Spencer Rendahl: Pre-existing Conditions
Late in 2008, as the economy went into free-fall, my husband - like 2.6 million other Americans that year - lost his job. We received 30 days of health insurance from his former employer, but after that, we were on our own. We could continue to purchase insurance through COBRA – according to federal law - and did so. It was an excellent but extremely expensive plan that consumed most of my husband’s monthly unemployment check. So we looked at alternatives.
An insurance broker arrived at our house and spent an hour asking questions. What was the reason for your last doctor’s visit? Are you currently being treated by a doctor for anything?
After making lighthearted banter about my 3-year-old daughter, he proceeded to ask my favorite question of the afternoon: “Was it a ‘natural’ childbirth?”
I was relieved to answer yes, first to get off the subject, but second and more importantly because I knew it was perfectly legal for health insurance companies to deny coverage to women who had had caesarean sections. Those expensive but life-saving surgical births put women at risk for needing them for subsequent births. Insurance companies didn’t want to deal with the financial risk, and legally they didn’t have to.
The broker laid out a series of high deductible plans, and finally, I got to ask a question: did they cover maternity care?
He said yes – with a rider that I’d have to sign up for immediately and continue to pay for, whether or not I ever conceived. It would almost double my premium.
We decided to stick with COBRA. We’d pay more but it would cover more, and who knew what types of medical challenges we’d face? When we’d brought our daughter home from the hospital after she’d been born, the medical bill had totaled more than the purchase price for our house.
And sure enough, we ended up needing a good plan. The hospital bill for our second child – who arrived almost a year later - could have covered a year of private college.
There’s been an avalanche of complaints about the problem-filled roll out of the Affordable Care Act.
A 55-year-old single and childless man doesn’t want his low-premium, high-deductible plan to be replaced by a more expensive one that covers maternity care, something he may never need. But he could have a heart attack tomorrow. And let’s be honest: his old plan - considered sub-standard by the new law - wouldn’t cover much. Plus, before the Affordable Care Act, his insurance company could simply drop him at renewal time, anyway. He’d be in the same boat as a woman with a caesarean section: denied coverage because of his medical history.
A better plan – even if it did turn out to be more expensive – would almost certainly be a big improvement over what we had before and eliminate an hour of invasive medical history questions designed to help deny coverage. To me, that’s priceless.