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Jackley’s ACA Lawsuit Imperils Coverage for 358,000 South Dakotans with Pre-Existing Conditions

Last month Dakotans for Health pointed out the widespread harm that repealing the Affordable Care Act could do in North Dakota. Now Dakotans for Health, led by spokesman Adam Weiland, puts out figures showing how much damage South Dakota would suffer if our Attorney General Marty Jackley, North Dakota A.G. Wayne Stenehejm, and eighteen other Republican state attorneys general led by Texas get the Trump Supreme Court to overturn the ACA. According to DFH, even if your health insurance would be safe post-ACA, the insurance of the South Dakotan sitting next to you probably wouldn’t be:

358,000 South Dakotans live with a pre-existing medical condition… of those, 50,000 are children, and 87,400 are adults between the ages of 55 and 64.

Prior to the passage of the ACA, people with medical conditions such as pregnancy, dementia, arthritis, cancer, diabetes, depression could automatically be denied insurance coverage.

Because of the Affordable Care Act (ACA), insurance companies can not deny coverage or charge individuals and families more because of pre-existing health conditions [Dakotans for Health, press release, 2018.08.08].

Repeal the ACA, and insurance companies can go back to padding their profits by denying affordable coverage to the people who need it most. 358,000 South Dakotans with pre-existing conditions would have to cling to whatever coverage they have, because the moment they change jobs and seek individual coverage as self-employed people, poof! away goes their insurance, and no private insurer will cover them.

As former North Dakota Congressman Earl Pomeroy said during DFH’s media tour up north in July, “We don’t think it’s unconstitutional for there to be a law protecting people against insurance companies.”

The harms to South Dakotans go well beyond the risk of becoming uninsurable again due to having a baby or a heart condition. Dakotans for Health has prepared this report chock full of stats on the positive impact the ACA is having in South Dakota and the harm Jackley would do by overturning it:

Here is how the Affordable Care Act is working in South Dakota:

19,000 South Dakotans gained health coverage because of the ACA.

Insurers can no longer deny or drop coverage because of a pre-existing condition. Because of the ACA, insurers in the individual market could no longer drop or deny coverage, or charge you more, because of a pre- existing condition. Roughly 350,000 South Dakotans have a pre-existing health condition.

Women no longer charged more than men. Because of the ACA, insurers can no longer charge women more than men for the same care.

Ended annual and lifetime limits. Because of the ACA, insurers can no longer put annual or lifetime limits on the care you receive.

Young adults can stay on their parents’ plan until age 26. Because of the ACA, roughly 6,000 young adults in South Dakota have coverage because they can stay on their parents’ coverage until age 26.

Free preventive care. Because of the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. This includes more than 390,000 South Dakotans, most of whom have employer coverage.

Comprehensive Coverage. Because of the ACA, insurers have to cover what are known as “essential health benefits,” such as maternity care, prescription drugs, and substance and mental health.

Tax credits are available to help people afford coverage. Because of the ACA, most people getting coverage on the marketplace qualify for tax credits to help pay for coverage.

Helping seniors afford prescription drugs. Because of the ACA, the Medicare prescription drug donut hole is closed. As a result, 12,563 South Dakota seniors are saving $12.5 million on drugs in 2016, an average of $994 per beneficiary [Dakotans for Health, “South Dakota Rural Health Report,” July 2018].

In the Texas lawsuit, A.G. Jackley is essentially recycling the arguments he crushingly lost in the Supreme Court against the ACA in 2012, hoping for some judicial activism from Justice Gorsuch and his next robed Trumpy buddy. Why an attorney general or any other elected official would put beating this ideological horse over the health and well-being of hundreds of thousands of South Dakotans is beyond me.

The upshot here is that even our votes for Attorney General could have an impact on public health. Democratic candidate Randy Seiler has said he disagrees with South Dakota’s lawsuit against the ACA. Elect Seiler in November, and he might be so busy protecting law and order that he might say it’s not in the public’s interest to keep expending A.G. resources on a lawsuit against a law the Supreme Court has already declared constitutional… and which the evidence has declared enormously beneficial to South Dakotans, North Dakotans, and the rest of America.

Related Listening: Learn more from Dakotans for Health driver Adam Weiland, who talked with Patrick Lalley about the challenge to the ACA on KSOO Wednesday.

26 Comments

  1. jerry 2018-08-10

    Obesity is a yuuuuge pre-existing condition and all that is related to having a two ax handle wide arse. Keep in mind, high blood pressure. 75% of the citizens of the state of South Dakota would not qualify for health insurance.

    “Obesity is an increasing problem both in the United States and South Dakota. Currently, 30.3 percent of South Dakota adults self-report being obese, which is higher than the national prevalence and also increasing at a faster rate than other states. The obesity rate for South Dakota 2- to 5-year-olds from limited-income households is 16.4 percent and above the national prevalence. Obesity prevalence among students Kindergarten through grade 12 was 16.0 percent for the 2009-2010 school year, not higher than national data.”

    So there ya go, why not just eliminate health insurance all together. When they go for your medical records to see what kind of lifestyle you have, it better be pristine. No kinds of infections like a bladder or a skin tag removed, who cares if it is benign or not, skin cancer will be the suspect, the doctor said.

    Meanwhile, Jackley rides into the sunset to a lucrative lobby job or some other form of payoff. When you have your benefit chili feed, invite him over and thank him for helping to bring your neighbors together to tell you how much they will miss you and what are you going to do with that north section of ground that is next to their’s. Yes, elections have consequences and as you go down the poorer lane, remember the good old days.

  2. bearcreekbat 2018-08-10

    It seems like there are three basic choices in SD regarding the medical needs of people with pre-existing conditions:

    (1) Require insurance companies to cover these people, thereby placing at least part of the cost on the people who pay all or or a portion of their insurance costs.

    (2) Shifting the cost of providing health care to hospitals and local taxpayers that fund the County Poor Relief programs with property tax dollars.

    (3) Deny any medical help to these people and let the chips (death and disability) fall where they might.

    What exactly is the current Trump/conservative/Republican position that wants to let insurance companes off the hook? Let people die? Or have local hospitals and the property tax payers cover the cost? I have been waiting for some other alternative by DFP’s local Trump trolls (you know who you are).

  3. mike from iowa 2018-08-10

    Happy to have your voice heard, again, bcb.

  4. bearcreekbat 2018-08-10

    So Jason’s response to my questions seems to be either (1) use taxpayer dollars to fund free clinics that apparently will cover the cost of the medical needs of people with pre-eisting conditions. Question – do you mean federal tax dollars or local property tax dollars. Or (2) simply ignore (i.e., let them die or become disabled) the 0.5% of people that he argues will be hurt by Republican changes to pre-existing condition rules because there are not enough people to worry about. Am I reading you correctly Jason?

    Thanks mfi!

  5. Jason 2018-08-10

    That’s just a starting point.

    Let’s start with some proof that 358,000 South Dakotans have pre-existing conditions. What is the definition of pre-existing condition they are using?

  6. bearcreekbat 2018-08-10

    Jason, You can use any definition you want.

    As an anecdote a friend of mine had some back problems. When they became extremely serious his pre-ACA insurance company denied coverage classifying it as a pre-existing condition. After several surgeries at the Mayo Clinic and treatments at the local hospital he incurred bills in excess of $600,000. His local country poor relief program paid out about $350,000 in county tax and he was forced into bankruptcy to relieve the rest of the debt after a forced sale of all his non-exempt property.

    The free clinic idea you advocate using tax dollars sounds pretty progressive. Allowing people to die or become disabled, even if only .05% of those with pre-existing conditions, seems a bit draconian, even for Trumpies. I thought Trumpies only wanted non-Americans to suffer and die.

  7. Porter Lansing 2018-08-10

    The Federalist is an invalid source.

  8. Jason 2018-08-10

    How long did he have his insurance before the issue?

  9. Jason 2018-08-10

    I want to know what definition the DFH is using.

  10. bearcreekbat 2018-08-10

    Jason as for how long he had his insurance – don’t know and it is not relevant. As for DFH, look it up (whatever it is) if you want to know – also seems irrelevant (which is not surprising given the attempt at distraction that I often read in your comments.

    Meanwhile I have run out of troll food, so unless you want to actually discuss the issue of how to, if at all, cover pre-existing conditions by law (more taxes, or insurance requirements, or nothing) rather than attempt at distractions, I’m done with your comments.

  11. Michael L. Wyland 2018-08-10

    Doing a Google search for “Dakotans for Health” produces no results for a website, corporate filing, funding sources, leadership, or the other typical results associated with an interest group. The report they link to is a decent first draft, but not nearly tight enough to withstand informed criticism.

  12. jerry 2018-08-10

    bcb, unfortunately, your story is not even a rare story for the pre ACA. Some acquaintances of mine both had serious health conditions. Their insurance company raised their rates each month for their location. I knew that Mutual of Omaha did that regarding zip codes, but was amazed an insurance company could do that to an individual (they both had separate policies) and they were the only two in the pool. They could not change to anything else so they had to keep them until they died.

    Cory’s post also touched on Medicare prescription drugs and how the ACA would have closed the dough nut hole. This is especially important to the Old Soviet as he is on Medicare but ignores his plight at his peril.

  13. jerry 2018-08-10

    A couple of posters here like happy camper, Comrade Jason as two for sure, like to point out that they have a grandfathered plan. What they do not know is that with those they have lifetime limits for what the insurance company will pay. That lifetime limit follows you and your plan for all expenses that the insurance company has ponied up on, all of them. 2 million seems like a lot, but as bcb clearly pointed out, that really is not that much in today’s money. The ACA/Obamacare has no lifetime limits or yearly limits, you are covered and that is that.

  14. Debbo 2018-08-11

    Russpublicans prefer BCB’s 3rd choice, let ’em die. That’s quite apparent from what they’re doing.

  15. jerry 2018-08-11

    Pre-existing mental health issues are reasons for not being able to get coverage pre-ACA/Obamacare. The problems we are facing today have more to do with not having enough qualified practitioners to take care of our needs, like this guy who stole a passenger jet yesterday and rammed it into the ground. We really do have to be our brothers keeper…that and having more access to mental health with no repercussions for seeking help.

    “But security screening and regular background checks can’t pick up changes in a person’s behavior. Only observation by close family and colleagues can do that and in one horrendous case all those checks failed: Andreas Lubitz, the copilot of a Germanwings flight in 2015 who waited for the captain to leave the cockpit, sealed the cockpit door, and flew his Airbus A320 deliberately into a mountain, killing himself, 144 passengers and six crew.

    In that case, strict German laws about the privacy of personal medical conditions had prevented doctors from alerting the airline that Lubitz, who feared without reason that he was going blind, was becoming suicidal.”

  16. mike from iowa 2018-08-11

    First I heard of any civilian casualties.

  17. jerry 2018-08-11

    The simple solution would be to put the ACA/Obamacare back to what it was originally. Medicaid Expansion, the Risk Corridor, Individual mandate (just like Medicare Part D passed in 2003). Both parties worked together in 2003 to fix the Medicare Part D as it was one helluva mess. Could still be done and it would be better than Medicare for all.

  18. Anne Beal 2018-08-11

    When your annual deductible is $6700, it’s kind of like not having coverage at all anyway, with or without pre-existing conditions. With deductibles that high, you just better not get sick.

  19. Jason 2018-08-11

    Jerry,

    The risk Corridors were never permanent.

    You would think with all the time on your hands you would be able to tell the truth on this board…

  20. Jason 2018-08-11

    Anne,

    Cory and the rest on here never mention the high deductibles.

  21. jerry 2018-08-11

    Anne Beal, as an older American (your claim), here is what to look forward to. Maybe it would be the best to just transfer the cost of healthcare to the taxpayers and eliminate it completely…or fix it. The elderly are broke and going further into the hole each minute.

    “For a rapidly growing share of older Americans, traditional ideas about life in retirement are being upended by a dismal reality: bankruptcy.

    The signs of potential trouble — vanishing pensions, soaring medical expenses, inadequate savings — have been building for years. Now, new research sheds light on the scope of the problem: The rate of people 65 and older filing for bankruptcy is three times what it was in 1991, the study found, and the same group accounts for a far greater share of all filers.

    Driving the surge, the study suggests, is a three-decade shift of financial risk from government and employers to individuals, who are bearing an ever-greater responsibility for their own financial well-being as the social safety net shrinks.” New York Times 08/09/2018

  22. Jason 2018-08-11

    Jerry wrote:

    “three-decade shift of financial risk from government.”

    Please explain what this is about Jerry?

  23. mike from iowa 2018-08-12

    From Forbes that bastion of liberal claptrap-

    High deductibles in individual plans have grabbed headlines during the political debate over the future of the Affordable Care Act, but the reality is that they have been common in employer sponsored plans and are becoming the dominant form of insurance offered by self-insured employers and insurers who sell group coverage.

    “While there has always been a lot of attention drawn to the high deductible plans on the ACA marketplace, the high deductible plan is truly becoming ubiquitous in the commercial sector,” said Katherine Hempstead, senior advisor at the Robert Wood Johnson Foundation.

    Many people with ACA were eligible for subsidies which helped pay their deductibles but stoopid bought and paid for wingnuts put an end to that in their over zealousness to make ACA fail. And they still haven’t succeeded, ACA is far more popular than stoopid effing wingnuts.

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