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PRE-EXISTING CONDITION PROTECTIONS

The Affordable Care Act banned insurance companies from discriminating against people with pre-existing conditions, and required plans to cover essential health benefits. Now, eight years after the Affordable Care Act improved our health care, President Trump and his Republican allies in Congress are taking steps to turn the clock back and put the insurance companies back in charge.

How the Affordable Care Act helped …

  • Pre-existing conditions: Before the ACA, insurers could discriminate against people because of their medical histories by charging more or denying coverage. Now, the law protects the one in four Americans who has a pre-existing condition.
  • Protection from charging more because of gender: Under the ACA, women cannot be charged more because of their sex.
  • Lifetime limits: Because of the ACA, insurers cannot impose lifetime or annual limits on benefits.
  • Essential Health Benefits: Thanks to the ACA, insurance has to cover the care we need. The ACA established 10 essential health benefits insurance companies must cover:
    • Ambulatory patient services
    • Emergency services
    • Hospitalization
    • Maternity and newborn care
    • Mental health and substance use disorder services
    • Prescription drugs
    • Rehabilitative and habilitative services, along with devices
    • Laboratory services; preventive and wellness services and chronic disease management
    • Pediatric services, including oral and vision care

… and how Trump would drag us back

  • Pre-existing conditions: The Trump Administration is peddling junk plans that skirt the rules of the ACA, increasing costs for millions of Americans with pre-existing conditions.  The Republican controlled House passed a repeal bill that discriminates against people with a preexisting condition.
  • Protection from charging more because of gender: Junk health plans can charge people more based on their health status, gender, age, and other factors.
  • Lifetime limits: Junk plans are allowed to impose lifetime and annual limits on coverage.
  • Essential Health Benefits: The Trump Administration and its Republican allies want to allow insurance companies to sell plans which do not have to cover essential health benefits, such as maternity care and prescription drug coverage. Easing regulations on essential health benefits makes it harder for Americans to access necessary care.
  • Analysis has shown that eliminating an essential health benefit raises costs for those who need that service. For instance, out-of pocket spending on maternity care could increase more than elevenfold, from $737 to $8,631.

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