Protecting Americans with Pre-existing Conditions

By Richard Sorian, Assistant Secretary for Public Affairs
Posted January 18, 2011

If you’ve ever been told by your doctor that you have a health condition, the last thing you want to hear is that your insurance company is limiting or denying your health coverage.

Under the full range of policies in the Affordable Care Act to be in place by 2014, Americans living with pre-existing conditions are free from discrimination and can get the health coverage they need at a price they can afford.  And families are free from the worry of having their insurance cancelled or capped when a family member gets sick, or going broke because of the medical costs of an accident or disease.

Today, there are many conditions that your insurance company may consider “pre-existing conditions,” including:

  • Heart disease
  • Cancer
  • Asthma
  • High blood pressure
  • Arthritis

Prior to the enactment of the Affordable Care Act, your insurance company can decide what is a pre-existing condition and refuse to sell you a policy, charge you two or three times more, or limit your benefits so that your condition is excluded.

Thanks to the Affordable Care Act, we have already prohibited these practices for children and by 2014 that will be the law of the land for all Americans. But if efforts in Congress to repeal the health law succeed, all those freedoms will be wiped away.

Most of us would like to think that pre-existing conditions are someone else's worry. But a new study released today by the Department of Health and Human Services shows that as many as 129 million Americans under age 65 have some type of pre-existing health condition and would be at risk of losing health insurance if the law is repealed. The study estimates that up to 30 percent of perfectly healthy Americans are likely to develop a pre-existing condition over the next eight years.  Older Americans – those between the ages of 55 and 64 – are most likely to have pre-existing conditions.

Under the Affordable Care Act, in 2014, most health insurers will no longer carve out needed benefits, charge higher premiums, put lifetime limits on coverage of key benefits, or deny coverage due to a person’s pre-existing condition

Among the other freedoms that would be taken away are:

  • Insurers can no longer deny coverage to children because of a pre-existing condition. 
  • Insurers can no longer take away coverage because of a mistake on an application and they cannot limit lifetime coverage to a fixed dollar amount.
  • Young adults now have the option of staying on their parents’ coverage up to the age of 26 if they lack access to job-based insurance of their own.

Uninsured people with pre-existing conditions in every state now have access to coverage through the new, temporary Pre-existing Condition Insurance Plan.  This serves as a bridge until 2014, when insurance companies can no longer deny or limit coverage or charge higher premiums to anyone because of a preexisting condition.  More information on whether you are eligible and how to enroll can be found at HealthCare.gov or by calling 1-866-717-5826.

The Affordable Care Act is making sure that you have health coverage when you need it most, and is putting your health care where it belongs – in your hands, not in the hands of your insurance company.