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View Diary: Georgia state commissioner compares having pre-existing conditions to cheating insurance companies (144 comments)

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  •  This Is What the Guy Is Trying to Say, I Think (1+ / 0-)
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    I think the guy is trying to make this point:
    Consider a person, young or old, with very little, if any net worth, and with low income.  Why wouldn't that person wait until he has an actual medical condition; i.e., an accident or illness requiring medical attention before signing up for ACA?  If an emergency happens, he would go to the emergency room and get treated.  Shortly thereafter he could apply for insurance under ACA and not be penalized by his now preexisting condition.  The same holds true if a sudden illness could wait for treatment until after he applied for ACA insurance.

    He has few assets that could be lost in a bankruptcy.  And, he now has ACA insurance that will cover future care.

    In other words, why not save the health insurance premiums and wait until medical care is actually needed?  Note that this is especially relevant for young, healthy people who have few assets that could be seized in a bankruptcy.


    ITLDUSO Honk "Hello" when I drive by!

    by caroman on Sat Dec 07, 2013 at 03:31:53 PM PST

    •  That's the reason for the mandate (1+ / 0-)
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        Yes, people could do this, just like people could refuse to buy car insurance on the assumption that they won't have an accident, and even if they do, nobody can force you to pay for the other guy's car repairs or medical bills if you have no money.  So every state mandates drivers to buy insurance and imposes financial penalties for noncompliance as a disincentive from doing this.  The mandate in the ACA serves the same purpose.

           Ironically, it's the opponents of the ACA who want to sabotage it who actually are advising young people NOT to buy insurance, and pay the penalties instead.  It's bad advice, because the ACA has a limited enrollment period at the beginning of each year, and if you don't sign up then, you can't sign up for another year.  So if you get sick or have an accident between March and December, you're pretty much stuck for paying your own medical bills out of pocket until next year.

           So if you choose to buy insurance, you're paying into a pool that provides for everyone's healthcare, and if you're young, healthy, and lucky, you won't actually need to use that insurance yourself, but you don't have to worry if you're unlucky and face an unexpected accident or illness.  On the other hand, if you choose NOT to buy insurance, you're still paying into the pool by paying the mandated penalty, and getting NOTHING in return, even if you DO get sick.  Yes, there are people who simply can't afford either to buy insurance or pay the penalty, and that's what the Medicaid expansion is for.  The people who can't afford it are offered and alternative, and are not required to pay the mandate penalty.  

           There will still be people who choose not to buy insurance for the very reasons you suggest.  They're willing to gamble that they won't get sick and would rather pay a penalty that gives them NOTHING than pay a bit more to have insurance that has a tangible benefit for them.  Likewise, there are people who choose to drive without insurance, gambling that they won't get into an accident and won't get pulled over.  But despite the fact that SOME people make this choice, enough people choose to buy insurance to make the auto insurance system work, and the auto insurance industry makes PLENTY of profit.  The Massachusetts mandated health insurance system also has "freeloaders" who choose to pay the penalty rather than buy insurance, yet that system works overall, and also generates plenty of profit for insurance companies.  

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