Obamacare: People with preexisting conditions could face much higher healthcare costs
There are a couple of provisions in Obamacare which have received universal praise. One of these provisions is the fact that people with preexisting conditions can no longer be denied healthcare coverage.
But, much like everything else with Barack Obama, all is not what it seems to be for while these people will have healthcare coverage it turns out that the insurers might not have to pay for their prescription medicines which means that these people will be facing much higher costs to receive the medications they need than they were led to believe.
People with serious pre-existing diseases, precisely those the president aimed to help with ObamaCare, could find themselves paying for expensive drug treatments with no help from the health care exchanges.
Those with expensive diseases such as lupus or multiple sclerosis face something called a “closed drug formulary.”
Dr. Scott Gottlieb of the American Enterprise Institute explains,”if the medicine that you need isn’t on that list, it’s not covered at all. You have to pay completely out of pocket to get that medicine, and the money you spend doesn’t count against your deductible, and it doesn’t count against your out of pocket limits, so you’re basically on your own.”
The plan had claimed it would rescue those with serious pre-existing conditions.
“So it could be that a MS patient could be expected to pay $62,000 just for one medication,” says Dr. Daniel Kantor, who treats MS patients and others with neurological conditions near Jacksonville, Florida. “That’s a possiblity under the new ObamaCare going on right now.”
But I thought the purpose of Obamacare was to lower healthcare costs in order to make insurance more affordable to the people who could not afford it?
The prospect of higher healthcare costs seems to be becoming a trend. Barack Obama promised the American people that if they liked their insurance and their doctors they could keep their insurance and their doctors but that has turned out not to be the case for roughly six millions of Americans.
When the American people realized the president lied to them the regime added a caveat to the lie of the year: if you like your insurance or your doctor you can keep your insurance or your doctor…..if you are willing to pay more. With the new talking point thusly released other Democrats, such as my Senator Jeanne Shaheen, began to parrot this new caveat.
But that does not change the fact that, at best, the Obama regime mislead the American people, and now it appears as if the same is happening in regards to people with preexisting conditions. What good is this new coverage if the people who need it most will have to pay for medications they still might not be able to afford?
Looks like the Obama regime will have to add yet another caveat to the Obamacare law…..
America's Watchtower 
Duh! That free lunch may not be so free after all.
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It never is!
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Yes Virginia, there is no Santa Claus.
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What about the Easter Bunny?
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And if the ACA is repealed, or had never been enacted, people with MS who had health insurance would be able to get that $65k prescription for just $25 or $35 or whatever?
Oh, that’s right – if they’ve got MS, they couldn’t get health insurance at all because they’ve got a pre-existing condition. Unless they contracted the disease after they got the insurance. Try that with juvenile diabetes or asthma or sickle-cell anemia. Bottom line – even if the possibilities you raise in your fear-mongering post came to pass, even people with pre-existing conditions would on balance be far better off than they were pre-ACA.
Closed formularies are not new or unique to ACA. They’re part of a number of cost containment tactics used by insurance companies. They fell out of common use as the trend shifted toward generics, but now are regaining popularity.
Of the insurance plans I’m familiar with, the non-formulary drugs are the most costly of several drugs used to treat a particular ailment. I’m sure many here are familiar with blood pressure meds that cost several dollars per tablet, and others that cost $4 for a month’s supply. Those more costly drugs are usually on a “legend” formulary for which the copay is significantly higher, and the most costly are on the non-formulary list. If a drug on the non-formulary list is medically indicated – that is, none of the others work for a particular patient, or there’s an allergy or problem with compatibility with other meds, then insurance companies frequently will waive a drug’s non-formulary status for that particular patient.
And of course, for those opposed to health insurance rates that are based in part on the insured’s ability to pay, or who think it’s morally acceptable for even insured people to be bankrupted by medical costs, if they find a drug they’ve been prescribed on the non-formulary list, and they don’t want to take a generic, they can always pay for it out of pocket . . .
Take good care and may God bless us all!
TGY
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I don’t recall saying this provision should be repealed, in fact I do remember saying it was universally praised. Just pointing out that the people were sold a bill of goods and it isn’t quite what we were told it was.
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Obama care has solved none of the problems you mentioned, it simply has someone else paying the costs. Obama care has done nothing to stop the outrageous costs that could bankrupt someone, again it just has others pay without looking at why.
Anticipating a pending personal attack, I will save the reader the trouble: I am one of those “who think it’s morally acceptable for even insured people to be bankrupted by medical costs” just as it is morally acceptable to be bankrupted by all the other things that can cause a person’s facial world to be turned upside down.
Before Obama care, you were GUARANTEED medical care REGARDLESS of your ability to pay. That is still the case with Obama care, just now we are also paying for an outrageously bloated bureaucracy to go along with it.
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ACA is not medical care or health insurance – it’s just legislation that provides for affordable insurance, and sets certain standards for that insurance. Is it perfect? Nah. Can it be improved? You bet – and this point that Denis raised may be one of those areas.
Before ACA, we were guaranteed emergency care, not routine medical care, regardless of ability to pay. This gave lots of people without insurance to use the e-room as their regular medical provider. Many others avoided doctors until routine medical situations became much more serious.
We’re told that around 3 million people so far have signed up for insurance through the exchanges set up by ACA. Lots of them have saved a good amount of money – including a friend of mine who’s seen a reduction of nearly $600 in his monthly bill.
Because these folks now have insurance coverage, we can count on them turning more and more to regular physicians for their medical needs, relieving e-rooms of the stress they put on them; in addition, those who once waited for meical conditions to become sufficiently severe as to warrant a visit to the e-room now can seek treatment in a doctor’s office before jeopardizing their health.
Take good care and may God bless us all.
Dale
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Dale, we agree that “ACA is not medical care or health insurance – it’s just legislation that provides for ..(someone else to pay for our)…insurance”. And we agree that everyone had major medical treatment covered. So out of the supposed millions without coverage we are told about half were the young “indestructible’s” who made a reasonable calculation as to their medical needs as I did at that age. Then subtract those in the country illegally, and that leaves us with the 10-15% who wanted insurance but couldn’t get it, and those who don’t want to pay out of their own pocket for preventive care, (even though they will pay out of pocket for thousands of dollars of tattoos, computers, sound systems, cars, toys and on and on)
How far would the $800 plus million dollars wasted on the useless computer system have gone toward that goal? How about the money spent on stupid duplicate state run wasteful computer systems? How about the wasteful bureaucracy? How about the big increases others are experiencing? For that 10-15% who were really stuck, it would have been far better and cheaper for the government to create a grant program like they do for education, and left the system alone. God bless us, and God help us.
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Unfortunately when the government steps into the market and attempts to run a business they never understand what is required. As I was told years ago the government could not make a profit running a hot dog stand at Coney Island on July 4. Government does not have the Midas touch, but just the opposite affect. Everything turns to lead.
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There is no problem so bad that the government cannot make it worse.
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Reblogged this on Brittius.com and commented:
My youngest daughter had her insurance cancelled. She tried to obtain ObamaCare as she cannot be without coverage, due to Cervical Cancer. She was told, IF, accepted, due to prior conditions, it will cost SEVEN TIMES what she was previously paying.
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Thanks for the reblog and I am sorry to hear about your daughter. I hope she is okay and I hope that everything works out.
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You’re welcome.
Thank you, she has had surgeries, this week more radiation and there is going to be another surgery soon.
My wife is also ill. From what is estimated since July, an aggressive and fast growing tumor. Ovarian Cancer. Had surgery and a ten pounder was removed plus other parts. She’s coming along nicely. I have been helping her up the steps outside and she went back to work recently because someone replaced her and couldn’t do the job, then another person replaced that one and couldn’t do the job so they gave her a helper, and the two couldn’t do the job. Phone rang here every ten minutes. The boss needs to know how does she do this/that/the other thing. So my wife wanted to go back to work, and the stress is off of the office staff, but you know me… I am thinking, wait a minute. The first woman couldn’t do the job. The second woman couldn’t do the job and needed a helper. The two of them together, couldn’t do the job. My wife does it alone. Are they killing my wife? My wife tells me to mind my own business.
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You are welcome and I am glad to hear your wife is doing well. Sounds like you have quite a bit going on right now and it sounds like you are a rock to those who are counting on you.
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Reblogged this on U.S. Constitutional Free Press.
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Thank you.
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Before obamacare, it was foolish not to have a basic catastrophic plan at least. They were cheap and affordable. Then when got a critical health issue, one was covered. I try to be emphatic. One can get cobra if laid off, start a basic plan so preexisting is covered in case some thing happens within a year. Sure, I would like to spend money on other things including fire and car insurance, but that is life.
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Here is a link to a Biden statement where he says MAYBE 6 million will sign up for obamacare. http://nws.mx/1jgwUW2. So, how much money has those 6 million signatures cost? A billion for the garbage federal web site, hundreds of millions more for state sites, how many millions on useless bureaucrats to waste more time and money on this disaster, all so someone else can pay for your insurance.
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