In the United States it is currently against the law for insurance companies to prevent you from obtaining coverage for having a preexisting condition under the ACA.
That law is being challenged now before the Supreme Court, and the DOJ* has filed a brief arguing that the law is unconstitutional.
If the SCOTUS strikes down the ACA, then it would be absolutely legal for insurance companies to deny you treatment for having had COVID-19 in the past. There is no current legislative plan to replace the ACA if its struck down.
* I personally find the argument in the DOJs brief to be manifestly absurd, but you can decide for yourself here: https://www.supremecourt.gov/DocketPDF/19/19-840/146406/2020...
What is absurd about that? It seems reasonable to me. Covering preexisting conditions and the individual mandate to buy health insurance are two sides of the same coin.
Personally, I'm on the side of "we should have both" rather than "we should have neither", but the argument that you can't have one without the other is sound.
Their argument doesn't work as the Federal individual mandate for insurance stands as law but has no penalty or requirement to report. The basically declawed that component of the ACA. It is not considered for any applications/forms/fees/etc and you no longer need a waiver.
With that in mind, the mandate for insurers to cover regardless of preexisting conditions should stand based on the 2012 decision but that doesn't mean it cannot also be declawed by congress. There are many laws like this, many of which rely on department head for discipline actions or censure but they can simply not do that. This is a common theme among the current administration where ethics laws are constantly broken but there is not mandatory fine or penalty so as long as the manager assigned to judge the penalty fails to oversee their employees, our checks and balances mean nothing.
> Starting with the 2019 plan year (for which you’ll file taxes by July 15, 2020), the Shared Responsibility Payment no longer applies.
After the ACA was originally passed 2010, it was challenged on constitutional grounds. It went to SCOTUS in 2012 (National Federation of Independent Business v. Sebelius, 2012). In that case the court ruled in a 5-4 opinion that the Individual Mandate was a constitutional and valid use of Congress' taxation powers. The law survived the constitutional challenge.
In 2017 a subsequent (now GOP controlled congress) zeroed out the individual mandate penalty.
The individual mandate is now being challenged on constitutional grounds. The logic goes that, since there is no penalty there is no taxation. If there is no taxation, the individual mandate cannot be a constitutional under Congress' taxation powers. I'm fine with all of that.
Here's now the part that I find absurd:
The argument that the individual mandate cannot be severed from the rest of the ACA based on the way it was amended by the 2017 Congress. Therefore, since the IM is no longer constitutional the entire ACA must fall.
The reason I find it absurd is it relies on speech and debate from the original passage of the ACA which argued that the individual mandate was required for the law to function. However, a subsequent congress deliberately chose to zero out the individual mandate without eliminating the law. The subsequent congress' decision making overrides the decision that the congress that passed the ACA. The 2017 Congress very deliberately made the individual mandate completely nonfunctional, while leaving the rest of the law in place.
TL;DR
- 2010 Congress passes the ACA with the Individual Mandate
- 2012 SCOTUS rules it constitutional
- 2017 Congress zeroes out the Individual Mandate
- The argument now is that the 2010 Congress thought the ACA required the IM to function, ignoring that the 2017 Congress very obviously decided that the ACA didn't require the IM to function.
To me there's just no way to square that circle. The 2017 Congress' decision overrides the 2010 Congress' decision.
-----
Finally, logically I agree with you and I agree with the 2010 Congress. The Individual Mandate is necessary for the ACA to function the way it was originally designed. The ACA is a better, more functional, law with the individual mandate in place. I disagreed with the 2017 Congress' decision to remove the mandate.
But that's no longer relevant. The question now is, is the IM necessary for the ACA to function the way the 2017 Congress amended it to function. The answer—since they repealed the individual mandate—is clearly "no".
The argument for the IM was that people would remain uninsured until they got sick, then go buy insurance. Or, would get crappy+cheap insurance until they got sick and then get good insurance to cover their sickness.
However, neither of those work because there is still an average 6-month waiting period before a person can obtain or change insurance, just like when you could obtain insurance anytime during the year, but there was a 6-month wait on PE conditions.
They campaigned on repealing the bill, but replacing it with an alternative (supposed "repeal and replace"). The replacement never materialized (and, to my knowledge, still hasn't a decade after the ACA went into effect). That said, they pressed forward with an attempt to repeal the bill without replacing it (promising to repeal it at a future date).
The House passed a repeal of the ACA (it was a partial repeal, because they were using the reconciliation process of the Senate to avoid the filibuster so it wasn't a total repeal, but it would have eliminated most of the provisions of the ACA.
The House of Representatives passed their repeal bill on May 4, 2017. The Senate attempted to pass their version of the repeal bill (a different bill, but substantively similar) on July 27, 2017. The bill failed in the Senate by a single vote, 49-51 (if it had ended in a tie the Vice President would've broken the tie and assuredly would have voted to pass the bill). 3 members of the Republican party broke ranks to vote against the bill: Lisa Murkowski, Susan Collins, and John McCain.
McCain was the last to vote against the bill. It was an extremely dramatic moment, as the voting was held open for an extended amount of time while the GOP lobbied McCain hard to pass the bill. Ultimately, he voted "No" in a dramatic fashion (https://www.youtube.com/watch?v=hT2pp_KrJGg), and the repeal bill failed in the Senate.
I was watching the Senate vote at the time and it was an incredibly tense and anxious moment. I cannot describe the relief I felt when McCain turned his thumb down and said "no" in that video above. It was a truly shocking moment, and one I'll probably remember for the rest of my life.
So, they tried, but they didn't have the votes.
After failing to repeal the full bill, they proceeded to pass the bill that zeroed out the individual mandate. That was much easier for them to get their caucus on board with, as the mandate was very unpopular with the base of the republican party.
As long people get a feeling of security, there will also be people willing to pay more in premiums than what they expect to get out.
If people start gaming the system, and DNA testing become very accurate in predicting the future (current commercial DNA testing is not even close), then what will likely happen is that big payouts will go away. It will have enough limits, caps, restrictions and conditions in order to rebalance the risk assessments in favor of the insurance company.
That is a very north american definition of insurance. But insurance companies are not collectives. They are for-profit corporations, probably with a PO box in Delaware. Buying an insurance plan isn't like moving into a commune. It is a risk-shifting arrangement with a corporation, a formalized financial hedge. When I buy insurance I don't much care about other customers. They aren't part of my transaction. Maybe I am the only customer for a product. That does happen. It doesn't impact the obligations of the parties.
Since the premium has increased, the only people who will still pay the higher premium are those that know they will need to make a claim. The premium will therefore rise to the point where _only_ the ones with that extra information will pay.
Insurance markets cannot survive with this kind of information asymmetry.
This is not a North American definition. This is what insurance is.
Unfortunately that's not actually how it works with shared pooling of insurance resources. You pay a monthly fee that gets bundled with the fees from other customers and paid out when there are claims against insurance.
If your care was only paid out of your pool of money you've paid into the insurance system, your first month of payment would cover essentially nothing.
What about one-off custom policies with a "local pool" of one customer? Such products are made every day.
Insurance is a regulated industry and those statements would be terrifying. You have to prove to the state that your mathematics will work into a functional business and have to maintain certain liquidity requirements.
> All that matters is that they pay.
Yeah, and that's one the reasons companies don't like paying since it can dip into their liquidity.
There's still the matter of law enforcement having future access to the database for a broad search which concerns me. I don't think I'd be willing to donate to a genomic database unless there was a very strong safeguard against the police making a broad search against the database.
Not likely. The whole point of the DB is to allow "broad searches."
Here's where things get a bit wonky.
LPRs (License Plate Readers), although "icky," are -more or less- legal. The whole purpose of a displayed license plate is to allow the authorities to rapidly match the vehicle with the registered entity.
Driving a vehicle is a privilege and an obligation, so it can easily be argued that driving a vehicle comes with the obligation to display a "tracking" plate. In fact, this might even extend to adding RF trackers. We're almost there, with EZ-Pass (Eastern US).
Phones get a bit dicier. Stingrays are still very much in a legal "gray area." Until they are explicitly banned, we'll probably be seeing lots of them. Just too damn juicy.
But DNA is something else. We don't need to be licensed as "humans" (although I'm sure there's folks that would love to give it a go).
Much as we'd wish folks would live in a manner that obliged them to follow social norms (which is a whole bucket of snakes, right there), that ain't happening. There's no "hook" to force people to submit to DNA tagging; nor (IMNSHO), should there be.
There was some founding father -I don't remember who- that said something along the lines of "I would rather see 100 guilty men go, than one innocent man imprisoned."
Depending on the size of your family, could be hundreds of people, some of whom might be criminals and forced to surrender their DNA.
Once you accept that socializing police, fire, elementary schools, high schools, power, water, highways, the entire judicial system, and so on is in the public interest -- and medicine for the poor, the old, the imprisoned and in some cases the young -- the question of socializing medicine for everyone is just a question of where you draw the line.
Currently 40% of America is already under socialized medicine. The argument at hand is 40% or 100%. That's all. Not nearly as big an existential question as the politicians may have you believe. The question is "do we double the number of people covered by socialized medicine or not"?
You qualify for it and then pick a company to administer benefits. Some companies have great benefits for elders, some have great benefits for young people and families with children.
So sometimes I talk to CEOs, they come in and they start telling me about leadership, and here’s how we do things. And I say, well, if all I was doing was making a widget or producing an app, and I didn’t have to worry about whether poor people could afford the widget, or I didn’t have to worry about whether the app had some unintended consequences -- setting aside my Syria and Yemen portfolio -- then I think those suggestions are terrific. (Laughter and applause.) That's not, by the way, to say that there aren't huge efficiencies and improvements that have to be made.
But the reason I say this is sometimes we get, I think, in the scientific community, the tech community, the entrepreneurial community, the sense of we just have to blow up the system, or create this parallel society and culture because government is inherently wrecked. No, it's not inherently wrecked; it's just government has to care for, for example, veterans who come home. That's not on your balance sheet, that's on our collective balance sheet, because we have a sacred duty to take care of those veterans. And that's hard and it's messy, and we're building up legacy systems that we can't just blow up.
- President Obama
The big one is mostly the BRCA mutations which increase cancer risk for women to around 70%.
- I want the full (98% +) sequencing, not just the exome
- I want to download the full sequence and keep it for own future use with no restrictions
- I don't want my sequence to be used for data mining or sold to third parties without my permission.
- I'm not willing to pay 5 digits for this but I don't expect it for 3 digits either.
As I noted in another comment, that law is currently being challenged in the Supreme Court by the State of Texas, and the DOJ has field a brief arguing that the law should be found unconstitutional.
(See my other comment here for a link to the DOJ brief: https://news.ycombinator.com/item?id=23744702)
It...has: https://www.hhs.gov/healthcare/about-the-aca/pre-existing-co...
I guess banning preexisting conditions would of been a more interesting alternative. Not sure what negative effects that ban would have, maybe coverage will rise due to surgeries not going as hoped or other cases.
Right now, I have no plans to ever get a test. My curiosity as to whether I descended from Dr. Zaius or Cornelius is not strong enough for me to risk having my information available for things like insurance companies dinging me.
On another note, I heard that the jury is still out on the lingering aftereffects of COVID-19, and there's a better than even chance that testing positive means that we can be discriminated against for a pre-existing condition for the rest of our lives.