Will Pre-Existing Conditions Only Cover Kids?

Politico says John Aravosis of AmericaBlog makes a good catch on David Plouffe's op-ed in the Washington Post: Obama may be preparing to drop the ban on denying coverage for pre-existing conditions for all but children in the health care bill. Plouffe wrote:

Parents won't have to worry their children will be denied coverage just because they have a preexisting condition.

Aravosis says,

Their children? The original promise - even the bad Senate bill - protects everyone, of any age, from being denied coverage because of pre-existing conditions. Now it's just children?

Aravosis says it's unlikely Plouffe was just using kids as an example. But, could Plouffe have been talking about when the ban kicks in? His full paragraph reads:

If we do pass it, dozens of protections and benefits take effect this year. Parents won't have to worry their children will be denied coverage just because they have a preexisting condition. [More...]

As support for the belief it will be dropped completely for adults, Aravosis cites these articles in the New York Times and at CBS. CBS:

Earlier this week, Obama had suggested shifting the focus to popular proposals like banning denial of coverage to those with medical problems. On Friday, he acknowledged that particular fix can't be done on its own because it would encourage people to put off getting insurance until they're sick, driving up premiums for everybody else. A comprehensive bill remains the best approach, the president suggested.

"None of the big issues that we face in this country are simple. Everybody wants to act like they're simple," he told workers in Ohio. "The health care system is a big, complicated system, and doing it right is hard." Banning pre-existing condition denials would have to go hand-in-hand with coverage for all.

The Times, on what a compromise bill might look like:

Lawmakers, Congressional aides and health policy experts said the package might plausibly include these elements: Insurers could not deny coverage to children under the age of 19 on account of pre-existing medical conditions....

It would be a huge mistake to cut adults from protection against denial for pre-existing conditons. And quite a change from where Obama began. See here, where it is number one on the agenda. I suspect a great deal of support for the bill came from those with pre-existing conditions. If they jump ship, who's left to support this bill -- besides parents of children with pre-existing conditions?

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    Could be a trial balloon. (5.00 / 2) (#1)
    by oldpro on Sun Jan 24, 2010 at 01:07:32 AM EST
    If so, it's a dumb one.  While kids are appealing when you're selling it, adults are the ones who vote and they will shoot such a notion down in a nanosecond.  Limiting it to kids would be a huge mistake.

    Only one of many, of course.

    There seems to be no end to the stupid.

    Unending Hype & Stupidity (none / 0) (#43)
    by norris morris on Mon Jan 25, 2010 at 11:10:48 PM EST
    More stupid White House hype that leaves more questions than answers and is as vague and unclear as Obama has been through this entire mess.

    Count me as one J (5.00 / 2) (#3)
    by Teresa on Sun Jan 24, 2010 at 01:42:45 AM EST
    I suspect a great deal of support for the bill came from those with pre-existing conditions. If they jump ship, who's left to support this bill

    I detest the bill but would like to see the pre-existing clauses gone. So if they do away with that, count me out, too.

    I could go for CoralGables plan above-basic care for all, if you want a premium policy, pay for it yourself. It beats what I have now depending on how limited the basic plan would be.

    Going over my crazy quilt of HC/I fm various plans (none / 0) (#9)
    by Ellie on Sun Jan 24, 2010 at 04:25:02 AM EST
    It looks like I've got basic for me and mine (got co-guardianship of my nephews to upgrade their iffy coverage) with enough of a safety net to offset destitution should any of us be struck with longterm illness.

    On principle, the punitive measure to cut women out for having female plumbing would, alone, be enough to walk away from this.

    The death of the PO and this public admission that Obama fears the Republican Meanie only vindicates my hunch that the Dems will implode after another year of in-vitro activism calling forth the foetal vote.

    (No dog in this fight, no fight in this dog.)


    Obama shd be in Governing Mode, not Campaign Mode (5.00 / 5) (#4)
    by Ellie on Sun Jan 24, 2010 at 02:14:41 AM EST
    He should be speaking to Congress using better terms than urging them to be a part of (his) "history".

    An Obamapalooza tour yet again puts his Image and Ego ahead of the wreck that was his first year of non-leadership. At least some of his Anonymice are on the record.

    "Our own political operation will be more rigorously in communication with the other elements, so we can compare notes," Mr. Axelrod said. "What we learned from Massachusetts is that we need to be more assiduous about getting our own data and our own information so we have a better sense of where things stand."

    Well that's a balloonful of hot air.

    .The White House intends to send Mr. Obama out into the country considerably more in 2010 than during his first year in office, advisers said, to try to rekindle the relationship he developed with voters during his presidential campaign. [...]

    [W]hen he delivers his State of the Union address ... Mr. Obama will try to reframe his agenda and how he connects it with public concerns. In particular, he will focus on how his ideas for health care, energy and financial regulation all fit into the broader economic mission of creating what he calls a "new foundation" for the country, the key words being "rescue, restore and rebuild."

    Isn't selling media (and voters) on his agenda kind of backwards? Shouldn't he be implementing what voters said they want him to do?

    Why don't Obama and his team get that people aren't hurting from a lack of SPEECHES.

    We all like to do what we do best............ (5.00 / 5) (#5)
    by BrassTacks on Sun Jan 24, 2010 at 02:46:31 AM EST
    For Obama, that's campaigning.  He's good at campaigning, not so good at the leadership thing.  So he has to go back to what works for him, and that's giving speeches.  Since that made people like him in the past, it should work again.  Or so he believes.  

    Lifeboats approach to 'save' Titanic bill is wrong (5.00 / 4) (#7)
    by Ellie on Sun Jan 24, 2010 at 03:47:02 AM EST
    I never knew that parents OR kids (but not both) got to be saved were a family struck with serious illness. The GOP iceberg's not showing any intention of moving, so why dump anyone overboard?

    I'm equally mystified by Team Obama's focus on imaging, polls, media strokes and the the perpetual promise of Repug cooperation if Dems are nice enough, and pretty enough, and darn well deserve it.

    Honestly, this process has become so convoluted and bereft of benefits in the name of indulging a handful of grandstanding fanatics, the more I see it, the less I understand it. (TMI: I backed away from a 2010 promotion to hang onto the job/seniority and coverage that I DO have for stability's sake.)


    His personal popularity (5.00 / 2) (#19)
    by gyrfalcon on Sun Jan 24, 2010 at 09:38:20 AM EST
    isn't his problem.  He's still very popular, even among all those folks who voted for Brown in Mass.

    He could, of course, help a lot by selling his "agenda" personally, except that he rarely condescends to get into the specifics, which are what's bothering all those people who agree with his lofty generalized goals.  Plus I don't know who even believes him anymore.  He can say as many times as he wants that, for example, if you like the insurance you have now, you can keep it, except that  it's clear that that's untrue.


    sure you can keep it, if (5.00 / 1) (#20)
    by observed on Sun Jan 24, 2010 at 09:42:13 AM EST
    you pony up more money.
    It's the American way---only losers are so stupid they can't put aside money for essentials like health insurance.

    Does he think people are stupid? (none / 0) (#38)
    by BrassTacks on Sun Jan 24, 2010 at 03:32:14 PM EST
    I am beginning to think so because he tells us things that no one could possibly believe yet he seems to think we'll believe it if he says it over and over.  

    The people who backed his candidacy (5.00 / 3) (#11)
    by esmense on Sun Jan 24, 2010 at 07:08:23 AM EST
    obviously always saw him as a front man rather than a leader. The Democrats' Reagan (the GE spokesman and front man for the defense industry.)

    The difference is this -- the people behind Obama are apparently a lot less competent (at getting what they want) than Reagan's backers and handlers were.  


    Voters elected Obama, not RR, FDR, JFK, MLK etc (5.00 / 1) (#14)
    by Ellie on Sun Jan 24, 2010 at 08:36:52 AM EST
    No matter who Obama's spoofing and goofing any given week, ultimately Obama has to lead. I found this piece of history interesting:

    ... Obama might look at another pivotal moment in the Kennedy presidency -- and this time heed the example.

    The incident unfolded in April 1962 -- some 15 months into the new president's term -- when J.F.K. was infuriated by the U.S. Steel chairman's decision to break a White House-brokered labor-management contract agreement and raise the price of steel (but not wages). ... And yet [J.F.K.], like that other Harvard patrician, F.D.R., had no hang-ups about battling his own class.

    Kennedy didn't settle for the generic populist rhetoric of Obama's latest threats to "fight" unspecified bankers some indeterminate day. He instead took the strong action of dressing down U.S. Steel by name ... for threatening "economic recovery and stability" while Americans risked their lives in Southeast Asia. J.F.K. threatened to sic his brother's Justice Department on corporate records and then held firm [...] U.S. Steel capitulated in two days.

    Can anyone picture Obama exerting such take-no-prisoners leadership to challenge those who threaten our own economic recovery and stability at a time of deep recession and war? ... (After the Massachusetts Massacre By FRANK RICH, NYTimes Jan 23, 2010)

    Selling voters on "their" health care gift to insurance companies just won't cut it here.

    Nor will a "Defiant" Obama asking Wall Street welfare recipients -- who are (quietly) living large off bailout bonuses -- to give back some bailout money.

    LAST year, investment bankers and their spouses kept their wallets shut during bonus season, first, out of panic, and later, fearing mobs with torches would descend upon their gated estates.

    Now, after a year of self-imposed austerity and in what is shaping up as a spectacular bonus season, the Wall Street crowd is shaking off what one luxury retailer called its "frugal fatigue." Unlike earlier spending sprees, however, the consumption will be a lot less conspicuous.

    On Wednesday, Morgan Stanley said it was setting aside $14.4 billion for salary and bonuses, or $235,000 per employee. A day later Goldman Sachs said it would pay an average of $498,000, with top producers at each of the two banks earning in the millions.

    More than in past years, this year's bonus numbers are stirring deep resentment in a nation staggering under 10 percent unemployment. [...]

    "A community like the Hamptons depends on house trades," said Diane Saatchi, an agent with Saunders and Associates who just sold a home to a banker for $4.9 million.

    "Don't ask to talk to him about it, because he won't," Ms. Saatchi said of the buyer, deflecting a reporter. "They don't want anyone to know they are buying." That includes the banker's extended family, she explained, because he is worried they will ask him for money. No one, she said, "is bragging about anything."

    At the heart of Wall Streeters' anticipated splurge is pent-up demand after a year dominated by fears of a new depression, retailers and cultural observers say. ... At the same time, investment bankers want to avoid the wrath of a fed-up public that continues to blame them for the nation's recessionary ills. ... As such, the prevailing wisdom on Wall Street is less show and no tell.

    "Bankers are being told by their bosses to be careful," said Janet Hanson, who was an executive at Goldman Sachs for 14 years ... "I mean, how does it look if you got a $1 million bonus from Goldman Sachs and you are sporting around in a new Audi TT? People will hate you." (To deflect criticism, Goldman announced last week it would pay its top 30 executives in stock only.)

    Few Wall Street executives or their spouses contacted for this article were willing to discuss how they planned to spend or invest their bonuses, expressing a fear of public scorn combined with the silence about personal rewards that bankers usually observe.

    Geez, they were frickin chatty enough when descending on Congress and the White House demanding to be bailed out.

    "There is the sense in the community that the world is not coming to an end," [said one banker's wife, who did not want to be named.] Of bonus critics, she added, executives like her husband work hard and are unjustly singled out as greedy.

    "Everybody wants someone to blame," she said, "and rich people are an easy target." [...] (Ready to Spend, but Not to Boast By LAURA M. HOLSON, NYTimes Jan 22, 2010

    Oh, the poor poor rich!


    "Can anyone picture Obama exerting such (5.00 / 1) (#16)
    by esmense on Sun Jan 24, 2010 at 09:19:25 AM EST
    take-no-prisoners leadership?" No.

    But, in fairness, this is a very different world. One in which Labor, working people (and work) are are no longer respected or represented in the public conversation, or, for the most part, in politics.

    It can be startling to look at old issues of news magazines like Time or Newsweek from the 60s and the 70s -- and see that the regular "Business" section of those magazines was matched with an equal and regular "Labor" section.

    Kennedy spoke as he did at a time when labor leaders appeared routinely on the Sunday political shows, and labor issues were considered of vital and legitimate interest to all Americans.

    And, when no one would have thought to label and dismiss his speech as merely "populist" rhetoric. Today's beltway and media reaction to Kennedy's speech would be to dismiss it as "pandering." And implied in that dismissal would be the smug confidence of those doing the dismissing that the millions of people he was "pandering" to don't, and shouldn't, count. (the don't count as investors in stocks and consumers of financial services, they don't count as consumers of the upscale luxury products their publications' advertisers are peddling, and therefore they shouldn't count as citizens).


    Different world, (none / 0) (#29)
    by brodie on Sun Jan 24, 2010 at 11:25:30 AM EST
    in some respects.  In 1962, union members represented about 30% of the total workforce.  Today, that percentage is down significantly to roughly 12%.  Combine that depressing figure with the increasing consolidation of major media into just a handful of huge corporations owning most of the major news outlets, and, with the loss of the Fairness Doctrine, you have a very uneven playing field established that greatly favors business over workers' concerns.

    But in 62 you still had a few major media outlets of a very conservative bent who weren't happy with Kennedy's perceived anti-business attitude -- Time magazine for instance, much more important back then, covered the Steel Crisis in a noticably snarky anti-Kennedy manner.  And you still had major public figures of great standing, like Ike, who weighed in to denounce Kennedy's actions as representing some dangerous concentration of power in the executive, etc.

    Kennedy, and FDR before him, showed that by standing firm against Big Business deception and greed and the various "economic royalists" who were not accustomed to being challenged, the people will be on your side.  But it takes some courage, smarts, and determination to actually get in there and fight the battle and not merely talk about fighting.  

    So far, Obama is still in the talking about fighting stage, and so the question remains whether he has the cojones to actually engage the battle with Big Insurance and Pharma.


    Wasn't he the second coming of Lincoln, (none / 0) (#39)
    by BrassTacks on Sun Jan 24, 2010 at 03:34:47 PM EST
    Just a year ago?  Haven't heard that comparison in a while.  

    Reagan had decades of practice (none / 0) (#12)
    by observed on Sun Jan 24, 2010 at 07:51:23 AM EST
    as GE"s paid spokesman for the right wing before he became President.
    He was effective as President because he had a persona which matched the message.
    Yet another problem with the "experience doesn't matter" judgment: experience in the public sphere gives a politician a brand name which he can use to influence policy.

    Reagan never had to contend with (none / 0) (#13)
    by Militarytracy on Sun Jan 24, 2010 at 08:10:16 AM EST
    the internet either, and a place for his opposition to all connect and organize.  He didn't have to deal with his many fraudulent policies being exposed very early on in their being sold to the people and challenged by internet bloggers either while newspapers went broke for not doing their real jobs.

    This is amusing: (none / 0) (#28)
    by oculus on Sun Jan 24, 2010 at 11:24:06 AM EST
    a place for his opposition to all connect and organize

    You don't feel connected (none / 0) (#34)
    by Militarytracy on Sun Jan 24, 2010 at 12:31:56 PM EST
    and organized :)?

    No. But maybe it's just me. (none / 0) (#35)
    by oculus on Sun Jan 24, 2010 at 12:56:37 PM EST
    You mean Reagan didn't have to deal with (none / 0) (#40)
    by BrassTacks on Sun Jan 24, 2010 at 03:37:21 PM EST
    The truth getting out there to the masses?  No one told them that there was no free lunch, and more people couldn't better health care for less money?  

    Obama does not seem to be aware that people know the truth and his silly lies in his lofty speeches won't work.  


    Waiting for (5.00 / 2) (#42)
    by jbindc on Sun Jan 24, 2010 at 04:05:14 PM EST
    Obama to declare ketchup a vegetable and Michelle to be caught consulting with www.tarot.com

    And led Hollywood's SAG: a librul commie pinko org (none / 0) (#15)
    by Ellie on Sun Jan 24, 2010 at 08:58:29 AM EST
    Funny how Reagan's hardcore worshippers never mention that he led a labor union during some of its most fractious years.

    Also never mentioned (none / 0) (#32)
    by kenosharick on Sun Jan 24, 2010 at 11:40:56 AM EST
    is that he signed pro-choice legislation as governor, opposed the anti-gay Briggs Inititive, and signed the largest tax increase in history (to that point)as president.

    Ronald Reagan had a dual role (none / 0) (#33)
    by KeysDan on Sun Jan 24, 2010 at 11:57:34 AM EST
    while leading SAG--an FBI anti-Hollywood informant.  Maybe that redeems him with his hardcore worshippers.

    They are trying to pare down the bill (5.00 / 1) (#6)
    by Manuel on Sun Jan 24, 2010 at 03:03:41 AM EST
    They want to pick a list of popular ideas and make it hard for thr Republicans to oppose it.  The mandate isn't popular without the public option.  The public option is out.  That means pre existing conditions (which need the mandate) need to be limited.  I guess the theory is that the Republicans will find it hard to vote against kids. There is a list of the proposals in the NYT story.

    Looks like the Dems have decided (5.00 / 1) (#26)
    by MO Blue on Sun Jan 24, 2010 at 10:47:33 AM EST
    that cuts to the Medicare budget are popular with voters. Somehow, this doesn't seem like a real vote getter to me. But what the heck.

    The package could also include changes in Medicare, to reduce the growth in payments to doctors and hospitals while rewarding providers of high-quality, lower-cost care. To help older Americans, it could narrow a gap in Medicare coverage of prescription drugs, sometimes known as a doughnut hole.

    BTW, Mayo Clinic used by Obama as the prime example of providing high-quality, lower-cost care, has announced that Medicare patients will be treated on  a cash only basis in Arizona due to its current low reimbursement rate.


    Kill it already! (5.00 / 1) (#8)
    by mexboy on Sun Jan 24, 2010 at 04:10:31 AM EST
    The only people who benefit from the present bill are the greedy insurance companies. Kill it, I say.

    What a mess (5.00 / 5) (#10)
    by Militarytracy on Sun Jan 24, 2010 at 06:36:51 AM EST

    Obama and The Dems (5.00 / 4) (#18)
    by SOS on Sun Jan 24, 2010 at 09:34:06 AM EST
    have totally destroyed their credibility.

    Again. (5.00 / 2) (#36)
    by Lora on Sun Jan 24, 2010 at 01:29:37 PM EST
    Remember the "early deliverables?" (5.00 / 2) (#21)
    by Anne on Sun Jan 24, 2010 at 10:14:32 AM EST
    We had a discussion about a month ago, about what and who would and would not be covered, and there was a lot of language in the summary that referenced "new plans," causing many of us to ask whether people would have to get new insurance coverage if they wanted to get the benefit of new regulations.

    Here's the link to the summary, and to my comment about it.

    What it says about pre-existing conditions:

    The Patient Protection and Affordable Care Act eliminates pre-existing condition exclusions for all Americans beginning in 2014, when the Exchanges are operational. Recognizing the special vulnerability of children, the Managers' Amendment prohibits health insurers from
    excluding coverage of pre-existing conditions for children, effective six months after enactment and applying to all new plans.

    So, as I read this, if you are an adult, you would have to wait until 2014 - four more years - before you could get some relief, but if you have a child with such a condition, you only need to wait for six months after enactment - but it apparently only applies to all new plans.

    I still do not think there has been an adequate explanation of the ins-and-outs of coverage and regulations - I'd be willing to bet Plouffe couldn't answer questions about the "new plans" part of the deal, either - but - when the campaign machine gets turned on again, what does that matter?  It's all about making people feel good again, right?  

    It's an interesting (4.20 / 5) (#2)
    by CoralGables on Sun Jan 24, 2010 at 01:27:06 AM EST
    dilemma. Cover all pre-existing conditions and you have to make insurance mandatory to balance out expenses and people complain. Drop the mandatory coverage and you have to drop the plan to include all pre-existing conditions or the balance sheet will be out of whack.

    Personally, if a choice needs to be made, I always lean towards better health care for 18 and under since they are unable to fend for themselves and to help prevent future problems which will be far more expensive.

    Of course I'm still an advocate of public health care like public schools. There would be a certain quality of care for you that will be free. If you don't like what the public plan covers, buy insurance and go your own route like paying tuition at a private school.

    Only thing they will keep is (none / 0) (#17)
    by SOS on Sun Jan 24, 2010 at 09:33:11 AM EST
    the mandatory purchase clause.

    Whatever happened to "Yes, we can?" (none / 0) (#22)
    by Coral on Sun Jan 24, 2010 at 10:14:56 AM EST
    Only a campaign slogan I guess. Obama is going to have the bottom drop out of his support if he passes a bill that doesn't get rid of the pre-existing conditions problem.

    Simple (5.00 / 3) (#27)
    by nycstray on Sun Jan 24, 2010 at 10:50:15 AM EST
    it doesn't equal or say "Yes we will".

    Yes we can (none / 0) (#41)
    by BrassTacks on Sun Jan 24, 2010 at 03:40:44 PM EST
    Do what exactly?  It's never clearly defined.  Smoke and mirrors.  Pay no attention to that man behind the curtain.

    yes (none / 0) (#23)
    by jedimom on Sun Jan 24, 2010 at 10:34:57 AM EST
    yes as I noted on a comment here over a month ago now IIRC the Dems cut a deal so ONLY KIDS are banned from preex denials for the first few years at least

    thus my desire to KILL THE BILL!

    scotus (none / 0) (#24)
    by jedimom on Sun Jan 24, 2010 at 10:36:13 AM EST
    it could not be more clear IMO the SCOTUS ruling on mccain feingold has them terrified that if they do not deliver the 30 million customers to insurers and big pharma they will not get corporate donors for the elections

    when will people wake up, these are corporatists not progressive liberal Democrats

    Maybe this is part of backup Plan "C"? (none / 0) (#25)
    by EL seattle on Sun Jan 24, 2010 at 10:45:13 AM EST
    If they decide to scuttle the entire bill, it might make sense to pick a few items that "everyone can agree on" and bundle them together as a "health care bill" that can be passed and hyped to provide a fig leaf victory to cover up the failures of the earlier plan(s).

    I'd think that it wouldn't be unbearably expensive for the US taxpayers to subsidize the insurance rates for families who can't otherwise afford it, as long as that taxpayer support is only going to coverage of those 18-and-under population.  I'd bet that imposing a mandate for parents to have health insurance for their children might have an easier time surviving potential legal challenges to the concept.

    If this were kept pretty simple, the bill could be crafted in such a way that anyone voting against it would look like the worst Scrooges ever.  And once in place, the program could be expanded bit by bit.  But, this would require some crafty and nuanced political strategy by the folks who write the bill, and I don't have much faith that there's a lot of that going around these days.

    There will be an immediate high risk pool (none / 0) (#30)
    by Joan in VA on Sun Jan 24, 2010 at 11:31:38 AM EST
    for uninsured adults with pre-existing conditions until 2014 in addition to the under-18 coverage is my understanding. After that, no pre-existing condition exclusions allowed for anyone.

    If it was allowed to continue unchanged, all those excluded adults would still be in the ER and one big reason for this whole drill was to get them out of there.I just can't see how reform happens at all if so.

    That's what's in the bill now (none / 0) (#31)
    by gyrfalcon on Sun Jan 24, 2010 at 11:37:00 AM EST
    The concern is what they appear to be talking about for a new, "scaled-down" bill.  And that seems to be covering pre-existing for kids only.

    Single Payer, for cryin' out loud (none / 0) (#37)
    by Lora on Sun Jan 24, 2010 at 01:34:32 PM EST
    "The health care system is a big, complicated system, and doing it right is hard."

    Uh Huh.  Don't insult my intelligence, Obama.

    Never have I thought this Congress or this administration would produce a bill that will actually be of benefit to me and mine.

    This BS just confirms my initial reaction.

    Progressives?  Hello?  Anybody out there with a pair to stand up to these yo-yo's?