Spotlight on the Need to Preserve Pre-Existing Conditions Protections

The Affordable Care Act Protects Patients With Pre-existing Conditions

Across The Country, Americans Depend On The ACA’s Consumer Protections

Under The Affordable Care Act, People Cannot Be Denied Coverage Or Charged More Because They Have A Pre-existing Condition. Per HHS, “Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a ‘pre-existing condition’ — that is, a health problem you had before the date that new health coverage starts.” Similarly, the Affordable Care Act eliminated “gender rating,” ensuring women do not pay an estimated $1 billion more than men for the same health care plans.

  • It Is Estimated That Before The ACA, 18 Percent Of Individual Market Applications Were Denied Because Of A Pre-Existing Condition. The Kaiser Family Foundation (KFF) believes this number to be an underestimate because “many people with health conditions did not apply [for coverage] because they knew they were informed by an agent that they would not be accepted.”

The ACA Outlaws Medical Underwriting, The Practice That Let Insurance Companies Charge Sick People, Older People, And Women More. Before the ACA, insurance companies could also screen applicants for any conditions that might be costly to the company. If someone had condition that was predicted to cost the insurance company more, such as acne, the insurance company would follow a practice called “medical underwriting” that allowed them to charge the applicant a higher premium, specifically exclude coverage for the condition that was expected to be costly, charge the applicant a higher deductible, or limit the applicant’s benefits (for instance, offer a policy that does not cover prescription drugs). As the Brookings Institution summarizes, the ACA outlawed this practice, guaranteeing that all applicants could buy insurance and that their premiums would not be adjusted for gender or personal characteristics other than age and smoking.

  • The ACA Prevents Insurance Companies from Charging Older People An Age Tax Of Up To Five Times More Just Because Of Their Age. The ACA prevents insurance companies from charging older people more than three times more for the same coverage as someone who is younger.
  • Prior To The Affordable Care Act, Insurance Companies Charged Women An Estimated $1 Billion More Than Men For The Same Health Care Plans.

Thanks To The Affordable Care Act, Insurance Companies Can No Longer Rescind Coverage Except In Cases Of Non-Payment Or Fraud. Because of the ACA, insurance companies can no longer rescind or cancel someone’s coverage arbitrarily or because they get sick.

  • Before The ACA, Insurance Companies Could Retroactively Deny Someone Coverage Once They Got SIck. This foul-play impacted Robin Beaton, whose insurance company denied her coverage for a double mastectomy because she had previously received acne treatment. “Robin Beaton found out last June she had an aggressive form of breast cancer and needed surgery — immediately. Her insurance carrier precertified her for a double mastectomy and hospital stay. But three days before the operation, the insurance company called and told her they had red-flagged her chart and she would not be able to have her surgery. The reason? In May 2008, Beaton had visited a dermatologist for acne.

Because Of The Affordable Care Act, Insurance Companies Can No Longer Impose Annual And Lifetime Limits On Coverage. Before the ACA, insurance companies could restrict the amount of dollar amount of benefits someone could use per year or over a lifetime. At the time the ACA was passed, 91 million Americans had health care through their employers that imposed lifetime limits. Many such plans capped benefits at $1 million annually, functionally locking people with complex medical needs out of coverage.

The Overwhelming Majority Of Americans Support Protections For People With Pre-Existing Conditions

July 2018 –  Kaiser Family Foundation’s July Tracking Poll Confirms That Protections For People With Pre-existing Conditions Are The Most Important Health Care Issue To Voters.

  • A Candidate’s Position On Continuing Protections For People With Pre-existing Health Conditions Is The Top Health Care Campaign Issue For Voters, Among A List Of Issues Provided. “This issue cuts across voter demographics with most Democratic voters (74 percent), independent voters (64 percent), and voters living in battleground areas (61 percent), as well as half of Republican voters (49 percent) saying a candidate’s position on continued protections for pre-existing health conditions is either the single most important factor or a very important factor in their 2018 vote.”
  • Nearly Two Thirds Of Those Polled Do Not Want Supreme Court To Overturn Protections For People With Pre-existing Conditions. “Nearly two-thirds (64 percent) do not want to see the Supreme Court overturn these protections compared to half (52 percent) who do not want to see the Supreme Court overturn the Affordable Care Act (ACA) more generally.”
  • Almost Six In Ten Americans Say They Think President Trump And His Administration Are Trying To Make The ACA Fail. “Almost six in ten (56 percent) Americans say they think President Trump and his administration are trying to make the ACA fail while one-third (32 percent) say they are trying to make the law work. Most of those who say they think the Trump administration is trying to make the law fail think this is a “bad thing” (47 percent of the public). In addition, most (58 percent) say since President Trump and Republicans in Congress have made changes to the ACA, they are responsible for any problems with it moving forward.”

July 2018 – Civis Analytics Poll On Behalf Of Planned Parenthood Action Fund And The NWLC Action Fund Confirms That Protections For People With Pre-Existing Conditions Are Tremendously Popular. The poll finds that 93 percent of voters want the Supreme Court to uphold laws that protect people with pre-existing conditions from being denied insurance.

June 2018 – Kaiser Tracking Poll Also Found That That ACA Protections For Sick Patients Still Overwhelmingly Popular Despite GOP’s Efforts To End Them. Key findings:

  • Health Care Is Top Issue For Voters. 25 percent of voters cited health care as the most important issue to them, compared to the next highest earner, the economy and jobs, which 23 percent of voters said was the most important issue. In total, 79 percent of voters considered health care to be the most important or a very important issue.
  • Candidates’ Continued Support For Protections For People With Pre-Existing Conditions Is The Single Most Important Health Position For Voters. 14 percent of voters said cited protections for people with pre-existing conditions as the most important factor. 66 percent of voters said it was very important, if not the most important, health care issue to them.
  • Nearly Three Quarters Of Those Polled Said It Was “Very Important” That ACA Provisions Protecting Those With Pre-Existing Conditions Remain Law. 76 percent of voters said it was very important to keep the provision of the ACA that prevents insurance companies from denying coverage because of a person’s medical history. 72 percent of voters said it was very important to preserve the ACA’s protection against charging sick people more. Majorities of all parties support these protections.
  • Nearly Six In Ten Say Someone In Their Household Has A Pre-Existing Condition. “Nearly six in ten (57 percent) say they or someone in their household suffers from pre-existing medical conditions such asthma, diabetes, or high blood pressure.”
  • Half Of The Public Continues To Have A Favorable View Of The Affordable Care Act. “Half of the public continue to hold favorable views of the 2010 health care law, known as the Affordable Care Act. This continues the more than a year-long trend of a larger share of the public viewing the law favorably (50 percent) than unfavorably (41 percent).

June 2018 – Hart Research Poll Finds That 66 Percent Of Voters Disapprove Of Trump Justice Department’s Actions To Overturn Protections For People With Pre-existing Conditions. When asked about the Trump Justice Department’s decision to take to court to argue against protections for people with pre-existing conditions, voters polled by Hart Research disapproved by 66 to 34 percent.

What You Should Know As President Trump Tries To Reverse Protections For More Than 130 Million Americans With A Pre-Existing Condition

BY THE NUMBERS:

More Than 130 Million Americans Have A Pre-Existing Condition. According to a recent analysis, roughly half of Americans have a pre-existing condition. This includes:

  • 44 million people who have high blood pressure
  • 45 million people who have behavioral health disorders
  • 44 million people who have high cholesterol
  • 34 million people who have asthma and chronic lung disease
  • 34 million people who have osteoarthritis and other joint disorders

More Than 17 Million Children Have A Pre-Existing Condition, which means one in four children have a pre-existing condition.

Nearly 68 Million Women And Girls Have A Pre-Existing Condition. More than half of women and girls nationally have a pre-existing condition.

More Than Six Million Women Have Pregnancies Per Year. Before the Affordable Care Act, insurance companies commonly denied women health coverage because they were or had been pregnant.

Over 30 Million Older Adults Have A Pre-Existing Condition. The analysis also shows that 84 percent of older adults, 30.5 million Americans between age 55 and 64, have a pre-existing condition.

76 Percent Of Americans Support Protections For People With Pre-Existing Conditions. Protections for people with pre-existing conditions are overwhelmingly popular — 76 percent of Americans think it’s very important that insurance companies are prohibited from denying someone coverage because they have a pre-existing condition.

THE BREAKDOWN:

Before the Affordable Care Act’s protections for people with pre-existing conditions, you could be denied health coverage for being sick, having a mental illness, getting pregnant, being employed in a certain industry, or even for taking certain medications.

Conditions That Could Cost You Your Care:

  • AIDS/HIV
  • Alcohol/drug Abuse
  • Cerebral Palsy
  • Cancer
  • Heart Disease
  • Diabetes
  • Epilepsy
  • Kidney Disease
  • Severe Epilepsy
  • Sleep Apnea
  • Pregnancy
  • Muscular Dystrophy
  • Depression
  • Eating Disorders
  • Bipolar Disorder
Jobs You Could Be Denied Coverage Because Of:

  • Active military personnel
  • Air traffic controller
  • Body guard
  • Pilot
  • Meat packers
  • Taxi cab drivers
  • Steel metal workers
  • Law enforcement
  • Oil and gas exploration
  • Scuba divers
Medications That You Could Be Denied Health Care For Taking:

  • Anti-arthritic medications
  • Anti-diabetic medications (including insulin)
  • Anti-cancer medications
  • Anti-coagulant and anti-thrombotic medications
  • Medications used to treat autism
  • Anti-psychotics
  • Medications for HIV/AIDS
  • Growth hormone
  • Medication used to treat arthritis, anemia, and narcolepsy
  • Fertility Medication