Will healthcare reform provide coverage if I have medical issues?

The simple answer is yes ultimately nearly all will be able to secure health insurance, at some cost. That does not mean everyone will have health insurance though. There is a lot that will come out during the next few months as we rapidly approach Q4 2013 when we will see the open enrollment begin for those who want coverage on the healthcare exchanges for 2014.

Presently Healthcare Reform is in the implementation stages and to a large extent is not fully implemented. Much of the rule making is still taking place and/or in comment periods. We will see more of it all shape up over the next few months.

The timeline for the law does not call for major changes such as implementing guaranteed issue for all major medical health plans until 2013. Thus for those who currently have major medical issues they must still meet all underwriting criteria for a plan to be issued by the insurance carrier. Thus, if you have serious medical conditions it is possible there will be no coverage offered.

Presently, in Texas, and some other states also, one can always go to the Texas High Risk Pool for help with coverage when you are declined by other carriers. Many other states have similar programs for those who are otherwise not insurable with traditional health insurance for individuals.

In 2014, you will be able to get coverage, however ratings can be applied so those with major health issued will still likely pay more. Some of those details are still not fully worked out. There is a 3:1 ratio that is to be implemented that one person does not pay more than 3 times what anyone else pays in the same geographical are. Also, smokers can be forced to pay 1.5 times what non-smokers pay due explicitly to the increased cost for care related to the smoking.

Ultimately yes it will help you get coverage, but it will not necessarily make the coverage any less expensive for you. There are still issues with how the law is structured that allows healthy people to opt out and pay a minimal fine thus making for a riskier pool of folks buying insurance thus higher premiums for those individuals. Aetna’s CEO for one is cited as saying some will see 100% rate increases in 2014 for their health insurance.

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, Houston Insurance Examiner

David is the owner of Brooks Insurance Services an insurance agency specializing health, life, long term care, disability, and Medicare related insurance products.

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