Ebola: Obamacare’s Ultimate Pre-Existing Condition
Policy + Politics

Ebola: Obamacare’s Ultimate Pre-Existing Condition

With the new Obamacare enrollment period scheduled to begin on November 15, here’s an intriguing question: If you’re one of the rare Americans to have the misfortune of contracting Ebola, can you apply for a new insurance policy on one of the government-run health exchanges without being rejected?       

Currently, only four people are being treated for Ebola in the United States, and a few hundred who may have been exposed to it are either being monitored or have been notified – so this is an extremely unusual situation. Still, while no insurance company would relish the prospects of taking on a consumer suffering from one of the worst viruses to occur in today’s modern world, the Affordable Care Act prohibits insurance companies from turning down applicants with pre-existing conditions, such as cancer, heart disease, kidney disease, or even – yes – Ebola. 

Related: Media ‘Ebolathon’ at Fever Pitch As Virus Goes Political 

Earlier this month, an American freelance photojournalist contracted the deadly virus while working for NBC News in Liberia. Ashoka Mukpo, 33, was relying on friends to help raise $500,000 online to cover his astronomical medical bills. NBC later said it would cover the cost of his treatment at the University of Nebraska Medical Center. 

If the network hadn’t offered to pick up the check, however, Mukpo probably would have been in deep financial trouble, had his friends been unable to raise the money. He could turn to Obamacare for future coverage at the start of the open enrollment period without fear of being rejected. As in any other case, his insurer would not be responsible for covering any previous medical expenses racked up in the treatment of the disease. Instead, the new coverage effective January 1 would cover only his future medical expenses related to treating the virus. 

“Ebola is exactly the same as asthma or any other medical malady that anybody has,” Joseph Antos, a health care expert with the American Enterprise Institute who has written extensively on Obamacare, said Monday. “It cannot exclude you from coverage. But by the same token, if there are non-medical interventions [JL1] that are necessary, medical insurance doesn’t cover” those things. 

Before the passage of the ACA, it would have been nearly impossible for an uninsured person with a severe and extremely rare illness like Ebola to obtain affordable coverage, or any coverage, for that matter. Now, health insurers have no choice but to accept you. That doesn’t mean you won’t need to pay a portion of your health costs, of course. 

Related: How to Protect Yourself from Ebola 

Health policies sold on the exchanges are designed to cover hospital and physician-related costs of the treatment, as well as follow-up therapy and observation. However, just like Medicare, the health insurance policies do not cover “long-term care,” including residential care and medical maintenance procedures in skilled nursing homes and assisted living arrangements. (Medicaid, however, is another matter altogether and coverage varies from state to state.) 

Because of the severity of the virus, Ebola patients may be required to receive the kind of long-term care that would likely require a separate insurance policy. 

On Monday, an insurance industry spokesperson said that the treatment for Ebola would more likely fall under the category of “acute care” rather than long-term care – making it eligible under the ACA. Still, if the patient required nonmedical care down the road, that care would not be included. 

“If it’s quarantine [that’s involved], that’s not a medical treatment, so that’s not covered even though it might cost some money,” Antos said. “I think generally the way it works is like Medicare. If you come out of the hospital as a Medicare patient and you need some post-acute care, that’s covered. But if you’re elderly and you’re deteriorating and you need long-term care, which is basically housing, food and that sort of thing, it’s not medical and it’s not covered.” 

Related: Ebola Scams Prey on the Public’s Fear 

Separately, the nationwide panic over the extremely few cases of Ebola in this country so far has prompted insurance companies to offer first-of-its-kind policies that would protect hospitals and businesses that might suffer losses as a result of an Ebola quarantine. Lloyd’s of London began underwriting the “Pandemic Disease Business Interruption Insurance” policies on Friday, the Advisory Board first reported. 

Currently, there is no Food and Drug Administration-approved vaccine or medicine for Ebola – though at least one vaccine is in the works and is being fast-tracked – and the symptoms such as a high fever, reddish eyes, projectile vomiting and diarrhea are treated as they appear, according to the Centers for Disease Control. The vast majority of people who contract Ebola die from it, but doctors and medical staff have had some success by providing quarantined patients with intravenous fluids and balancing electrolytes, maintaining oxygen status and blood pressure and treating other infections as they occur. 

“Recovery from Ebola depends on good supportive care and the patient’s immune response,” according to the CDC website. “People who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer. It isn’t known if people who recover are immune for life or if they can become infected with a different species of Ebola. Some people who have recovered from Ebola have developed long-term complications, such as joint and vision problems.”

So far this year, the deadly virus has killed more than 4,500 people and infected thousands more, almost all in the three West African countries of Liberia, Sierra Leone and Guinea. Thomas Eric Duncan, a Liberian man, was the first person to die of Ebola in the United States, and he infected two nurses at the Texas Health Presbyterian Hospital in Dallas who cared for him during his illness.

The World Health Organization has called the crisis the most severe acute public health crisis of modern times. The Obama administration is sending as many as 4,000 troops to aid in the efforts to quell the outbreak.

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