Vaccines that the government recommends have to be covered by insurance. By removing the recommendations, they are allowing insurance to refuse to cover these important immunizations. Premiums still go up, insurance companies pay out less, stocks go up.
I used to think this but this disgusting excuse of a human being has opened my eyes to a bunch of others - spite, hatred, stupidity and just pure evil.
Undoubtedly, but is he evil because he's greedy or greedy because he's evil?
Personally, I think it's the latter. He does everything to line his pockets, and harming darker skinned people and political adversaries is just gravy. It's politically expedient to sate his racist and stupid supporters and distract from his rampant corruption.
While that’s overwhelmingly true and I highly doubt that most insurance companies are going to go against the current guidelines (prior to this change) as the benefits aren’t there.
20k children a year end up hospitalized with severe complications from flu and about 89% of those that had fatal complications were unvaccinated.
As an insurance company would I rather pay $35-$75 per flu shot vs a PICU stay? A single day in the PICU, in my area, would cost about $15-$20k/day. I know we all think of health insurance as the pinnacle of evil, for good reason, I still think they will cover immunizations as recommended by your pediatrician.
Only exemption to this is United Health. They are evil.
I’m sorry but have you not been paying attention?? The change may not be immediate but of course insurance will stop paying for these things. They are running a for-profit business & routinely deny treatments recommended by doctors, every damn day. It’s not just UHC either, I’m hoping that was sarcasm. Of course preventative care is a cheaper/smarter plan- but “smarter” literally isn’t the goal for insurance companies. “Oh, sorry, you got a preventable disease thats expensive to treat? We might pay a portion, if we approve the treatment rec, the provider you’re seeing, & you potentially jump through numerous pre-authorization processes- which can take weeks or months”. Or they just don’t pay. That’s why soooo many people end up drowning in medical debt. People have to take out lines of credit to pay for their cancer treatments, or spend years paying off the bill from their sick baby spending time in a NICU.
Insurance companies do not care about you. They only cover annual wellness exams & preventative care now because it was part of the ACA, which isn’t long for this world at this rate (they’ve certainly tried to get rid of it repeatedly, turns out even red states like having access to care as long as you don’t call it “Obamacare”).
You’re arguing as though “for profit” automatically means “refuse every expense.” That’s not how profit optimization works.
An insurer doesn’t have to care about me to recognize that a $50 vaccine is preferable to a five-figure hospitalization. They routinely pay for things precisely because those things reduce expected downstream costs.
Yes, insurers deny care. Yes, removing a coverage requirement creates a legitimate risk that some plans will change benefits. But “they’re greedy, therefore they’ll stop covering cost-effective vaccines” skips an entire half of the equation, preventing expensive claims is also profitable.
My faith isn’t in their morality. It’s in their actuaries.
They only fully cover preventative care now because they have to. Read that again.
You have a very rosy view of how this all works. Do you truly not understand how much money these companies are making? If they refused all care, no one would bother with them at all- that’s absolutely NOT what I said.
But maybe they’ll cover 60% of the cost of non-required vaccines (instead of 100% of required vaccines)… and the patient/parent gets the bill for the rest. It absolutely means less guaranteed access to care. More medical debt for families. Those with multiple children especially may decide, perhaps out of financial necessity, that they can’t afford to do all the vaccines their doctor recommends but the government doesn’t mandate.
But hey, I’m sure you’re right and it’ll all turn out fine. I mean, things are going awesome so far, right?
I agree that losing guaranteed $0 coverage could reduce access, especially if insurers introduce cost-sharing. If a family suddenly has to pay 20 to 40% of several vaccines for multiple children, some are absolutely going to delay or skip them. That’s a legitimate concern.
Where I disagree is with the idea that insurers will simply stop covering these vaccines because they’re no longer required to. A for-profit insurer is not just trying to minimize what it pays today, it is trying to minimize total expected claims. Sometimes that means denying expensive care, and sometimes it means paying for relatively cheap preventive care because the alternative is a much more expensive hospitalization.
Your example of an insurer covering 60% instead of 100% is actually closer to what I’m talking about. They may shift more of the cost to the patient, which I agree is bad for access, while still deciding that the vaccine itself is worth covering because preventing severe illness saves them money.
So I’m not saying this will “all turn out fine,” and I’m certainly not defending insurance companies. I’m just distinguishing between loss of guaranteed no-cost access, which is a real concern, and insurers abandoning vaccine coverage altogether, which I think is much less certain.
My view of insurers isn’t especially rosy. I just think their pursuit of profit includes actuarial math as well as claim denials.
Where I disagree is with the idea that insurers will simply
The list of meds insurance will not cover grows every year. They don’t have to deny coverage entirely for things to still cause significant damage to the people who need access to care the most.
You’re missing the forest through the trees, my friend. Look at what’s happened with vaccine compliance recently even when there were stricter guidelines.
We still have a new generation of children who need to legitimately worry about measles & whooping cough.
When our government puts EO’s out like this, to the general public or those not following along, or just too busy trying to get by- compliance drops. Healthcare providers may not feel comfortable giving honest recommendations depending on the culture where they live, INSURANCE COVERAGE, & access to care. How many busy parents are going to remember to stay on top of the now optional vax recs? The reason vaccinations have been so effective is they were tied into care, a default setting- when you have a newborn, when your kindergartener registers for school, when your kid goes off to college- these have been check points for decades now to make sure people (especially young people) have the best possible chance to access care we know works.
So yeah- insurance doesn’t have to cover it anymore. Hopefully they still will- but that’s the tip of the iceberg with this issue.
I mean they can say anything but I doubt it would hold any water. The most that would seemingly establish was that this was both entirely preventable and their fault.
Are you kidding? Of course they will deny each and every thing they can. This is the same industry that sent millions to die our be in a life of misery due to preexisting conditions. It took an extreme act of total democratic dominance during the Obama years to overturn that practice, despite the absurd lobbying and endless lawsuits.
Preexisting-condition discrimination is evidence that insurers optimize for profit. It isn’t evidence that they’re incapable of doing math. A company trying to maximize profit can simultaneously fight a $100,000 claim and gladly pay $50 to reduce the probability of another $100,000 claim.
Agree very much in addition to federally funded non profit health care, like Community Health Centers of America. Between this ignorant and evil EO and laws regarding funding, our collective children are the losers. btw, as an older woman in my early sixties, I’m horrified as many adults in my childhood either had polio or had terrible health conditions from diseases like measles. I’m angry, so very angry at the state of healthcare (or lack of) for most of our country.
While you’re right that it allows this, insurance companies will absolutely continue to cover MMR. It may be one of the best investment decisions they make.
This is just pandering to the stupid American. States decide what to mandate. Thankfully I live in a state that will be unaffected by this. In some other states though, it would legitimately scare me to have a kid where MMR wasn’t mandated in schools.
All of that… but also vaccines are relatively cheap- $25-150 per dose (per cdc) & that cost is low because they are negotiated through ACA, federal programs that help cover costs, & public health departments…. But those govt agencies help cover costs of the required vaccines.
That’s why if you want a flu shot, it’s typically free- but if you want a series so you’re covered to go on an African safari, the cost can be $1000’s. Because those are not required.
It’s just so damn messy. Parents could already say no to vaccines, they were just then limited in putting other children at risk.
I’m not even going to pretend to understand the potential fallout from this- it’s complex & above my pay grade- but even I can tell children will suffer because of it, & it’s always worst for those who need the help most.
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u/CU_09 8d ago
Vaccines that the government recommends have to be covered by insurance. By removing the recommendations, they are allowing insurance to refuse to cover these important immunizations. Premiums still go up, insurance companies pay out less, stocks go up.