New Healthcare Requirements for US Immigrants

[Whanlin 42]

3 minutes ago, Jorgedig said:

Oh, I wasn't joking.  I've been an RN for 20 years, the last 15 in oncology.  I have seen first hand how diagnoses can ruin people financially.  I think it is very irresponsible to not have health insurance.  I can't understand it not being a priority and a significant factor when taking a job.

Crazy how the other half has to live huh. Maybe in the next life I'll get the luxury of options. 

[artcodex 28]

1 minute ago, sol_sol said:

Is not there any way parents can buy private insurance before entering?

The only way I've seen is travel insurance companies that offer limited new immigrant insurance policies, these are few and far between and don't really conform to the ACA. It's hard to tell right now without clarification if this will satisfy the requirements for the changes (even though it seems these changes will effect IR-5 differently anyway).

[sol_sol 31]

I think the medical tests are the key. here.They will see overall health now rather than just communicable diseases 

[vivfran 64]

Hello! How does this affect a person who is adjusting their status / waiting to get their green card? I dont have health insurance and getting on my wife's health insurance would be pricey. I just figured I'd wait to get my own health insurance when I got my job. Let me know. Thanks!

[Lil bear 4,263]

5 minutes ago, artcodex said:

right there is still the public charge test they have to pass, it usually comes down to income being enough from sponsor / any assets income for parents, but I wonder if internally they set a higher income barr then what is publicly the minimum (125% of poverty line).

The public charge test is different to assessing the future health risk of a beneficiary. Far more difficult that requiring a certain balance in the bank account or a certain income 

[yuna628 9,689]

3 minutes ago, Jorgedig said:

Oh, I wasn't joking.  I've been an RN for 20 years, the last 15 in oncology.  I have seen first hand how diagnoses can ruin people financially.  I think it is very irresponsible to not have health insurance.  I can't understand it not being a priority and a significant factor when taking a job.

 I was uninsured once. Then got very sick. Big bills to pay, but whatever I did it, learned a little and then bought insurance. Still, I made very sure to keep that very expensive insurance, and add my husband to it when he got there, even as it drained our savings. And yes, insurance is a significant factor I think when accepting a job offer, but in my husband's case when he started out he didn't have any options but a part time, no insurance job. But I knew it would give him potential and lead him to the full time position which now offers us great health insurance. They've rewarded his loyalty and six month gamble well.

 

But I understand, every state is different, and not every job will offer insurance. Sometimes it's all that's available until you get experience or a foot in the door, or you're young or just starting out.

[artcodex 28]

4 minutes ago, Lil bear said:

The public charge test is different to assessing the future health risk of a beneficiary. Far more difficult that requiring a certain balance in the bank account or a certain income 

well yes for sure but part of the assesment might be balancing health risk with financial resources to account for the risks. I think the go hand in hand, but there are a lot of factors I'm sure to take into account.

[Lil bear 4,263]

6 minutes ago, artcodex said:

well yes for sure but part of the assesment might be balancing health risk with financial resources to account for the risks. I think the go hand in hand, but there are a lot of factors I'm sure to take into account.

I agree. My question is on what basis ... with what evidence .. are the CO able to determine health risk ?  Insurance companies pay high salaries to actuarial gurus to get risk predictors ... definitely not within the scope of the CO 

[SalishSea 17,988]

Just now, Lil bear said:

I agree. My question is on what basis ... with what evidence .. are the CO able to determine health risk ?  Insurance companies pay high salaries to actuarial gurus to get risk predictors ... definitely not within the scope of the CO 

I'm sure they have access to actuarial info from the department of health, etc.  Not hard to estimate lifetime projected health care costs by age.

[Lil bear 4,263]

7 minutes ago, Jorgedig said:

I'm sure they have access to actuarial info from the department of health, etc.  Not hard to estimate lifetime projected health care costs by age.

But these rely on knowing risk factors that are outside the purview of the information in the hands of the CO. The risks  for a 60 year old person for example is affected by many factors ...  it would require the sort of medical assessment that health insurance underwriters do when assessing a new policy application. It’s not just finding and age in one column and reading across to identify the  % risk  ... that would result in an arbitrary line being drawn .. under age X... acceptable risk .. age X plus one day ... unacceptable risk   I’d hate to see that happen here 

Edited October 7, 2019 by Lil bear

[SalishSea 17,988]

Just now, Lil bear said:

But these rely on knowing risk factors that are outside the purview of the information in the hands of the CO. The risks  for a 60 year old person for example is affected by many factors ...  it would require the sort of medical assessment that health insurance underwriters do when assessing a new policy application. It’s not jus finding and age in one column and reading across to identify the  % risk  

Risk can be generically assessed by age.

 

"it would require the sort of medical assessment that health insurance underwriters do when assessing a new policy application."  Are you confusing health insurance with life insurance?  No medical exam is required for obtaining health insurance.  The ACA rule about no consideration for preexisting conditions is still in effect.

 

[sol_sol 31]

2 minutes ago, Lil bear said:

But these rely on knowing risk factors that are outside the purview of the information in the hands of the CO. The risks  for a 60 year old person for example is affected by many factors ...  it would require the sort of medical assessment that health insurance underwriters do when assessing a new policy application. It’s not just finding and age in one column and reading across to identify the  % risk  ... that would result in an arbitrary line being drawn .. under age X... acceptable risk .. age X plus one day ... unacceptable risk 

Exactly thats what I am thinking. Similarly risk factors can be found in different ethnicities So how come they gonna predict:? Moreover a 50- year-old can get cancer while a 70-year-old can be healthy

[Crazy Cat 41,985]

34 minutes ago, vivfran said:

Hello! How does this affect a person who is adjusting their status / waiting to get their green card? I dont have health insurance and getting on my wife's health insurance would be pricey. I just figured I'd wait to get my own health insurance when I got my job. Let me know. Thanks!

This latest proclamation does not affect adjustment of status.  However, after Oct 15th, applicants for adjustment of status will be required to complete the I-944 which addresses self sufficiency, health care, and public benefits.....

[artcodex 28]

25 minutes ago, Lil bear said:

I agree. My question is on what basis ... with what evidence .. are the CO able to determine health risk ?  Insurance companies pay high salaries to actuarial gurus to get risk predictors ... definitely not within the scope of the CO 

 

23 minutes ago, Jorgedig said:

I'm sure they have access to actuarial info from the department of health, etc.  Not hard to estimate lifetime projected health care costs by age.

yeah. I think the process becomes much more subjective. Also you can't really ascertain risk by age purely. Two people can be 70 years old but in very different health situations. You could assess the estimated costs by age as an average in which case younger people would cost more since they have longer to live on average -:).

I feel like it does require someone to have knowledge of a persons current conditions to review their risk profile.

 

On the other end of things with ACA and the exclusion of pre-existing conditions, the idea would be for the person to obtain medical insurance at which point the medical insurance is responsible in partnership with the individual to pay for medical costs. None of that should fall onto the government or be a tax burden. I think the real risk is someone who doesn't obtain medical insurance and has health conditions that could cause an emergency in which case public funds are used for this.

 

So to me it's a balancing act between health risks, the financial means to afford medical insurance and the lack of enforcement to have medical insurance even if you can afford it. It seems like a lot of data for a CO to have to process and review instead of a more objective system where one could just tick the boxes. 

[Lil bear 4,263]

24 minutes ago, Jorgedig said:

Risk can be generically assessed by age.

 

"it would require the sort of medical assessment that health insurance underwriters do when assessing a new policy application."  Are you confusing health insurance with life insurance?  No medical exam is required for obtaining health insurance.  The ACA rule about no consideration for preexisting conditions is still in effect.

 

No ... I am saying that the new ruling on requiring health insurance  talks about assessing the health risk of an IR 5  beneficiary at the interview stage. This is not a simple “ look at the age tables “ decision