I completed both the Sudoku and the crossword puzzle from today’s newspaper. I tackle these puzzles each day at breakfast and finish them, if I have a chance, later in the day. The puzzles become more successfully challenging as the week progresses. Solving Monday’s puzzles is really no big deal. Friday and Saturday require more skill. But be it Monday’s or Saturday’s, I hate to fail and give these games my best effort.
Insurance agents, especially those of us who have been practicing for decades, are used to a good challenge. And, we hate to fail. You might think that this is about selling. It is not. I am talking about the challenge of finding good, affordable health insurance for our clients. This is not a game. People’s lives depended on our success. And that success was not guaranteed.
“Dave, you’ve got to find coverage for Jane or she’s gonna die.”
The name has been changed, but those words still ring in my ears nearly twenty years after a panicked husband called my office right after the association covering him, his wife, and hundreds of others lost their group insurance. Her advanced cancer and other conditions made her virtually uninsurable. Ohio and other states had a backstop at the time, a patchwork of HMO insurers that were forced to have periodic open enrollments. The policies were limited, incredibly expensive, and difficult to access. There were other failsafe options, like the association I had found for them two years earlier, but they were quickly disappearing in the early 2000’s as preexisting conditions overwhelmed our system. And yes, I was able to find Jane and her husband coverage for her last couple of years of life. It was one of my greatest professional successes.
There are those who would like to return to the way is used to be. Let’s talk about what if was like to purchase a health insurance policy for you and your family in 2009. You called my office and I asked you about your family’s health history. I needed to know the entire health history of you, your spouse, and your children. Sure you were prepared to answer questions about cancer and heart conditions, but I also needed to know about your kids’ ear infections and diagnoses of ADHD and asthma. Our next questions dealt with accidents. We then moved on to your driving records and whether or not you rode a motorcycle or traveled out of the country, and where. You might be able to provide the answers we wanted to hear. Lots of people couldn’t.
The insurance companies then had up to four options:
- Issue the policy at the standard rate
- Offer you a policy at a higher rate reflecting your higher risk
- Offer you a policy that excluded your preexisting conditions and/or hobbies (riders)
- Decline to issue a policy for one or more members of your family
Different companies accepted different risks. Our job as independent agents was to find the company that would do the best job to insure each client (risk).
The Patient Protection and Affordable Care Act put an end to the underwriting of individual (non-employer sponsored) health policies. This opened the door to millions of Americans with preexisting conditions. There are now three questions:
- What is your date of birth?
- What is your home zip code?
- Do you smoke?
Here is my question – Do you really want to go back to 2009?
There are those in congress, in certain state capitals, and currently in the White House who would like to eliminate Obamacare. And since there is no alternative, no other plan, no other fully-formed option waiting to immediately kick-in the minute the PPACA is repealed or declared unconstitutional by the Supreme Court, if you eliminate Obamacare you would return to 2009.
In 2016 the Kaiser Family Foundation found that 52 million Americans have preexisting conditions that would have precluded coverage under pre-Obamacare underwriting. That is a little less than 20% of our under age 65 population. One of them might be you or your family.
I love a good challenge, but I prefer my daily Sudoku and crossword puzzles, where there are no consequences to failure, to finding live-saving health insurance for less than perfectly healthy families.
Dave
Picture – Today’s Challenge – David L Cunix