I haven’t read the Obamacare tome (why should I? Congress didn’t). But I gather it limits exclusions on preexisting condition.
But – how do they find out in the first place? What makes it officially preexisting? I ask because I know that under HIPAA (?), medical records are super-confidential in a lot of cases. And it’s not like there’s a centralized database (is there?) of my endocrinologist in Fresno’s notes with my those of my internist in Minneapolis or syphillologist in Tijuana such that they could piece together that as of date X I had incipient type II diabetes with chlamydic complications.
Or do they use insurance billing/claims records (which I guess may be centralized?). If that’s the trigger event, I guess if I was in Tijuana paying cash, as a practical matter it’s not pre-existing.
Finally, to return to my diabetes example (or emphysema, or any slow-onset/chronic condition) – when do I go from being a fat insulin resistant twinkie guzzler to a “type II diabetic” for something to be “preexisting” as of date X? Is it a magical DX code appearing in the insurance records, or more subjective (under the current regime, that is, where preexisting condition coverage can be excluded)?