Ever since the passage of the Affordable Care Act (ACA) in March of 2010, one of the most popular aspects of the law is that it does not allow insurance companies to discriminate against people with pre-existing conditions. What that means is a health insurance company may not deny coverage or charge more to uninsured patients with medical conditions than patients without them.
In December of 2018, U.S. District Judge Reed O’Connor from Northern Texas, ruled the entire ACA, even the popular provision that protects people with pre-existing conditions, be thrown out. The Trump Department of Justice took action to back O’Connor’s ruling on March 25. Between congressional efforts to repeal the ACA throughout 2017 and action in the courts, protection for people with pre-existing conditions continues to be in danger.
This is bad news for the tens of millions of Americans who have them. And like so many policy issues that affect millions of Americans, the devil is in the details.
This blog will be the first in a series we’re doing on pre-existing conditions. To start, we’ll outline why these protections are the most popular piece of the law and what an America without these protections looks like.
From there, we’ll jump into Republican proposals, Democratic proposals, what experts say, and where we think this debate is going.
But getting back to why this matters in the first place.
Polling finds pre-existing conditions protections have remarkably strong support across the political spectrum. A September 2018 Kaiser Family Foundation poll found that 75% of Americans say it is “very important” to them that insurance companies not deny coverage because of a person’s medical history. The same poll also found 72% say it is “very important” health insurance companies be prohibited from charging sick people more. A Morning Consult poll also from September 2018 found 83% of Democratic voters and 80% of Republicans voters say insurers should have to cover all people regardless of health issues. There is no doubt that Americans care about protecting pre-existing conditions and that the provisions have had a positive effect on many people’s lives.
Despite a subpar rollout with a few kinks in healthcare.gov, some people immediately reaped the benefits of the law as intended. Instead of “job-lock,” which caused nearly 11 million people to be tied to jobs they did not want solely because of health benefits, the number of self-employed freelancers increased by 3.5 percent within two years of the law’s passage. Kendall Brown, a young woman from Oklahoma City who has Crohn’s disease, was able to shift back on to her parents’ insurance plan since she had yet to reach the age of 26 and thus was able to get surgery and access to Remicade, an expensive but helpful treatment for her pre-existing condition. Phil Sherbrune, a man from Salt Lake City who was previously denied coverage due to a shoulder issue, was able to get insurance through the marketplace exchanges for just $123 a month.
One Republican Arkansas retiree said, “I would tell [people badmouthing Obamacare] to learn more about it before they start talking bad about it” after learning the ACA would save him $13,000 a year.
Pre-existing conditions should not be such a political game but in our next blog, we will examine how they have become exactly that.