# Factually and simply speaking...what IS the new health care plan? **URL:** \ **Category:** Factual Questions\ **Created:** [September 12, 2010, 5:49pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523 "2010-09-12T17:49:56Z")\ **Posts on this page:** 17\ **Page:** 1
**Author:** ![Stoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/stoid/32/272_2.png) [@Stoid](https://boards.straightdope.com/u/Stoid)\ **Post date:** [September 12, 2010, 5:49pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/1 "2010-09-12T17:49:56Z")
I’ve never been able to buy private individual insurance because my obesity is considered a “pre-existing condition” - which is why my ex and I formed the LLC - California mandates that 2-person companies be allowed to buy group insurance. Well, thanks to the wonderful and wise people who run our legal system and the wise and wonderful rulings made, I find myself without health insurance at the moment. So I’m exactly the sort of person that should be helped. What kind of help am I supposed to get? ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [September 12, 2010, 6:03pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/2 "2010-09-12T18:03:44Z")
[Health Reform Bill Summary: The Top 18 Immediate Effects | HuffPost Latest News](http://www.huffingtonpost.com/2010/03/22/health-reform-bill-summary_n_508315.html#s75157) Here are some of the changes. The Repubs watered down as many as they could. But a lot of good will be done. ---
**Author:** ![RandomLetters](https://avatars.discourse-cdn.com/v4/letter/r/8edcca/32.png) [@RandomLetters](https://boards.straightdope.com/u/RandomLetters)\ **Post date:** [September 12, 2010, 7:05pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/3 "2010-09-12T19:05:35Z")
Most of the provisions of the health care plan don’t kick in fully until 2014. The health care plan requires you to either buy insurance, or pay a fine. It also prevents insurance companies from denying people for pre-existing conditions, and caps how much more they can charge for that. Unless you are accident prone or drive a lot, you are probably better off not getting insurance and just paying the fine, and only buy insurance if something major comes up. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [September 12, 2010, 11:34pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/4 "2010-09-12T23:34:59Z")
> [@RandomLetters](#): > > Unless you are accident prone or drive a lot, you are probably better off not getting insurance and just paying the fine, and only buy insurance if something major comes up. Yep, all of the folks paying for health care will continue to pay higher premiums to support Emergency Rooms and uncompensated care. As far a buying insurance when something major happens, I won’t be surprised to see waiting times for coverage of pre-exisiting conditions or annual open enrollment periods. That is exactly what we have now for new policies, changes in coverage or enrollment in Medicare and I can’t see it changing. (I’m sure the uninsured won’t mind waiting a few months to buy a policy and start treatment when something major comes up :rolleyes: ) ---
**Author:** ![Duckster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/duckster/32/1244_2.png) [@Duckster](https://boards.straightdope.com/u/Duckster)\ **Post date:** [September 13, 2010, 12:51am UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/5 "2010-09-13T00:51:24Z")
Try the source —\> [http://www.healthcare.gov/](http://www.healthcare.gov/) ---
**Author:** ![Gruntled](https://avatars.discourse-cdn.com/v4/letter/g/34f0e0/32.png) [@Gruntled](https://boards.straightdope.com/u/Gruntled)\ **Post date:** [September 17, 2010, 4:21pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/6 "2010-09-17T16:21:34Z")
> [@Stoid](#): > > I’ve never been able to buy private individual insurance because my obesity is considered a “pre-existing condition” Well, isn’t it? ---
**Author:** ![Stoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/stoid/32/272_2.png) [@Stoid](https://boards.straightdope.com/u/Stoid)\ **Post date:** [September 17, 2010, 7:42pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/7 "2010-09-17T19:42:05Z")
> [@Gruntled](#): > > > [@Stoid](#): > > > > I’ve never been able to buy private individual insurance because my obesity is considered a “pre-existing condition” > > Well, isn’t it? Gruntled… what is your damage? Did some fat person beat you up or something? ---
**Author:** ![Gedd](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gedd/32/4938_2.png) [@Gedd](https://boards.straightdope.com/u/Gedd)\ **Post date:** [September 17, 2010, 9:25pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/8 "2010-09-17T21:25:57Z")
> [@jasg](#): > > As far a buying insurance when something major happens, I won’t be surprised to see waiting times for coverage of pre-exisiting conditions or annual open enrollment periods. That is exactly what we have now for new policies, changes in coverage or enrollment in Medicare and I can’t see it changing. > > (I’m sure the uninsured won’t mind waiting a few months to buy a policy and start treatment when something major comes up :rolleyes: ) One thing that I would have enjoyed would be letting kids/young adults/whatever you call them staying on their parent’s insurance longer. When I got booted off my mom’s plan there was a screw up with COBRA and I had a 2 month lapse in coverage. That meant that when I got a job the insurance didn’t cover any pre-existing condition, including my epilepsy and the $800/month medication for it. Grr . . . So am I correct that people who already have private health insurance probably won’t be affected too much? (Obviously if you have a major event like cancer the dropping of the annual and lifetime caps will be nice). ---
**Author:** ![Markxxx](https://avatars.discourse-cdn.com/v4/letter/m/5daacb/32.png) [@Markxxx](https://boards.straightdope.com/u/Markxxx)\ **Post date:** [September 18, 2010, 12:53am UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/9 "2010-09-18T00:53:14Z")
> [@Gedd](#): > > So am I correct that people who already have private health insurance probably won’t be affected too much? I think what is likely to happen with employers is they are going to start having tiered systems. In other words they basic “must” policy will go to their employees and the higher up you go in the company (and the higher the title) the more health insurance options you will have. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [September 18, 2010, 2:00am UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/10 "2010-09-18T02:00:38Z")
> [@Gedd](#): > > > [@jasg](#): > > > > As far a buying insurance when something major happens, I won’t be surprised to see waiting times for coverage of pre-exisiting conditions or annual open enrollment periods. That is exactly what we have now for new policies, changes in coverage or enrollment in Medicare and I can’t see it changing. > > > > (I’m sure the uninsured won’t mind waiting a few months to buy a policy and start treatment when something major comes up :rolleyes: ) > > One thing that I would have enjoyed would be letting kids/young adults/whatever you call them staying on their parent’s insurance longer. When I got booted off my mom’s plan there was a screw up with COBRA and I had a 2 month lapse in coverage. That meant that when I got a job the insurance didn’t cover any pre-existing condition, including my epilepsy and the $800/month medication for it. Grr . . . > > So am I correct that people who already have private health insurance probably won’t be affected too much? (Obviously if you have a major event like cancer the dropping of the annual and lifetime caps will be nice). > [@Markxxx](#): > > > [@Gedd](#): > > > > So am I correct that people who already have private health insurance probably won’t be affected too much? > > I think what is likely to happen with employers is they are going to start having tiered systems. In other words they basic “must” policy will go to their employees and the higher up you go in the company (and the higher the title) the more health insurance options you will have. The insurance reforms which were enacted will eliminate denial of insurance for pre-existing conditions and cancellation if you get ill (cancellation for non-payment etc. can still happen though). I expect that there will be changes for people with existing plans, but what that might be is anyone’s guess at this point. The ‘insurance exchanges’ will have different coverage tiers, gold, silver and so on - with different coverages and costs. Both private purchasers and group coverage through an employer will probably follow that model (or must follow it?). This [document](http://www.naic.org/documents/committees_b_exchanges_100812_bcbsa_req.pdf) (PDF) from Blue Cross/Blue Shield explains a bit about the exchanges. It confirms my statement above - waiting until you are sick to purchase insurance will not be feasible. When the exchanges begin in 2014, there will be both an initial enrollment period and then annual enrollment periods (with a provision for special enrollments to cover loss of a job and so on). This is similar to both Medicare and Employer coverage. So, if you don’t sign up in the initial enrollment in 2014 - you are rolling the dice that you will not need coverage until the next open enrollment period, a year later. In the meantime, you pay for all health expenses. People who think they can wait until they are sick or injured to buy insurance are just wrong. ---
**Author:** ![Gruntled](https://avatars.discourse-cdn.com/v4/letter/g/34f0e0/32.png) [@Gruntled](https://boards.straightdope.com/u/Gruntled)\ **Post date:** [September 18, 2010, 3:26am UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/11 "2010-09-18T03:26:13Z")
> [@Stoid](#): > > > [@Gruntled](#): > > > > Well, isn’t it? > > Gruntled… what is your damage? Did some fat person beat you up or something? You admit that you are hugely obese. That is due to you eating too much. Stop eating so much and your obesity will go away. The only way you can be “helped” is if you help yourself…by stopping with the excess food intake. You say _“I’m exactly the sort of person that should be helped. What kind of help am I supposed to get?”_ See above. Why should other people pay in the way of insurance premiums for you to simply stop stuffing your face? ---
**Author:** ![Stoid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/stoid/32/272_2.png) [@Stoid](https://boards.straightdope.com/u/Stoid)\ **Post date:** [September 18, 2010, 4:35am UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/12 "2010-09-18T04:35:19Z")
I’ll take that as a yes. ---
**Author:** ![Gary\_Robson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gary_robson/32/3448_2.png) [@Gary\_Robson](https://boards.straightdope.com/u/Gary_Robson)\ **Post date:** [September 18, 2010, 4:51am UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/13 "2010-09-18T04:51:26Z")
> [@Gruntled](#): > > Why should other people pay in the way of insurance premiums for you to simply stop stuffing your face? [moderating] This is GQ, **Gruntled**. Tone it down. [/moderating] ---
**Author:** ![DanBlather](https://avatars.discourse-cdn.com/v4/letter/d/f4b2a3/32.png) [@DanBlather](https://boards.straightdope.com/u/DanBlather)\ **Post date:** [September 18, 2010, 3:20pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/14 "2010-09-18T15:20:43Z")
> [@Gruntled](#): > > Why should other people pay in the way of insurance premiums for you to simply stop stuffing your face? Does your insurance cover removing one’s head from one’s ass? ---
**Author:** ![Gary\_Robson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gary_robson/32/3448_2.png) [@Gary\_Robson](https://boards.straightdope.com/u/Gary_Robson)\ **Post date:** [September 18, 2010, 6:45pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/15 "2010-09-18T18:45:25Z")
[moderating] I said _stop it_, and that applies to you, too, **DanBlather**. Yours is a warning. **Gruntled** , you’d better not respond in kind or yours is, too. [/moderating] ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [September 18, 2010, 11:03pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/16 "2010-09-18T23:03:00Z")
> [@DanBlather](#): > > > [@Gruntled](#): > > > > Why should other people pay in the way of insurance premiums for you to simply stop stuffing your face? > > Does your insurance cover removing one’s head from one’s ass? Why should other people pay because you can’t walk down stairs correctly? Why should other people pay because you forgot to look both ways one of the ten thousand times you crossed the road? Why should other people pay because you like to go skiing and break a leg? When someone comes in with a heart attack, should we put treatment on hold until we determine it is in no way related to lifestyle? By your logic, birth should not be covered either. If the solution to health care is to blame the people who injure themselves, either in an instant or over time, then what? If you meet the weight-height guidelines and are over 25, odds are you are in the bottom 5th percentile. Who then gets denied coverage? The top 10%? the top 50%? People don’t go out and get themselves sick to create costs to the system, most try to avoid it. Simplest system is universal coverage instead of wasting resources figuring out who gets what and how much… Works for Canada. ---
**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\ **Post date:** [September 19, 2010, 4:16pm UTC](https://boards.straightdope.com/t/factually-and-simply-speaking-what-is-the-new-health-care-plan/553523/17 "2010-09-19T16:16:42Z")
> [@md2000](#): > > Why should other people pay because you can’t walk down stairs correctly? Why should other people pay because you forgot to look both ways one of the ten thousand times you crossed the road? Why should other people pay because you like to go skiing and break a leg? When someone comes in with a heart attack, should we put treatment on hold until we determine it is in no way related to lifestyle? By your logic, birth should not be covered either. > > If the solution to health care is to blame the people who injure themselves, either in an instant or over time, then what? If you meet the weight-height guidelines and are over 25, odds are you are in the bottom 5th percentile. Who then gets denied coverage? The top 10%? the top 50%? > > People don’t go out and get themselves sick to create costs to the system, most try to avoid it. Simplest system is universal coverage instead of wasting resources figuring out who gets what and how much… Works for Canada. **[Moderator Instructions]** This is GQ. The objective here is to describe the provisions of the new US health care plan, not to debate them or discuss the programs of other countries. Please refrain from engaging in debate about the subject. If you want to debate, open a thread in GD. This goes for everyone. Colibri General Questions Moderator