit could imperil the law and some congressional Republicans have promised to kill the law in 2021 if they regain full control of the federal government.
This story has been updated to clarify that the pre-existing conditions protection will be necessary after the COBRA period is over.
He noted that former members of Congress don’t get health insurance for life and explained he plans to get a COBRA plan for his family — utilizing a 1985 law that allows people to pay to stay on their employers’ health plans at their own expense for up to 18 months after leaving a job.
“We pay the full boat for that so we can transition and with the condition of the baby, we have that complete coverage,” Duffy said. “But, yeah, you are right. I had to look at that and make sure that with, open heart surgery, we had coverage to make sure that, you know, we could pay for that and we have got that worked out. So, thank God, that’s not a consideration as we look to the birth.”
While his daughter’s coverage will be protected for up to 18 months, after that in order to insure her the Duffys will need those pre-existing condition protections. (No, she will not. An existing condition currently insured will continue to be insured with any subsequent plan.)
While Duffy promised as a candidate that he would protect insurance coverage for those with pre-existing conditions and would not back any repeal of the Affordable Care Act (commonly known as Obamacare) that did not include a replacement with comparable protections, his record in Congress shows just the opposite. (Obamacare changed coverage for pre-existing conditions, it did not create it. Prior to Obamacare, a person with an existing condition [that is, they had a condition and had coverage] could not be denied coverage if they changed insurance companies. The new insurance company could not decline because of a currently covered condition.
With Obamacare the definition changed, so now the person doesn't have coverage and has a condition. This is what a *pre* existing condition is. the change means they can now buy coverage and be covered for it.
In other words, a sick person needing treatment could buy coverage and go in and get treated the next day. By comparison, this is like a homeowner buying property insurance while his house is on fire.
This is not insurance, by definition. Buying a policy when there is an existing condition that will immediately be covered is not insurance, it is welfare.
Insurance is based on certain principles, where the risk must
- be where an opportunity for loss is exists and the opportunity for financial gain is absent.
- result in a loss that is unintended and unexpected.
- result in a loss that has a definite proof of loss that can be demonstrated and is measurable.
- allow an insurance company to predict losses from a pool of data for frequency and severity.
- not be due a catastrophic risk, which are not insurable because the loss potential is too expensive, pervasive or unpredictable for the insurance company to reasonably cover.
- be based on a sufficiently large number of homogeneous exposures in order for the insurance company to make a reasonable prediction about any loss related to an event.
- must result from a loss that causes economic hardship, otherwise there is no reason to insure against the loss.
A 2011 PolitiFact examination of Duffy’s vote to fully repeal Obamacare with no replacement noted that as a 2010 candidate, he vowed he “would not vote to repeal the legislation unless a better proposal was in place.” Months later, he voted to repeal the legislation without any replacement. PolitiFact dubbed this vote “a Full Flop.”
During his eight years in Congress, Duffy repeatedly voted to destroy Obamacare and undermine the pre-existing condition protections. He enthusiastically voted for Trumpcare in 2017, which would have made insurance coverage significantly less affordable for those with pre-existing conditions, (In a world based on reality, a person who is not healthy and is being underwritten for coverage would be charged a higher premium. That is, an insurance company would evaluate the risk of a potential insured and charge an insurance premium commensurate with the possibility of loss.
It is quite proper to charge a less healthy person more for his coverage. But even then he still wouldn't bear the entire cost of a potential loss in his premiums. The pool of insureds must pay more for their coverage as well. They would pay based on the total losses in the pool. This is the real world.
But what the Left has achieved via Obamacare is the insurance company must pay for losses for people who come into the pool without having contributed to it and intend to use it immediately. That is, those who have a 100% chance of loss are be covered.
We have already acknowledged that a pool of insureds will pay more if the loss experience of the entire pool is higher. However, if we add into the cost to the pool those claims that have a 100% chance for loss, the cost of coverage would be prohibitive for everyone.
This is why the ACA created subsidies and mandatory participation. Premiums are manipulated, based not on loss potential, but on the insured's income [which is not a factor in insurance risk].
Therefore, a poor person with the pre-existing condition will not have to pay anywhere near the actual premium. He gets his coverage, with an immediate need to use it, without paying hardly anything for it. Therefore, costs are being shifted from very high risk individuals to the government, then to the taxpayer.
Mandatory participation eliminates, in theory, adverse selection. If a pool of insureds has a high loss experience, those insureds who can exit the pool will do so, leaving behind those who are unable to leave the pool. The loss experience increases, which in turn increases government intervention, until only the sickest people are in the pool.
The penalty for not having insurance was supposed to dissuade people from leaving the pool. However, though Obamacare was supposed to cover everyone, it has never achieved this.
Chart found here.
and just this May he voted against the Protecting Americans with Preexisting Conditions Act of 2019. (As is typical for the Left, their "solutions" never solve anything. More laws are always needed, more programs, more government control.)
While legislative Obamacare repeal efforts are unlikely to go anywhere as long as Democrats control the House of Representatives, a Trump administration-backed lawsuit could imperil the law and some congressional Republicans have promised to kill the law in 2021 if they regain full control of the federal government.
This story has been updated to clarify that the pre-existing conditions protection will be necessary after the COBRA period is over.
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