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.