We’re Tired

Can you really talk something to death? Can you stress over an issue, every day, to the point that you are just numb?  Health Insurance?  It appears that the new Republican goal is to do just that.  In just the last week we have been told by President Trump that he has repealed Obamacare (The Patient Protection and Affordable Care Act), that he has severely damaged it, and that Congress’s next task is to fix Obamacare in a bi-partisan fashion.  I’m tired and I’m not alone.

The PPACA has proven to be far more resilient than anyone imagined. Abandoned at birth by some of the very people who had created it (The Gang of Six), the law was relegated to a life with a parent (the Democrats) who didn’t always understand it and consistently failed to explain both its benefits and drawbacks to the American public.  For seven years the Republican controlled Congress has proven that “sticks and stones may break my bones, but words will never hurt me”.  The 60 plus faux attempts to repeal Obamacare may have riled up the base and kept the campaign funds coming, but they had little impact on the law.   And in 2017, in the year of Trump, we have seen the end of the funding for the Cost Sharing Reduction, a 50% reduction in the Open Enrollment Period, and, last week, the elimination of the Individual Mandate.

So this time he succeeded? Obamacare is dead, right?  Not so fast.

Cleveland area insurance agents became reacquainted with our clients in 2017’s Open Enrollment Period. There was a major change in our market.  Anthem Blue Cross, a major player since 1985 when the then Community Mutual Blue Cross Blue Shield of Cincinnati invaded Cleveland, chose to stop selling individual policies until the Cost Sharing Reduction got resolved.   Mr. Reliable, Medical Mutual of Ohio, found it necessary to move policies on individuals, under age 65, purchased after 2014 away from the Cleveland Clinic Foundation.  And the Cleveland Clinic formed a partnership with New York based Oscar to market their own policy.

Due to the PPACA, agents no longer ask health questions or engage in medical underwriting. We used to get involved with claims issues, but HIPAA ended that.  So imagine our surprise when we got calls like this:

“Dave, I really like Medical Mutual, but my cardiologist is at the Clinic”.


   “Yes.  I had quadruple by-pass in February”.

“Wow. I didn’t know. Didn’t I see you over the summer at an art show?  You didn’t say anything about this.”

The last two months have been filled with talks about cancers, heart conditions, and expensive dermatology treatments. Who knew?  More importantly, which insurance company would cover these people if there was medical underwriting and the possibility to decline a bad risk?  The clients come in, concerned, sometimes crying, hoping to hear that they can still purchase health insurance for another year.  AND THEY CAN.

But the stress is showing. How many times can you walk to the edge of the abyss before you fall in?  If you are working your way through a major illness, facing months of treatment, and hundreds of thousands of dollars of medical expenses, you hope that this is all a bluff.  You hope that the president will forget about health care and his fixation on all things Obama and move on to something less consequential.  Like Korea.

But more than anything else, you’re tired.



Photo – “It’s True It’s True” – David L Cunix


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One Response to We’re Tired

  1. Michael Saltzman says:

    Conception is an pre-existing condition.
    David – If you ever see this on a T-Shirt, I am a XXL.

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