# Obamacare: why aren't people with pre-existing conditions signing up ? **URL:** \ **Category:** Factual Questions\ **Created:** [November 16, 2013, 6:05pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067 "2013-11-16T18:05:16Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![chappachula](https://avatars.discourse-cdn.com/v4/letter/c/d2c977/32.png) [@chappachula](https://boards.straightdope.com/u/chappachula)\ **Post date:** [November 16, 2013, 6:05pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/1 "2013-11-16T18:05:16Z")
I had thought that one of the great improvements of Obamacare was that it will let every single person buy insurance, even if the insurance companies til now refused to cover him because of pre-existing conditions. And I had thought that the are millions of Americans who are desperate to buy better insurance but can’t --because they have diabetes, family history of heart problems, etc. So , okay… now Obamacare has begun–But there are incredibly few people who have actually signed up for a policy–even though millions and millions of Americans live in fear of having their lives totally ruined (financially) because one day they might need health care. Now, I understand that the web site is buggy, and it takes a long time, and sometimes you get kicked off, or whatever. But if I was a typical American citizen with barely-adequate insurance, or none at all, I would be desperate to grab this new opportunity to solve a major life problem, before the opportunity gets repealed. I would be desperate enough to willingly sit for two days straight at my computer, logging on hundreds of times, or whatever it takes. Why is this not happening? (Note: this is GQ, not GD. I don’t want a debate about Obamacare…I’m just curious why the people who most need it don’t seem to be signing up for it) (Disclaimer: I live in a country with good health care for every citizen --and therefore I am incapable of comprehending the American health system. So please go easy on me if this is a stupid question) ---
**Author:** ![Mdcastle](https://avatars.discourse-cdn.com/v4/letter/m/958977/32.png) [@Mdcastle](https://boards.straightdope.com/u/Mdcastle)\ **Post date:** [November 16, 2013, 6:23pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/2 "2013-11-16T18:23:48Z")
A few thoughts. Despite the noises the Republicans are making Obamacare is not going to be repealed. With all the publicity about what a disaster the site is why not wait until the bugs are worked out. As I’ve pointed out repeatedly, the fine isn’t nearly big enough to make healthy people buy insurance when they wouldn’t otherwise, so these people aren’t signing up like was expected. I’d question the number of “millions of people can’t get insurance due to pre-existing conditions”, or that a “typical” American has “barely adequate” insurance. Most people get insurance through employers, in the past you couldn’t be denied a group policy for pre-exist, only the pre-existing conditions themselves were not covered, and then only for up to 18 months. Of course now pre-exist is covered by group policies, so these people have no reason to try to get insurance on the exchanges. ---
**Author:** ![beowulff](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beowulff/32/542_2.png) [@beowulff](https://boards.straightdope.com/u/beowulff)\ **Post date:** [November 16, 2013, 6:48pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/3 "2013-11-16T18:48:59Z")
I can’t get traditional insurance due to a pre-existing condition. I’m currently on the interim pre-Obamacare PICP program, which is great. It expires at the first of the year, and I’ll have to move to a standard program, but so far, haven’t been able to use the website to sign up. As soon as the website starts working, I’ll sign up. ---
**Author:** ![pravnik](https://avatars.discourse-cdn.com/v4/letter/p/8edcca/32.png) [@pravnik](https://boards.straightdope.com/u/pravnik)\ **Post date:** [November 16, 2013, 7:09pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/4 "2013-11-16T19:09:14Z")
I don’t know if there is a GQ answer, but I suspect one possible reason is that many people who have what would be considered preexisting conditions have current coverage. The problem with the preexisting condition is that it makes it difficult to change jobs or get a private policy if they want to strike out on their own, i.e. “job lock,” for fear of losing their benefits or coverage. For those cases the benefits of not excluding preexisting conditions will take some time to realize. ---
**Author:** ![Iggy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iggy/32/3364_2.png) [@Iggy](https://boards.straightdope.com/u/Iggy)\ **Post date:** [November 16, 2013, 7:25pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/5 "2013-11-16T19:25:03Z")
> [@pravnik](#): > > I don’t know if there is a GQ answer, but I suspect one possible reason is that many people who have what would be considered preexisting conditions have current coverage. The problem with the preexisting condition is that it makes it difficult to change jobs or get a private policy if they want to strike out on their own, i.e. “job lock,” for fear of losing their benefits or coverage. For those cases the benefits of not excluding preexisting conditions will take some time to realize. Actually the Health Insurance Portability and Accountability Act (better known as HIPAA) provides protections for persons changing jobs so they are not locked in due to pre-existing conditions. It’s not perfect, but does offer protection _if_ you are moving to a group medical plan at a new employer and previously had “creditable coverage” (which is broadly defined). As to the OP… most Americans are insured. And overwhelmingly they get their insurance through their employer or a government program that pre-dated the PPACA (aka Obamacare) such as Medicare or Medicaid. The federal insurance exchange is targeted specifically to the individual market so those insured in group plans have not been applying through the exchange. ---
**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\ **Post date:** [November 16, 2013, 7:46pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/6 "2013-11-16T19:46:09Z")
> [@beowulff](#): > > I can’t get traditional insurance due to a pre-existing condition. > I’m currently on the interim pre-Obamacare PICP program, which is great. It expires at the first of the year, and I’ll have to move to a standard program, but so far, haven’t been able to use the website to sign up. As soon as the website starts working, I’ll sign up. I am in the same boat. Nevada’s site is not part of the Federal one and it was easy to sign up. ---
**Author:** ![Dewey\_Finn](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dewey_finn/32/4222_2.png) [@Dewey\_Finn](https://boards.straightdope.com/u/Dewey_Finn)\ **Post date:** [November 16, 2013, 8:15pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/7 "2013-11-16T20:15:13Z")
Wait, you’re back in the US? I thought you were living in the Czech Republic and Dubai and were considering renouncing your US citizenship. > [@Renouncing US citizenship to get a bank account](https://boards.straightdope.com/t/renouncing-us-citizenship-to-get-a-bank-account/672691/128): > > > [@Renouncing US citizenship to get a bank account](https://boards.straightdope.com/t/renouncing-us-citizenship-to-get-a-bank-account/672691/93): > > > > Not directly related to the question in the OP, but I’m curious. From previous threads, I gathered that the reason that **Desert Nomad** lived overseas was that a preexisting condition prevented him from buying individual health insurance in the US. As I believe that issue was addressed in the Obamacare legislation, have you considered moving back to the States? Based on this thread, I take it the answer is no. So at this point are you just happier living in Europe and the Middle East? > > You are correct about my health situation (both before and now with Obamacare). However, given the US pushing to make my life as difficult as possible overseas, I see no reason to give in and move back to the USA. In fact I have since lost my residency status in the Czech Republic (with a change of rules recently in the visa requirements). > > Therefore I have to currently live as a perpetual tourist and move countries every 90 days as I did from 2002-2005. I have few assets in the USA, but it would be hard to live without a passport. I’d have to seek refugee status somewhere. ---
**Author:** ![Mahaloth](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mahaloth/32/1079_2.png) [@Mahaloth](https://boards.straightdope.com/u/Mahaloth)\ **Post date:** [November 16, 2013, 8:37pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/8 "2013-11-16T20:37:19Z")
> [@beowulff](#): > > I can’t get traditional insurance due to a pre-existing condition. > I’m currently on the interim pre-Obamacare PICP program, which is great. It expires at the first of the year, and I’ll have to move to a standard program, but so far, haven’t been able to use the website to sign up. As soon as the website starts working, I’ll sign up. Do you need the web site? Isn’t there a sign-up over the phone? ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [November 16, 2013, 8:50pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/9 "2013-11-16T20:50:43Z")
Procrastination. My wife is currently covered by crappy COBRA and has just started shopping - in WA where the site works just fine. She will buy in the next month so she can dump the lousy coverage she has now. ---
**Author:** ![The\_Other\_Waldo\_Pepper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/the_other_waldo_pepper/32/12370_2.png) [@The\_Other\_Waldo\_Pepper](https://boards.straightdope.com/u/The_Other_Waldo_Pepper)\ **Post date:** [November 16, 2013, 9:25pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/10 "2013-11-16T21:25:48Z")
> [@chappachula](#): > > I had thought that one of the great improvements of Obamacare was that it will let every single person buy insurance, even if the insurance companies til now refused to cover him because of pre-existing conditions. I had thought that one of the great features of Obamacare was that if you liked your plan you could keep it; since _that_ turned out to be false, I’d wait to see whether any part of it happens to be true before jumping in with both feet. (That’s not GD; I could’ve posted all of it even if I were in favor of Obamacare.) ---
**Author:** ![beowulff](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beowulff/32/542_2.png) [@beowulff](https://boards.straightdope.com/u/beowulff)\ **Post date:** [November 16, 2013, 9:33pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/11 "2013-11-16T21:33:36Z")
> [@Mahaloth](#): > > Do you need the web site? Isn’t there a sign-up over the phone? Yes, although I haven’t heard great things about that method, either. But, I’m in no rush - if it gets to be the end of December, and the website is still broken, I’ll call. ---
**Author:** ![Leo\_Bloom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/leo_bloom/32/10377_2.png) [@Leo\_Bloom](https://boards.straightdope.com/u/Leo_Bloom)\ **Post date:** [November 16, 2013, 10:32pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/12 "2013-11-16T22:32:12Z")
> [@beowulff](#): > > Yes, although I haven’t heard great things about that method, either. > > But, I’m in no rush - if it gets to be the end of December, and the website is still broken, I’ll call. I believe you were whooshed. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [November 16, 2013, 10:43pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/13 "2013-11-16T22:43:02Z")
“If you like your plan you can keep it” is only false in the sense that the federal government isn’t forcibly taking over all of the insurance companies. The companies can still choose on their own to change your plan, just like they could before the ACA. ---
**Author:** ![Ferret\_Herder](https://avatars.discourse-cdn.com/v4/letter/f/e47774/32.png) [@Ferret\_Herder](https://boards.straightdope.com/u/Ferret_Herder)\ **Post date:** [November 16, 2013, 11:09pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/14 "2013-11-16T23:09:09Z")
Yup. And part of the problem is that they didn’t promote the notion that under the ACA, insurance policies need to meet certain standards of coverage - which a lot of the people on those being-cancelled policies didn’t realize their plans failed at. Typically, you’d only know that was the case after you really got sick, the policy covers maybe $50K and says “oops, you hit your limit, sucks to be you,” and you’re on the hook for hundreds of thousands in medical bills and go bankrupt. ---
**Author:** ![The\_Other\_Waldo\_Pepper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/the_other_waldo_pepper/32/12370_2.png) [@The\_Other\_Waldo\_Pepper](https://boards.straightdope.com/u/The_Other_Waldo_Pepper)\ **Post date:** [November 16, 2013, 11:45pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/15 "2013-11-16T23:45:13Z")
> [@Chronos](#): > > “If you like your plan you can keep it” is only false in the sense that No. Stop. It doesn’t matter what follows _“is only false in the sense that”_, because this isn’t GD and we’re not debating the rightness or wrongness of it; my point here is simply and only that they were flatly told something false, and they were also told other stuff which may also be false – and regardless of why the former is false, there’s ample reason for them to wonder if the latter is also false; they may well also wonder whether someone like you will later explain why those other claims are likewise false, but the reasonable question is _whether_ and not _why_ those other claims are likewise false. ---
**Author:** ![Morgenstern](https://avatars.discourse-cdn.com/v4/letter/m/f9ae1b/32.png) [@Morgenstern](https://boards.straightdope.com/u/Morgenstern)\ **Post date:** [November 16, 2013, 11:47pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/16 "2013-11-16T23:47:25Z")
Didn’t they just roll back the intro by a year? Or is that still before congress? ---
**Author:** ![Mangosteen](https://avatars.discourse-cdn.com/v4/letter/m/6a8cbe/32.png) [@Mangosteen](https://boards.straightdope.com/u/Mangosteen)\ **Post date:** [November 17, 2013, 3:48am UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/17 "2013-11-17T03:48:56Z")
> [@Ferret\_Herder](#): > > Yup. And part of the problem is that they didn’t promote the notion that under the ACA, insurance policies need to meet certain standards of coverage - which a lot of the people on those being-cancelled policies didn’t realize their plans failed at. Typically, you’d only know that was the case after you really got sick, the policy covers maybe $50K and says “oops, you hit your limit, sucks to be you,” and you’re on the hook for hundreds of thousands in medical bills and go bankrupt. Why wouldn’t you have simply read what the limit was on your policy? Are you saying that “typically” this is too much to ask of a person? Read the policy. My brother’s policy was cancelled because it didn’t meet Obamacare’s “standard”. His health insurance policy lacked both maternal and pediatric care among other things. The problem is both his wife and him are in their 50’s and certainly don’t plan on having any more kids. ---
**Author:** ![actualliberalnotoneofthose](https://avatars.discourse-cdn.com/v4/letter/a/e79b87/32.png) [@actualliberalnotoneofthose](https://boards.straightdope.com/u/actualliberalnotoneofthose)\ **Post date:** [November 17, 2013, 4:14am UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/18 "2013-11-17T04:14:55Z")
I think there is a lot of uncertainty, and most people don’t signup for things early. I do my taxes in January, but I think more people wait until the last minute. Personally, I have a lot of uncertainty based on what’s going on with the ACA, having no clue what my income will be in January or what if any subsidy I will actually be eligible for or how things will work out with that. I am well-read on most broadly-important issues, but I think I still have a lot of questions about how everything actually works. If I have those questions, I would think many others do unless they wouldn’t think of any in the first place. ---
**Author:** ![actualliberalnotoneofthose](https://avatars.discourse-cdn.com/v4/letter/a/e79b87/32.png) [@actualliberalnotoneofthose](https://boards.straightdope.com/u/actualliberalnotoneofthose)\ **Post date:** [November 17, 2013, 4:25am UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/19 "2013-11-17T04:25:08Z")
> [@The\_Other\_Waldo\_Pepper](#): > > No. Stop. It doesn’t matter what follows _“is only false in the sense that”_, because this isn’t GD and we’re not debating the rightness or wrongness of it; my point here is simply and only that they were flatly told something false, and they were also told other stuff which may also be false – and regardless of why the former is false, there’s ample reason for them to wonder if the latter is also false; they may well also wonder whether someone like you will later explain why those other claims are likewise false, but the reasonable question is _whether_ and not _why_ those other claims are likewise false. So, did most people interpret Obama’s promise as meaning the federal government would force all insurance companies to keep their existing plans and rates for anyone who liked them? I always took if to mean "IF your current plan meets these conditions and your insurance company chooses to continue offering it, you can keep it,"and it was more about communicating that people weren’t going to be forced to abandon what they had for some public scheme, not that the government was going to interfere in their existing insurance arrangement even more for their benefit. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [November 17, 2013, 3:22pm UTC](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067/20 "2013-11-17T15:22:30Z")
> [@Chronos](#): > > “If you like your plan you can keep it” is only false in the sense that the federal government isn’t forcibly taking over all of the insurance companies. The companies can still choose on their own to change your plan, just like they could before the ACA. Sure, they can just double the number of policies. All that will happen is that more costs will be added to maintain a larger product line. All of this was predictable before the law was enacted. [Next page](https://boards.straightdope.com/t/obamacare-why-arent-people-with-pre-existing-conditions-signing-up/674067.md?page=2)