Good News for Those With Pre-existing Conditions

Now that the Affordable Care Act has been upheld by the Supreme Court, there’s good news for those with pre-existing conditions that might have previously kept them from getting health insurance.

Starting in 2014, insurance companies can no longer refuse to issue policies because an adult has a pre-existing condition, or issue a policy that doesn’t cover that condition. They also can’t charge more based on health status. (Children were already protected.) A recent study from Families USA and the Lewin Group breaks down the numbers for Nebraska:

  • More than 400,000 non-elderly Nebraskans are diagnosed with a health condition that regularly results in denials of coverage. That means 1 in every 4 Nebraskans are at risk for being denied coverage.
  • Nearly half of those Nebraskans are between the ages of 55 and 64, an age range that typically pays more in insurance premiums already. Under the ACA, also starting in 2014, insurance companies will be limited in how much they can charge based on age.
  • Pre-existing conditions are found across racial and ethnic groups and across income groups at approximately the same rate.

Why is health insurance so important for those with pre-existing conditions? 

  • The uninsured often delay or forgo seeking care because of cost, which means they’re usually sicker when they do seek care, and that leads to more expensive care.
  • Uninsured people usually can’t afford preventive care that can catch health problems early. Early detection for things like cancer, heart disease, and diabetes can greatly improve a person’s chances for successful treatment, as well as reduce costs.
  • Uninsured people are more likely to go to the emergency room for non-emergency services.  Emergency care is the most expensive kind of care.
  • And the uninsured pay more for care because they cannot negotiate the same rates that an insurance company does, and therefore they struggle to pay for care. Medical bills are linked to nearly two-thirds of all personal bankruptcies filed and nearly half of all home foreclosures.

The ACA presents a significant step forward for hundreds of thousands of adults in Nebraska who no longer have to fear that they will be denied coverage based on a pre-existing condition or risk going broke by seeing a doctor.

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