About that HHS Report on Pre-Existing Conditions

posted at 7:40 pm on January 18, 2011 by John Sexton

Is the Department of HHS now reporting to White House political director Patrick Gaspard? It certainly looks that way based on the timely release of a new report today:

As many as 129 million Americans under age 65 have medical problems that are red flags for health insurers, according to an analysis that marks the government’s first attempt to quantify the number of people at risk of being rejected by insurance companies or paying more for coverage.

The secretary of health and human services released the study on Tuesday, hours before the House began considering a Republican bill that would repeal the new law to overhaul the health-care system.

You can read the report for yourself here. What HHS has done is revive the big numbers game that the administration used to push health reform in the first place. Remember how there were 46 million uninsured? Then it was suddenly 30 million in the President’s address before Congress. Now they’ve got an even bigger number to bandy about, 129 million Americans with pre-existing conditions. But pay close attention to how HHS came up with that 129 million figure:

Because pre-existing conditions are determined by insurer practices which vary, two estimates of the number of non-elderly individuals likely to be denied coverage in the individual market were constructed.  The first includes only conditions that were identified using eligibility guidelines from State-run high-risk pools that pre-dated the Affordable Care Act.  These programs generally insure individuals who are rejected by private insurers.  As such, the “lower bound” estimates are people with a health problem likely to lead to a denial or significant mark-up or carve-out of benefits.  The second includes additional common health and mental health conditions (e.g., arthritis, asthma, high cholesterol, hypertension, and obesity) that would result in an automatic denial of coverage, exclusion of the condition, or higher premiums according to major health insurers’ underwriting guidelines identified using internet searches.  Individuals with these conditions would at least get charged a higher premium but could also have benefits carved out or be denied coverage altogether.

So the 129 million Americans figure, which is already appearing in headlines, includes five common maladies which might result in higher premiums. In fact, if you skip down to the methodology section, the dragnet is even broader than that:

Individuals with five common conditions – arthritis, asthma, high cholesterol, hypertension, and obesity (BMI > 35) – were included in the second measure, as were individuals who had “ever been” diagnosed with arthritis, asthma, high cholesterol, or hypertension

In addition, individuals who were currently being treated for neurotic and related disorders, stress and adjustment disorders; conduct disorders; emotional disturbances; and including attention deficit hyperactivity disorder (ADHD) were included in the second measure, as were individuals who had ever been diagnosed with ADHD.

If you’ve ever been diagnosed with a common, treatable illness like hypertension or ADHD (which affects about 4% of American adults), you fit into the broad HHS definition as someone with a pre-existing condition. Again, this is a bald-faced attempt to come up with a big number.

In case you have any remaining doubt that this is a political effort, check out this conclusion:

A central element of the Affordable Care Act, passed by the last Congress and signed into law by the President, is a new set of patient protections that prohibit insurance companies from denying coverage to Americans because they need it…Rescinding the new health insurance protections would, now and starting in 2014: Reduce the health care and health insurance options of the 50 to 129 million Americans with pre-existing conditions…

This is the White House’s latest attempt at messaging on health reform. It’s a little surprising how completely HHS seems to have been turned over to that effort. After all, this report isn’t about carrying out the law as written, which is HHS’ job; it’s about winning a current political debate through a creative use of statistics designed to grab headlines. Is that sort of politicization what we should expect under this administration?


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Is that sort of politicization what we should expect under this administration?

Did the sun rise in the East today?

Schadenfreude on January 18, 2011 at 7:45 PM

The Death Panels will that that 129 Million number down to a more manageable number.

portlandon on January 18, 2011 at 7:47 PM

Well, they can’t have it both ways. More people with pre-existing conditions means higher initial costs for this boondoggle.

The reps need to hammer that hard and then the games Obama is playing become crystal clear.

csdeven on January 18, 2011 at 7:47 PM

Is that sort of politicization what we should expect under this administration?

Pretty much. But I’m still waiting for the Presiden’t address and the MSNBC coverage that shows children dying in the streets from pre-existing conditions.

If they were smart they’d project how global warming will lead to pre-existing conditions in epidemic proportions.

hisfrogness on January 18, 2011 at 7:50 PM

I was about to say par for the course, but this is more like 6 or 7 under par.

This is not the political propoganda you’re looking for….move along.

BobMbx on January 18, 2011 at 7:51 PM

The Death Panels will get that 129 Million number down to a more manageable number.

portlandon on January 18, 2011 at 7:47 PM

portlandon on January 18, 2011 at 7:51 PM

The second includes additional common health and mental health conditions (e.g., arthritis, asthma, high cholesterol, hypertension, and obesity) that would result in an automatic denial of coverage, exclusion of the condition, or higher premiums according to major health insurers’ underwriting guidelines identified using internet searches.

Say what?? I’ve been diagnosed with asthma since I was six years old, and it has never once affected my eligibility for health insurance or the rate I’ve paid.

Socratease on January 18, 2011 at 7:55 PM

As many as 129 million Americans under age 65 have medical problems that are red flags for health insurers, according to an analysis that marks the government’s first attempt to quantify the number of people at risk of being rejected by insurance companies or paying more for coverage.

The secretary of health and human services released the study on Tuesday, hours before the House began considering a Republican bill that would repeal the new law to overhaul the health-care system.

Translation: It’s time once again to crank up the CLIMATE OF FEAR PROPAGANDA MACHINE!

pilamaye on January 18, 2011 at 7:55 PM

In addition, individuals who were currently being treated for neurotic and related disorders, stress and adjustment disorders; conduct disorders; emotional disturbances; and including attention deficit hyperactivity disorder (ADHD) were included in the second measure, as were individuals who had ever been diagnosed with ADHD, broken a bone, cought a cold or flu, had a booboo, or ever sneezed, or ever knew or heard of someone who had.

BobMbx on January 18, 2011 at 7:55 PM

The only pre-existing condition that I have is life and citizenship therefore, I must play.

Electrongod on January 18, 2011 at 7:57 PM

This is the White House’s latest attempt at messaging on health reform. It’s a little surprising how completely HHS seems to have been turned over to that effort. After all, this report isn’t about carrying out the law as written, which is HHS’ job; it’s about winning a current political debate through a creative use of statistics designed to grab headlines. Is that sort of politicization what we should expect under this administration?

.

As they are writing the law as they go, why is it surprising?

This sound familiar ” As determined by the secretary” or ” to be determined by the administrator…” etc. . It does not surprise me one bit that HHS is just another mouthpiece for the White House.

bluemarlin on January 18, 2011 at 7:58 PM

Propaganda.

Knucklehead on January 18, 2011 at 8:00 PM

HHS – make the LIE big enough and everyone will believe it.
Hey, what happened with all those with pre-existing conditions who were now going to be able to purchase policies thanks to ObamaCare……oh, yeah….they still can’t afford them.

GarandFan on January 18, 2011 at 8:01 PM

I’m surprised they didn’t include people expected to age in their calcs.

BKeyser on January 18, 2011 at 8:01 PM

Knucklehead exactly. Pretty pathetic. I saw Nancy P. talk about it today . What a whack job she is. She just ate it up and spewed it out.

CWforFreedom on January 18, 2011 at 8:02 PM

And there are 20M cars out there with pre-existing damage. If you have one tell your agent, “I wanna buy insurance so I can get these dings fixed,” and see what happens.

Akzed on January 18, 2011 at 8:02 PM

“Also included: allergies, pimples, and cavities”. Just about.

michaelo on January 18, 2011 at 8:04 PM

And there are 20M cars out there with pre-existing damage. If you have one tell your agent, “I wanna buy insurance so I can get these dings fixed,” and see what happens.

Akzed on January 18, 2011 at 8:02 PM

Actually in the case of health insurance they will still manage much of the pre existing issues while I know of no car insurance policies that fix prior issues.

CWforFreedom on January 18, 2011 at 8:07 PM

Is that sort of politicization what we should expect under this administration?

Rhetorical question, right?

Midas on January 18, 2011 at 8:07 PM

Want to save some money? Get rid of HHS and everything associated with it. Yeah, that includes SSI.

upinak on January 18, 2011 at 8:09 PM

In addition, individuals who were currently being treated for neurotic and related disorders…

So this includes folks who are simply ‘liberal’, but only if they’re ‘currently being treated’ for it?

What about all of those other poor delusional liberals who aren’t already seeking treatment? DOES NO ONE CARE ABOUT THEM??!?!!?111/ *weepy weepy dramatic sob for effect*

Midas on January 18, 2011 at 8:10 PM

“Is that sort of politicization what we should expect under this administration?”

To ask the question is to answer it. This whole outfit is as crooked as a dog’s hind leg (I love rustic references).

Mason on January 18, 2011 at 8:12 PM

So if the insurance companies refuse to insure half the people in the U.S., from whom will they get premiums?

SlaveDog on January 18, 2011 at 8:18 PM

So if the insurance companies refuse to insure half the people in the U.S., from whom will they get premiums?

SlaveDog on January 18, 2011 at 8:18 PM

They go out of business which is what this BS is all about. Remember big corporations are evil.

Knucklehead on January 18, 2011 at 8:20 PM

My fingers always suffer from sking splits near the end of my nails in cold weather, therefore I have a preexisting condition. Where’s my free gubmint lotion?

Bishop on January 18, 2011 at 8:21 PM

But pay close attention to how HHS came up with that 129 million figure:

Just wait until they add in the liberalism disorder—now we’re talkin’ trillions.

Rovin on January 18, 2011 at 8:22 PM

129 million? Really? Really? Not counting over 65 yr olds?

Given about 310 million Americans, and a WAG of 15% senior citizens (> 65 yrs of age) or 46 million seniors, leaving 263 million non-seniors, then every other American has a pre-existing condition. What total bullshit. How can they believe that anyone can take these numbers seriously?

parke on January 18, 2011 at 8:28 PM

My fingers always suffer from sking splits near the end of my nails in cold weather, therefore I have a preexisting condition. Where’s my free gubmint lotion?

Bishop on January 18, 2011 at 8:21 PM

Two blocks down on the left, look for the Kool Aid stand and order the Obamaglo flavor, all better now, right?

bluemarlin on January 18, 2011 at 8:30 PM

129 million? Really? Really? Not counting over 65 yr olds?

Given about 310 million Americans, and a WAG of 15% senior citizens (> 65 yrs of age) or 46 million seniors, leaving 263 million non-seniors, then every other American has a pre-existing condition. What total bullshit. How can they believe that anyone can take these numbers seriously?

parke on January 18, 2011 at 8:28 PM

Precisely! I ran this past my kids when I first heard the number and they realized that it was nonsense. I understand that the MSM is in the tank for Obama & print this stuff without even thinking about it, but are Americans really so passive & unthinking that they accept it? I know that the MSM expects them to, but do people really believe this, something that really, really simple math proves to be absolutely absurd? And how can they continue to pay attention to the media when they treat them like such morons?

29Victor on January 18, 2011 at 8:41 PM

Is the Department of HHS now reporting to White House political director Patrick Gaspard?

Is this really any different from that DHS report on “right wing extremism” meant to discredit the Tea Parties right before the Tax Day 2009 events?

malclave on January 18, 2011 at 8:41 PM

But but but Jugears gives such wonderful, uplifting speeches. I’m sure he has turned over a new leaf and it is just a bunch of rogue appointees spewing out this propaganda.

Really, it’s true, I read it right here at HA.

GnuBreed on January 18, 2011 at 8:45 PM

129 million? Really? Really? Not counting over 65 yr olds? … How can they believe that anyone can take these numbers seriously?

parke on January 18, 2011 at 8:28 PM

The same people that believe this 129 million are the same that believe that the sea level would rise 100 feet and snow would be a thing of the past. And that a cross-hair on a map cause anyone to do anything.

tjexcite on January 18, 2011 at 8:46 PM

Krauthammer just said on O’Reilly that Obamacare will and should decide the 2012 election—-OUCH!

Rovin on January 18, 2011 at 8:54 PM

Shameless lying fascists. I really do hate these people.

American Elephant on January 18, 2011 at 8:58 PM

I wonder where crr6 is?

darwin on January 18, 2011 at 9:11 PM

When it comes to advancing their agenda, the Democrats play in the major leagues.

The Stupid Party doesn’t even know what hit them.

rickyricardo on January 18, 2011 at 9:20 PM

Come on, Kathleen.
http://www.nationalreview.com/critical-condition/257413/come-kathleen-avik-roy

What kind of numerical ju-jitsu is this idiot trying to pull?

onlineanalyst on January 18, 2011 at 9:30 PM

A nice big, juicy fat number…just in time for the SOTU speech.

How convenient.

catmman on January 18, 2011 at 9:32 PM

With my penetrating oracular vision, I foresee that if Obamacare is repealed, you will all die. If it is not repealed, on the other hand, you will all die. Moreover, I see the present as sharply as I do the future. Know, then, that most of you are old and ugly, and all of you are getting older and have begun or will soon begin getting uglier every year. You are probably too dull to see these matters as clearly as I do, but even so, you will probably get even duller as you get older and uglier. You see, then, that it is not so much that you have pre-existing conditions as that you are pre-existing conditions. Please schedule your replacements, and do so promptly, so that you will have time to wean and potty-train them before you die. Thank you. That is all.

Kralizec on January 18, 2011 at 9:33 PM

Given about 310 million Americans, and a WAG of 15% senior citizens (> 65 yrs of age) or 46 million seniors, leaving 263 million non-seniors, then every other American has a pre-existing condition. What total bullshit. How can they believe that anyone can take these numbers seriously?

parke on January 18, 2011

And how many of the 263 million non-seniors are little kids who haven’t had any pre-existing conditions?

This reminds me of the ridiculour figure spouted often during the Clinton “reign” that 3,000 children every day started smoking.

Sloan Morganstern on January 18, 2011 at 9:39 PM

This is the White House’s latest attempt at messaging on health reform. It’s a little surprising how completely HHS seems to have been turned over to that effort. After all, this report isn’t about carrying out the law as written, which is HHS’ job; it’s about winning a current political debate through a creative use of statistics designed to grab headlines

Its also an admittance to have lost the original healthcare debate, wasting taxpayer time,energy,and money and– having passed and signed terrible legislation against the will of the American electorate– will continue on doing exactly the same thing– trying to sell taxpayers on the same exact failed ideas that voters voted against in the November elections. Insanity. But no one is talking about that. Maybe everyone should be.

canditaylor68 on January 18, 2011 at 10:26 PM

Did the sun rise in the East today?

Schadenfreude on January 18, 2011 at 7:45 PM

No, it stayed below the horizon. Sunrise won’t happen until March.

unclesmrgol on January 18, 2011 at 11:37 PM

Hmmm… Ts this a slow news day, or PRESSSSidential farting?

Could it be this include folks who might pay more for HC because of ‘issues’ like being over 50. Toss in those with significant weight problems and you’re pretty close to a couple bazillion Americans. So what else is new?

Seems this poll is all about “there is a right for everyone’s health care to cost them the same amount — nothing”.

drfredc on January 19, 2011 at 12:25 AM

The last sentence puts the estimate somewhere between 50 and 129 million!! Sounds like an implicit admission that they’re just making this s$&t up as they go along.

LASue on January 19, 2011 at 2:27 AM

All Americans are human.

All humans are mortal.

Mortality is a problem that ends life.

Therefore, all Americans have a pre-existing condition: they are alive.

The government will help you on that little problem as there are too many uncovered Americans with pre-existing conditions.

6′ under enough coverage for you?

ajacksonian on January 19, 2011 at 7:28 AM

All they have to add to the list is bad breath and body odor, and the entire Democrat party in the pre-existing condition pool.

VelvetElvis on January 19, 2011 at 7:29 AM

Today, the Department of Health and Human Services and the Census Bureau will be making a joint announcement. The Census Bureau will provide the final adjusted population figure for the United States, and HHS will announce that 100% of the population has pre-existing conditions.

olesparkie on January 19, 2011 at 7:47 AM

Um, I’m asthmatic. I’ve never been denied health insurance or had to pay a higher premium. This is just bald-faced lying.

rbj on January 19, 2011 at 8:22 AM

since when do we expect liberals to even pretend to have any honesty whatsoever?

I used to believe liberals were decent people who simply had very different ideas on how the gov’t should operate and how to make america better for everyone.

Now I firmly believe that the liberal leaders (not the rank and file voters who don’t really understand anything but are willing to vote for pie-in-the-sky “solutions”) are evil and dishonest to their core.

I can’t believe that otherwise intelligent individuals don’t realize that they are lying, that their ideas have failed everywhere they have been tried, that economics informs us that it is impossible for the gov’t to provide quality “free” anything to anyone.

So, the only possible truth is that these people know they are harming the country and do it b/c it increases their power and the possiblity of pure socialism occuring, which in their minds will make them rulers because they are the “elite”. There can be no other answer for their behavior. For instance, promising to insure “40 million” more people while reducing the costs and keeping accessability and quality of care the same. That is impossible and they know it (unless they truly are that stupid).

They either know they are bold face lying to everyone or they are too stupid to understand simple math and economics. It is nice to believe they are that stupid because it is difficult to believe there are that many truly evil people in the high echelon of our society. But the reality is that they cannot all be that stupid.

Monkeytoe on January 19, 2011 at 8:22 AM

I wonder if HHS includes these pre-existing conditions
According to the California-based advocacy group Consumer Watchdog, other possible situations falling under pre-existing condition clauses are chronic conditions as acne, hemorrhoids, toenail fungus, allergies, tonsillitis, and bubunions, hazardous occupations such as police officer, stunt person, test pilot, circus worker, and firefighter, and pregnancy and/or the intention to adopt.

My understanding of the law is that if you have had toenail fungus and have a recurrence during the exclusion period (which is triggered if one went without insurance for more than 63 days), you’ll have to pay for your toenails, but if you have, say, a heart attack you’ll be covered.

Am I wrong about this?

Buy Danish on January 19, 2011 at 8:48 AM

So.. the ultimate pre-existant would be birth .. and they’re obviously working hard to disallow that.

/.

CaveatEmpty on January 19, 2011 at 8:57 AM

Last time I checked, the definition of pre-existing condition didn’t include maladies that a person contracted after they were already insured, which knocks this 129 million number down by over 80%.

Vashta.Nerada on January 19, 2011 at 9:06 AM

Vashta.Nerada on January 19, 2011 at 9:06 AM

Exactly. And HHS is trying to scare people into thinking that if they have, say, ADHD they will be denied health insurance for any ailment in the future if they are not now insured.

Buy Danish on January 19, 2011 at 9:10 AM

How is it that these people can be taken seriously by even the most stupid among us when they come up with this ridiculous propaganda. This is pushing fear mongering past the limits.

Kissmygrits on January 19, 2011 at 9:33 AM

Individuals with five common conditions – arthritis, asthma, high cholesterol, hypertension, and obesity (BMI > 35)

So I’m supposed to subsidize the health insurance for my neighbor with bad diet and exercise habits? I understand there’s a genetic component to obesity, but when it comes to having to subsidize other people’s lifestyle choices…

taznar on January 19, 2011 at 11:52 AM

I’m confused. I was diagnosised (sp?) with hypertension in 1996. I have changed jobs and insurance plans numerous times, I have always been up front about my condition and I have never been denied coverage. HUH?? As long as it is treatable, Im told it can be covered.

Claimsratt on January 19, 2011 at 6:24 PM