Coverage for pre-existing medical conditions by health insurance
In the United States, until the Affordable Care (ACA) Act was enacted in 2010 most individual and group health plans excluded coverage of people with existing conditions. In other words, people with health conditions like asthma, high blood pressure or allergies might have to pay more for their health insurance.
Discrimination against people with chronic conditions and injuries made it more difficult for them to obtain affordable health insurance. Historically, employees who worked for companies with 500+ employees could only purchase large group health plans to avoid discrimination.
These plans were more expensive and did not offer all the features that most individuals needed, such as prescription drug coverage or preventive services. These plans often had lifetime benefits limits. Many of these plans charge very high out-ofpocket expenses for cancer treatments and major medical costs.
Before the ACA was passed, a person who had a pre-existing medical condition might have to wait a period of time before being able enroll in a different plan. The waiting period varies from six months up to a full year depending on what type of plan you choose and your state's regulations.
Lori, 48, was a freelance writer who had high blood pressure that she controlled well with two medications. She was unable to get affordable coverage until she purchased her own policy and began paying her monthly premiums. She was frustrated with the lack of affordable coverage that she could afford. So, she tried to find ways to get a more comprehensive insurance policy for herself.
She finally enrolled into a Medicare Advantage Plan which covered her medications and did not have a waiting time for pre-existing medical conditions. She also paid an additional $2 per month for a prescription drug benefit that covered her meds.
Those who have preexisting conditions can still be denied or forced to pay higher premiums for insurance, but this is rare and only happens in very few cases. Because the ACA caps the amount insurers may charge those with preexisting medical conditions, they are still subject to discrimination by companies that do not comply with the ACA. These companies will either exclude these individuals from their policy or raise the premiums for them in order offset the cost.
Coons suggests the ACA protected preexisting health conditions for the more 150 million Americans that get their coverage through their employers, but the claim isn't true. HIPAA only provided protections against pre-existing conditions for people with employer-sponsored health insurance. The ACA, however, extended this to anyone who purchases their own individual or family coverage via the ACA marketplace.
A Ca and Existing Conditions
The Affordable Care act is a law that has been very important in helping millions of Americans get affordable health insurance. The law's provisions that prevent people with preexisting health conditions from being denied coverage are among the most popular. Republicans have attempted to challenge the law at the Supreme Court on several occasions, but this hasn't been successful. As a result, it is vital that Congress enacts a strong bill to ensure that all Americans have access to affordable healthcare.