It’s a scary thing, to hear something that’s been lurking over you for decades get a name.
My therapist used words like “depression” and “anxiety.” Maybe some people take comfort in it. I didn’t. I met those labels face-to-face, for the first time, and no weight lifted from my shoulders. But it was a start.
It’s also evidence of a pre-existing condition. And if Obamacare’s repealed, it’s possible that people could be denied coverage for something like what I’m doing right now: Writing about their mental illness on websites and social media. That could include me, and millions of other Americans who’ve taken to the internet to give and take solace in the sharing of these intensely personal experiences.
There aren’t actually reports of insurance companies scrolling through Facebook feeds and rejecting claims because of a status update—yet. If the Affordable Care Act, which guarantees coverage to people with pre-existing conditions, gets repealed?
It’s absolutely something insurers could do.
“It depends on how the pre-existing condition is defined in the insurance policy, but it could very well be the case that you could be at risk even if you never saw a doctor or otherwise received any treatment for the condition,” Tom Baker, an expert in insurance law at Penn Law, told me. “The situation is that serious.”
In the GOP’s Obamacare replacement, pre-existing conditions are still covered. But there’s no guarantee it’ll survive Congress, seeing as Breitbart and plenty of Republicans have blasted the legislation for not being conservative enough.
Donald Trump’s failsafe plan is just as worrisome: Let Obamacare die, blame the Democrats, then try to pass something else in a few years. Even if the GOP plan passes, many experts think that without the individual mandate requiring people to buy insurance, the health insurance market could enter a “death spiral,” as not enough healthy young people sign up to subsidize the elderly and sick.
In other words, we’d be back where we started.
Three years before President Barack Obama signed the Affordable Care Act in 2010, one out of seven applicants were denied coverage because of a pre-existing condition, by the four biggest for-profit insurers: Aetna, Humana, UnitedHealth Group and WellPoint.
It’s not clear how many of those people had mental health conditions, because insurance companies don’t legally have to disclose that information. They can, however, look at information you post on social media. As long as it’s public, it’s fair game, and can be used by insurance companies as proof of a pre-existing condition.
“It doesn’t matter if you’ve sought out help for a pre-existing condition or not, so long as there is evidence that you do indeed have the condition,” said Allison Hoffman, a professor at the UCLA School of Law.
1 out of 7 applicants were denied coverage because of a pre-existing condition
Tech companies have already researched how to analyze your social networks to determine whether you’re a credit risk. It’s not much of a technical leap to imagine an algorithm searching for words like “bipolar” or “depression.” It just might not be cost-effective.
“It’s possible that some insurers would invest in data-mining software to find pre-existing conditions or risky behaviors to deny insurance when someone applies,” Hoffman said.
“But I think it’s much more likely that they would go hunting for information once an insured [patient] files for expensive claims.”
Just how stingy were insurance companies before the ACA?
In a Kaiser Family Foundation study from 2001, researchers made up a recently widowed 56-year-old woman, “Emily,” who suffered from situational depression — meaning it wasn’t chronic, but stemmed from a depression she experienced after her husband suddenly died. They sent out her application to 60 insurance companies. Twenty-three percent rejected her outright, while half sent her offers with premiums increased from 20 to 50 percent.
That’s right: being depressed because of a tragedy was something that prevented people from getting insurance. And according to the National Institute of Mental Health, “Emily” isn’t so uncommon: The NIMH estimated 6.7 percent of all American adults (or 16.1 million people) experienced at least one major depressive episode over 2015.
And if you had bipolar disorder? Psychosis? There’s no way you were getting covered in the individual market, according to Sherry Glied, who served as assistant secretary for planning and evaluation at the U.S. Department of Health and Human Services under Obama.
“Mental health conditions were definitely pre-existing conditions,” she said. “They were serious pre-existing conditions. Companies do not like covering them.”
Mental health conditions were definitely pre-existing conditions
As a freelance writer before Obamacare, I didn’t make enough money to afford basic health insurance, let alone shell out the $600 a month for generic meds and therapy to treat my…