Going Without Health Insurance to Qualify for Coverage

When the federal government stipulated that Americans had to have no health insurance for six months before they would qualify for the government’s high-risk health insurance plan, they weren’t hoping for people to drop any health insurance and go without for six months.  That has been an unintended consequence though.  According to Kaiser Health News’ “Taking A Risk To Secure Health Insurance,” freelance writer Randy Dotinga dropped his California high-risk health insurance in January to go without coverage for six months and qualify for the federal high-risk plan.  The reason is that there is a huge cost and benefits difference when you compare California’s high-risk health insurance and the federal program.

Unfortunately, the author only qualifies for high-risk plans because of his pre-existing condition, atrial fibrillation in his heart diagnosed at age 27.  He has a very low risk for complications, but could not find an individual health insurance company to insure him with his pre-existing condition label.  As a resident of San Diego, he opted for California’s high-risk health insurance plan.  He pays $9,000 a year for his PPO coverage, but its limits are extremely low.  With only $75,000 for annual spending and $750,000 of lifetime coverage, Dotinga would be in deep medical debt if he were to face a medical crisis.  The federal plan he is hoping to qualify for would only cost him $3,180 per year and would offer unlimited yearly and lifetime coverage, quite an upgrade.  Now you see why he is willing to risk going six months without health insurance.

Even if the government were to eliminate its six month requirement, they would have to find another way to keep it so that the numbers of Americans joining their plan was not out of control.  The need for health insurance coverage is high right now and many Americans are looking forward to a certain provision in the Health Care Reform Act that takes full effect in 2014.  Health insurance companies will no longer be able to deny coverage to Americans with pre-existing conditions.  This is good news for the author and others suffering from conditions like diabetes and asthma, but this good news might not come to fruition.  There is a good chance that President Obama’s health care reform will be overturned, leaving Dotinga with no option other than his low coverage, $9,000 a year California high-risk health insurance plan.

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