April 29, 2024
Health Insurance Solutions Part III

As consumers it is our responsibility to become proactive and find the right solution to a health plan that will be beneficial for yourself, family and finances. The Affordable Care Act law needs the necessary changes to make health insurance premiums reasonable for all Americans, especially for individuals who can afford to purchase insurance without receiving any financial assistance from the government. Every person should be entitled to healthcare regardless of their ability to pay.

Pre-ACA
Prior to ACA Insurers’ were able to deny coverage for people with pre-existing conditions, or increase the premiums so high that consumers were unable to afford coverage altogether.

Post ACA
The law measuring parameter today is based on everything except a person’s health condition. The problem with this whole concept is the fact that there is no underwriting to measure risk for insurers. This in turn provides no fair assessment of risk to the insurers interested in providing protection for consumers. Why? Simply because the risk factors of the consumer’s medical history are unknown. The solution is not acknowledging the cost of coverage and how it gets paid for based on taxes and all the rhetoric spoken by politicians’, media critics, and other bipartisan groups.

A New Approach for Coverage
For consumers who has money and are in good health, the underwriting process needs to be put back in place so health insurance companies can measure and estimate risk with insuring people’s lives. Consumers should be able to purchase coverage based on their health and well-being. There should be no reason why all Americans should be put in the same category when it comes to how health insurance premiums are calculated based on the current structure and law.

A Place For The ACA
For Americans who are:
• financially challenged,
• whose incomes are low, these individuals and families would continue to receive
Medicaid for their care.
• have pre-existing medical conditions
• in need financial assistance

In circumstances listed above, insurers’ will provide coverage to people whose healthcare cost would be much higher compared to someone without much risk. Compensation from the government to the insurers’ could occur in the situations above; to compensate Insurance companies not only from subsidies, but also from the high risk assessment. Insurers’ can be reimbursed from the government since they chose to take on such risk.

As you hear in the media more and more carriers are pulling out of the healthcare marketplace; known as “exchanges” due to the uncertainty with the current approach from government guidelines. As consumers there is no need to panic. We need coverage that protect our lives and money before something happens to our physical bodies. Be encouraged seek and find the right plans you need. Consider this as an example:
• if you have a 5K deductible; get insurance that will cover that deductible amount.
• if you happen to have an accident; have accident coverage in your plan
• if there is a family history of terminal illnesses such as: cancer, heart attack or stroke, have a plan that will cover these type of health related conditions before being diagnose with such a condition.

This is an easy fix, it just needs to be implemented. There are carriers today who are offering plan designs based on the examples given above in this article.