> Aren't you comparing conditionally-issued insurance with guaranteed-issue health insurance?

In addition to guaranteed issue, the Obamacare plans have (1) an annual out-of-pocket limit (2) no annual or lifetime limit on benefits (3) an absolute right to renewal.

These features raise the cost substantially compared to previous plans on the individual market. The classic example is if you get cancer and need $2 million in treatment. If your plan had 20% coinsurance, or a $1 million lifetime limit, then you'd be in rough shape. And if the insurance company dropped you when you got sick, on the grounds that you forgot to disclose some trivial and unrelated illness on your application, then you'd be in really rough shape.

The things that make Obamacare expensive are the features that don't show up on the sticker -- because they are now required of all plans. Guaranteed issue is the major one, because they prevent sick people from being washed out of the actuarial pool. All of these features are things that you hope you will never need to "take advantage" of. If you waste your money buying them, that's actually not a bad outcome.

I've also found it's like viewing interest rates on Zillow, it will be the lowest possible number that almost no one could qualify for but, it looks nice when shopping and gets people thinking they can afford it so the small increases later are accepted.

Yes, but how many people is that actually an issue for? Most of the preexisting condition demagoguery you hear about seems to stem from people who were going w/o insurance until they found out they had a medical condition. There were already limits on preexisting condition exclusions in a number of states. You also have to wonder if that in and of itself is worth a doubling in costs?

http://en.wikipedia.org/wiki/Pre-existing_condition#Current_...

Horse. Shit. I have a perfectly healthy family, a family in which I am notably the least actuarially sound bet. When we started Matasano, we found my wife and (at the time) 7 year old daughter both uninsurable, full stop, at any price, due not to preexisting conditions but instead previous medical examinations that led insurers to believe that at some point in the future the two (coincidentally? female) members of my family might develop a condition.

I've talked to dozens of people since then and come to the conclusion that "functioning human female reproductive system" is, in essence, a coverage-denying preexisting condition in many US states.

You're in IL right? For some reason the insurance situation in IL seems to be really crappy. They allow(ed) for looking back further in people's medical history than a lot of other states according to wikipedia. That doesn't explain why the new plans are so much more expensive though even in states that previously had restrictions on preexisting conditions and medical history use in underwriting.

Let's again be clear about what I said. "They" (meaning every insurer in IL) did not "look at our medical history". They looked at visits to doctors and (in one case) the emergency room that did not result in diagnoses, and decided to hedge their bets by presuming a preexisting condition that was not indicated in the record.

Another thing that happens --- particularly in California, lest you think this is an IL problem --- is that comparatively minor medical conditions were used as proxies for rare but expensive conditions. For instance, if you were a woman with abnormal cramping, you might be default-denied based on a simple blacklist of uninsurable conditions because insurers were scared that might presage something expensive down the road.

The preexisting condition and recission policies of insurers prior to Obamacare were a national disgrace.

It sounds like the insurers decision had more to do with visits to the emergency room than anything else. Those are expensive.

Thanks for your insight.