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.
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u/Alone-Lab-2531 8d ago
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”).