Coverage for pre-existing medical conditions by health insurance
Before the Affordable Health Care Act (ACA) came into effect in 2010, many individual and family health insurance plans in the United States excluded people with preexisting 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, the only way to avoid the discrimination was to purchase a large group health plan that was available to employees of companies with 500 or more employees.
These plans were expensive and did NOT include the services or coverage that most individuals need, such as preventive health care or prescription drug coverage. These plans often had lifetime benefits limits. These plans often charge high out of pocket costs for cancer treatments, major medical expenses and other health care.
Prior to the ACA, a patient with a preexisting condition would have had to wait a certain amount of time before enrolling in a new health 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, a 48 year old freelance writer with chronic high blood-pressure that was controlled by two medications. She couldn't get affordable coverage until after she bought her policy and paid her monthly premiums. She was frustrated by the lack of affordable insurance that she could afford and tried to find a way to get more comprehensive health insurance coverage for her.
She eventually enrolled in a Medicare Advantage Plan. This plan included drug coverage, and there was no waiting periods for pre-existing health conditions. She paid $2 extra per month to cover her medications with a prescription drug plan.
Preexisting conditions are still a factor in insurance decisions, and can be used to deny coverage or force people to pay more for their policy. However, this happens very rarely. This is because the ACA has put a cap on how much insurers can charge people with preexisting conditions, but they can still be discriminated against by non-ACA-compliant companies who will exclude these people from their policies or raise premiums to offset the cost of covering them.
Coons suggests that the ACA provided preexisting condition protections to the more than 150 million Americans who get their health coverage through their place of employment, but this is not entirely true. HIPAA protected those with employer sponsored coverage from preexisting conditions, but ACA expanded this protection to include all individuals and families who purchase their own insurance through the ACA Marketplace.
A Ca and pre-existing conditions
The Affordable Care Act is an important law that has helped millions of people in the US gain affordable health insurance. The provision of the law which protects people with preexisting illnesses from being refused health insurance is one of its most popular features. Republicans have brought several challenges to the Supreme Court, but they have not succeeded in overturning it. In light of that, it is crucial that Congress enact a strong law to ensure that everyone has access to affordable health insurance.