Millions of Americans are unable to obtain affordable health insurance due to pre existing conditions. Why are health insurance companies turning you down during the application process? Why won’t they approve your application? There is one main reason: individual states insurance department’s rating guidelines.
All 50 States have a department of insurance which set’s their own regulations and rating guidelines for all insurance companies that want to operate in their state. All insurance companies have to submit their rates to be approved. In some states they can change their rates at the time of submission to be approved later and other states require the rate change to be approved before the rate change take effect.
Either way, if an insurance company were to submit a rating classification for high risk individual health insurance, it would be immediately declined by the state’s department of insurance due to the high premium that would be associated with such policy. The premium would exceed the states allowable threshold.
Insurance companies would accept individuals with pre existing conditions if the states would allow them. The consumer’s primary concern should not be directed toward the health insurance companies but should be directed toward the state’s insurance department. Also, if the insurance companies were allowed to set adequate premiums for high risk individuals, the public would clamor about not being able to afford the premium. The consumer is caught in the middle: access to high risk insurance policies but no means to afford them.
Under the current state guidelines, insurance companies do not want to adapt high risk policies while trying to set the lowest possible premium to remain profitable. That is why health insurance companies do not want you with your conditions. You are too difficult to balance profit against affordability. The companies know how much you are going to cost them in the long run given any condition. They weigh that cost against what they are allowed to charge in acceptable premiums by state insurance departments.
State mandated high risk pools are a good solution to access affordable health insurance for Americans with pre existing conditions. It allows unhealthy consumers access to quality healthcare without taking all their money but still having access to private health insurance provider networks.
The answer to healthcare reform does not need to come from Washington. We should look closer to home for some answers to our problem. Talk to your state representative about what your state can do make healthcare more affordable to Citizens in your situation. In the mean time, if you are one of the millions uninsured Americans looking for an alternative to affordable high risk health insurance, discount medial and dental plans are a viable option or your states Medicaid program if your income is low enough to qualify.