As House Republicans today push for repeal of the Patient Protection and Affordable Care Act (ACA), a new Department of Health and Human Services (HHS) study shows that without the ACA’s protections up to 129 million non-elderly Americans with pre-existing health conditions would lose their health insurance or be denied coverage altogether.
The HHS report “At Risk: Pre-Existing Conditions Could Affect 1 in 2 Americans” warns that “Repealing the law would once again leave millions of Americans worrying about whether coverage will be there when they need it.”
The HHS analysis found the following:
• Between 50 and 129 million (19% to 50%) of Americans under age 65 have some type of pre-existing condition such as heart disease, high blood pressure, arthritis, asthma, and cancer. The highest rates of those with preexisting conditions, ranging from 21% to 54%, are among those with employer-sponsored insurance. However, 32 to 82 million people with both health problems and job-based coverage would be vulnerable without the ACA, which lifts limits on annual and lifetime benefits.
• Older Americans between the ages of 55 and 64 are at particular risk of preexisting conditions; 48% to 86% of people in that age bracket have a pre-existing condition.
• 15% to 30% of people under age 65 currently in good health, reporting very good or excellent health with no chronic conditions, are likely to develop a pre-existing condition over the next eight years.
• Up to one in five Americans under age 65 with a pre-existing condition – 25 million individuals – is uninsured.
Prior to the ACA, in the vast majority of states, insurance companies in the individual market could deny coverage, charge higher premiums, and/or limit benefits based on pre-existing conditions. Surveys have found that, due to preexisting conditions, 36% of Americans who tried to purchase health insurance directly from an insurance company in the individual insurance market encountered challenges purchasing health insurance.
A number of ACA protections already are in place. For example, insurers can no longer limit lifetime coverage to a fixed dollar amount or take away coverage because of a mistake on an application. Young adults 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, and insurers cannot deny coverage to children because of a pre-existing condition.
Many uninsured Americans with pre-existing conditions have already enrolled in the temporary high-risk pool program called the Pre-existing Condition Insurance Plan (PCIP), which provides private insurance to those previously excluded from the insurance market because of a pre-existing condition. The PCIP program is an interim measure until 2014, when insurance companies can no longer deny or limit coverage or charge higher premiums because of a pre-existing condition.
In addition to the ban on discrimination against people with preexisting conditions, in 2014, individuals and small businesses will have access to new, high-quality insurance choices through health insurance exchanges.
We can only hope that those bent on "repeal" of health reform will recognize the good aspects of the law and focus instead on improving it.
More information about provisions of the Patient Protection and Affordable Care Act is available here.
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