[chimeracoder]

No, you are misreading it. They cannot limit benefits due to your condition, but that doesn't mean that they have to cover treatment for your condition.

If you have a disease or syndrome, the treatments for that condition (whether pharmaceutical, outpatient, or inpatient) may simply not be on the list of benefits provided by the insurance plans offered.

It's legally distinct from, but analogous to, a nodiscrimination clause. They can't refuse to cover your mammogram (which they cover for everyone else) just because your initial diagnosis for Vamipiric Brain Syndrome occurred before your plan went into effect. But they can choose to say they they don't cover Nosferatudone for anyone (when Nosferatudone happens to be the only effective treatment for Vamipiric Brain Syndrome).

(There are, separately, certain treatments that all insurance plans must cover by law, although that's separate from the ACA, and it's a very limited set).

[giaour]

The ACA has "minimum value" requirements and defines what constitute "essential health benefits" that plans must include to satisfy the ACA's coverage requirements and be eligible for sale on healthcare.gov or state-level marketplaces: https://www.healthinsurance.org/obamacare/essential-health-b...

[chimeracoder]

> The ACA has "minimum value" requirements and defines what constitute "essential health benefits" that plans must include to satisfy the ACA's coverage requirements and be eligible for sale on healthcare.gov or state-level marketplaces

Yes, I'm well aware of that, and those requirements are incredibly bare-bones. Nearly any insurance provided by employers far exceeds those requirements, whereas the same cannot be said for insurance provided on the marketplace.

This post is about people who are losing employer-provided insurance, and there's almost no universe in which the non-COBRA options available to most of those people aren't markedly worse than what they're losing, even if we ignore the increased cost of self-purchased insurance.

[rcme]

Yes, you're always able to buy a bad health insurance plan. But you're also able to buy a good health insurance plan, and your pre-existing condition won't impact the price of the good insurance plan.

[chimeracoder]

> Yes, you're always able to buy a bad health insurance plan. But you're also able to buy a good health insurance plan,

If one exists, and as I stated in the original post, in many states, even the best plans available on the marketplace are quite terrible. And that's a problem that's actually gotten worse in recent years, not better, as plans have left the exchange (and providers have dropped marketplace plans from their networks).

> and your pre-existing condition won't impact the price of the good insurance plan.

Your "pre-existing condition" won't impact the price of the insurance plan relative to others who are purchasing that same plan, but you quite likely will be in a situation where the "good" (eg, gold) plans are the only ones which will provide the coverage that you need, and those are the most expensive ones. This satisfies the letter of the law, but in practice it still means that often people with chronic health condition either are are forced to pay more for coverage or are literally unable to get coverage for their conditions at all (because none of the marketplace plans will cover it).

The protections provided by the ACA are much more narrow than you're portraying them as, which is understandable because it's a common misconception about how the ACA operates, but it's unfortunately a very important distinction.

[rcme]

Do you have any evidence that the plans aren't sufficient? Others in the thread have mentioned they have gotten nearly identical plans to their old employer plans. People I know who buy their own health insurance have totally adequate coverage, and this is in a "blue northeast state" that, according to you, has inadequate options.

[chimeracoder]

> Others in the thread have mentioned they have gotten nearly identical plans to their old employer plans.

One person said this, without mentioning either their state or any details of their previous plan.

> a "blue northeast state" that, according to you, has inadequate options.

I did not say that every "blue, northeast state" has "inadequate options". I said that many states have terrible options, and that, contrary to the stereotype of ACA issues being limited to poorer red states that refused to expand Medicare, this set includes wealthier blue states.

> Do you have any evidence that the plans aren't sufficient?

You stated that "public exchanges are guaranteed to cover their existing condition", an assertion of universality. This is completely false, for reasons that I have explained. The federal statues guaranteeing coverage for individual conditions are incredibly narrow and exclude both the most expensive conditions for patients, as well as almost all expenses for chronic conditions.

Furthermore, it's very easy to disprove this assertion of universality, because it's incredibly easy to find counterexamples - the ACA has been around for a decade, and there are tons of forum posts all over the past ten years from people struggling to find non-COBRA coverage that continues to match their needs after losing a job. A marketplace plan cannot deny you an insurance plan for a preexisting condition, but that doesn't mean that there exists a marketplace plan that will cover it.

The fact that you happen to know people who are satisfied with their coverage for themselves is neither here nor there, because it does not contradict the main point: the ACA is no guarantee that people losing their jobs will actually have any non-COBRA options to address their health needs (and given that Microsoft has pretty comprehensive insurance and employs people in nearly every state, it's all but certain that the marketplace options will be appreciably worse for many of those people than the status quo).

[rcme]

Wow, a lot of words and not a shred of evidence that some blue northeast states have inadequate coverage. Yes, some blue states having adequate coverage does not mean all such states have adequate coverage. However, you have provided absolutely no evidence of inadequate coverage in a blue northeast state. So what do we know? At least some blue northeast states, and maybe all blue northeast states, definitely have adequate coverage.

[chimeracoder]

Let's be clear: you made a bold claim without evidence. I responded with an explanation of why your claim is incorrect, based on the actual text of the law which defines the terms. I also provided specific examples of the differences, which are in the post you just responded to.

At no point have you provided any actual evidence, other than an unsourced offhand anecdote (which I addressed), to support your bold initial claim.

I've taken the time to provide much more in the way of both evidence and explication than you have presented. If you'd like more, then perhaps first you can provide some concrete evidence to support the scope of your original, claim, and also address the specific examples that I revealed which refute the premise of your claim.

[foogazi]

> But they can choose to say they they don't cover Nosferatudone for anyone

Does private employer insurance not have the same limitations?

[chimeracoder]

> Does private employer insurance not have the same limitations?

Yes, but insurance sold to private employers is a completely different market, and it is almost universally better than the insurance plans available on the exchanges.