pre-existing conditions

Six Things I Learned about Healthcare While Working at the WHP

Editors Note: This post was written by a wonderful summer intern, Madeline Higgins, as a reflection on her work over the summer. Madeline is a student in the MPH program at the University of Michigan School of Public Health, and we are sure she will go on to do great things!

I was lucky to intern at the Washtenaw Health Plan this past summer, where I got to observe the services that WHP provides and work with a new program involving Community Health Workers. Meanwhile, the federal government was attempting to greatly reduce the Affordable Care Act, which had the potential to negatively impact the health of residents in Washtenaw County. While I learned many facts, protocols, and systems, the items listed stick out most in my memory.

 

healthcarepolicy.jpg

1. There is a significant gap in understanding of the reality of healthcare and policy impact from federal legislators.

I believe this stems from decision makers finding information that enforces their current worldview instead of looking at fact-based data. While watching and reading about the legislative process for healthcare reform, I was struck by the lack of listening and understanding from both sides of the aisle. While everyone utilized individual stories to demonstrate their points, there was little conversation about population-level health outcomes. After reading reports and statistics which utilized a population health framework, it is obvious to me that overall, the Affordable Care Act has positively impacted health in the US.

 

2. You can work minimum wage full time and not qualify for Medicaid (as a single individual household).

minimum-wage poverty.gif

I learned this towards the end of my time with WHP. I hadn’t done the math before, and it was hard for me to imagine living on the minimum wage in the Ann Arbor area in regards to housing costs, let alone health care. To me, this further demonstrates the need for a livable minimum wage.

 

 

3. Pre-existing condition protections help us all.

1 in 2 pre-existing-conditions.jpg

At some point in our lives, we are likely to experience some health setback where we utilize the healthcare system. It is advantageous to us all to include people with pre-existing conditions in the insurance pool because one day that could be us!

 

 

4. Everyone has questions about healthcare- and it is important to find places to get good information.

stamp contact .png

The Washtenaw Health Plan is a great place to ask for help! No matter your insurance plan, there seem to be terms and deadlines that won’t make a lot of sense until you ask an expert or seek reliable resources. I also wrote a blog post this past summer about reliable resources regarding health care access, and it totally changed the way that I look for information about health.

 

5. People who do direct service work can (and must) also do policy advocacy.

policy advocacy.png

Washtenaw County is organized and ready for action! I sat in on many meetings where people were putting their heads together to make sure they had the right information to talk to colleagues, legislators, and their clients about how federal policy change (for example, reduction in SNAP benefits) is detrimental to our community. This is vital to both keeping their jobs but also elevating the health status of the Washtenaw County population.

 

6. Above all, if healthcare was treated like a human right, the tone of this conversation would be very different.

health-care-human-right.jpg

People at the WHP recognize that healthcare is more complicated than having access to insurance. Health is about access to nutritious foods, opportunities to relax, space to exercise, and of course the occasional donut from Dom’s. Working in the county government showed the interconnectedness of the systems that comprise of people’s access to health. I believe if we are more inclusive to people’s needs we can work together to improve the health of Washtenaw County.

Print Friendly and PDF

Subscribe to our blog here!

Pre-existing conditions, the ACA and the AHCA

Under the Affordable Care Act (ACA) of 2014, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer. They cannot limit benefits for that condition either. Once you have insurance, they can’t refuse to cover treatment for your pre-existing condition.
— U.S. Department of Health and Human Services https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html

On May 4, 217 Republican Representatives voted to approve the American Health Care Act.  This Act is meant to repeal and replace the ACA.  One provision of this act is a change to the way pre-existing conditions are treated.  The bill in its current state does continue to cover pre-existing conditions under certain circumstances.  You must have continuous care.  Because this plan also removes the mandate that everyone must have health insurance, you can choose to not buy health insurance.  If you get cancer, you will have to pay a penalty and then you are allowed to get coverage.  The insurance company can CHARGE YOU whatever they want.  Let's just say that again.

Yes, you can have health insurance if you have a pre-existing condition but the health insurance company can charge you a lot of money. many people will not be able to afford that coverage.

High Risk Pools: We've been here before 

Click the image above to go to the video from Kaiser Health News 

Click the image above to go to the video from Kaiser Health News 

What about the high risk pools (HRP)?  What about them?  In the past, many states had high risk pools. They were extremely expensive, and many people did not get the care they need. Julie Rovner explains why this "sounds like a good idea" but isn't.  Sounds Like A Good Idea: High Risk Pools

 

 

If you are wondering what's included in the list of pre-existing conditions, so are we.  This is a partial pre-existing conditions list from CNN:  

Acne

Acromegaly

AIDS or ARC

Alzheimer's Disease

Amyotrophic Lateral Sclerosis

Anemia (Aplastic, Cooley's, Hemolytic, Mediterranean or Sickle Cell)

Anxiety

Aortic or Mitral Valve Stenosis

Arteriosclerosis

Arteritis

Asbestosis

Asthma

Bipolar disease

Cancer

Cardiomyopathy

Cerebral Palsy (infantile)

Chronic Obstructive Pulmonary Disease

Cirrhosis of the Liver

Coagulation Defects

Congestive Heart Failure

Cystic Fibrosis

Demyelinating Disease

Depression

Dermatomyositis

Diabetes

Dialysis

Esophageal Varicosities

Friedreich's Ataxia

Hepatitis (Type B, C or Chronic)

Menstrual irregularities

Multiple Sclerosis

Muscular Dystrophy

Myasthenia Gravis

Obesity

Organ transplants

Paraplegia

Parkinson's Disease

Polycythemia Vera

Pregnancy

Psoriatic Arthritis

Pulmonary Fibrosis

Renal Failure

Sarcoidosis

Scleroderma

Sex reassignment

Sjogren's Syndrome

Sleep apnea

Transsexualism

Tuberculosis

The Kaiser Family Foundation, a nonpartisan research group, has estimated that 27 percent of Americans younger than 65 have health conditions that would likely leave them uninsurable if they applied for individual market coverage under the system that existed before the Affordable Care Act. (New York Times, 5/6/17)  

One last point, this bill was passed by the House of Representatives and has a long way to go before it is signed by the President and becomes law.  Please make your voice and opinion heard by your elected officials.  It does make a difference. 

If you have questions, post them in the comments section and we will do our best to answer.  

-Meredith Buhalis

Print Friendly and PDF

Subscribe to our blog here!

Thanks To The ACA: Pre-existing Conditions Are Covered

Fine print insurance.png

How quickly it all fades into the background. 

Back in the day (just a few short years ago!), if you had asthma, or diabetes, or if you had cancer ten years ago--you might not be able to get health coverage because of your pre-existing conditions

As a friend reminisced on Facebook today, 

Pre-ACA, 10 years ago--on the day I was told that I needed to have surgery in the next week because of an abnormal PAP--the nurse pulled me aside to mention to me that I needed to make sure I never let my insurance lapse. An abnormal PAP requiring surgery counts as a pre-existing condition. I am not now, nor have I been for five years, considered medically high risk. I would still be considered to have a pre-existing condition.

Today, the fact that you had surgery a few years ago wouldn't matter. The Affordable Care Act individual mandate operates on the idea that "everybody is in for insurance, and so the risks are spread out." The part that not everybody understands is this: in order to make it possible to cover pre-existing conditions, everybody--not just people with pre-existing conditions--needs to be in the insurance pool. 

If you wait until you're sick to get covered, well...that would be like waiting until you got into a car accident to try to get auto insurance! Which wouldn't make sense, right?

Don't wait--get covered! You can visit the Washtenaw Health Plan Monday through Friday, 9-4, 555 Towner, Ypsilanti MI, or call us at (734) 544-3030 for a free insurance assessment.

Print Friendly and PDF

Subscribe to our blog here!