Barring Insurance Discrimination Based on Pre-Existing Health Conditions

By Kathleen Sebelius, Secretary of Health and Human Services
Posted November 20, 2012

Too often, I’ve heard from people worried that they couldn’t leave a job because they had diabetes or breast cancer and they wouldn’t be able to get health insurance on their own because of their pre-existing condition.

Thanks to the health care law, those fears will soon be a thing of the past. As part of the Affordable Care Act, HHS today proposed a rule that would prohibit some of the worst insurance industry practices that have kept affordable health coverage out of reach for millions of Americans.

Under this new rule, starting in 2014, families and individuals would see new protections from egregious insurance company practices, including higher premiums or the denial of health coverage because of a pre-existing condition.

No longer would women like Myrna Rodriguez Previte, a breast cancer survivor, have to struggle to find health coverage because insurance companies refused to cover her because she had cancer previously.

No longer would young adults like Abby Schanfield, who has a rare genetic parasitic disease that has required multiple surgeries, and Steven Giallourakis, a two-time cancer survivor with chronic health conditions, have to worry about being refused coverage or charged more because of their medical history.

The proposed rule that HHS is issuing today would guarantee that being sick will not keep you, your family, or your employees from getting affordable health coverage.

This rule builds off earlier successes of the Affordable Care Act, which prohibited health plans from denying children health coverage because they had a pre-existing condition.

The Obama Administration today also issued the following:

  • A proposed rule outlining policies and standards for coverage of “essential health benefits,” while giving states flexibility to implement the Affordable Care Act. Essential health benefits are a core set of critical benefits that would give consumers a consistent way to compare health plans in the individual and small group markets.
  • A proposed rule implementing and expanding employment-based wellness programs to promote health and help control health care spending, while also ensuring that individuals are protected from unfair underwriting practices that could otherwise reduce benefits based on health status.