New Health Insurance Law takes aim at Pre-existing Conditions

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New health insurance law takes aim at pre-existing conditions
New health insurance law takes aim at pre-existing conditions

The new health insurance law currently working its way through the US healthcare industry—also known as “Obamacare”—has generated more controversy than probably any other law in history. Most people agree that the healthcare system is in need of reform, but when you start getting into the specifics as to what needs to be changed, that’s when the sparks start flying.

There’s no doubt about it, the new health insurance law is a monster—there’s plenty in the bill to either delight or enrage the entire population. But one area that Obamacare specifically addresses is pre-existing conditions and I think this is one part of the bill that has doubtless merit. In my opinion, fixing this one problem will remedy a great deal of what is currently wrong with our entire healthcare industry.

Obamacare and pre-existing conditions

There are three provisions in the new health insurance law that deal with pre-existing conditions, and what ever anyone’s thoughts about the bill as a whole, I think all three of these are steps in the right direction:

  1. Applicants must be accepted for coverage despite pre-existing conditions
  2. Insurers cannot charge higher premiums for pre-existing conditions, and
  3. Guaranteed renewability

The provisions are in only partial affect right now, but will become mandatory as of January 1, 2014. The combination of the three should ensure that everyone will be able to get health insurance, which is the major goal of the new law. Essentially, insurance companies will not be able to decline an applicant, charge higher premiums, or refuse to renew coverage due to pre-existing conditions.

If you’re interested in digging deeper, more information can be found about the specifics of the provisions (Section 1201), and of the entire healthcare bill in the National Association of Insurance Commissioners (NAIC) Patient Protection and Affordable Care Act, Section by Section Analysis(see pages 16 and 17 for the provisions relating to pre-existing conditions).

Why pre-existing conditions are such a huge problem

There are some 50 million people in the US who are going without health insurance—that’s roughly one out of every six people. One of the major reasons they don’t have coverage is because of pre-existing conditions. Either health insurance companies deny them coverage due to pre-existing conditions, or they approve them with premiums that are so high that the applicant can’t afford the coverage anyway.

Right now, you can be turned down or charged a higher premium for everything from major medical issues such as diabetes, heart disease or a previous bout with cancer, to more modest afflictions like moderate obesity, high blood pressure or even taking too many medications. You can even be declined or rated for depression or having a dangerous occupation.

We’re all paying for healthcare for the uninsured whether we know it or not. We do so either through taxes (Medicaid, publicly funded hospitals, etc) or through higher healthcare costs. Fact: if hospitals and other healthcare providers can’t collect fees from the uninsured, they’ll build them into fees for those who do have coverage.

And here’s something else…if an uninsured person is sick or injured and unable to get the comprehensive care that will make them well, they’ll be unable to work. If they can’t work, they could end up on public assistance. End result: more taxes and one more person (and maybe an entire family) losing economic independence.

Lack of health insurance portability in a world of career instability

Do you know people who are quite literally terrified at the prospect of losing their job—not just because their income will be gone—but for fear of losing their employer sponsored health insurance? I know many, and I’ll bet you do too. Maybe you’re even one of them.

Millions of people are or will be unemployed; many are moving into contract work or self employment because salaried jobs in their field have become scarce. The prospect of losing their health insurance adds a terrifying dimension to a change of employment status.

In a very real way, the fear of being uninsured is adding to the nations economic woes. People are unable to deal effectively with rapidly changing employment prospects because of the implications it has for their health insurance. I could be wrong about this, but it seems to me that requiring coverage be provided for people with pre-existing conditions will go a long way toward creating some degree of health insurance portability. That will expand income earning choices for millions of people.

How will this all play out?

Now admittedly, my support for at least this small portion of Obamacare is based on a set of changes that have yet to come to full fruition in the real world. But based on what we have right now as regards to limitations on pre-existing conditions, I think the new health insurance law is heading in the right direction. It will need to be tweaked, but just the fact that we have a new set of laws addressing the problem gives solid reason for hope.

What are your thoughts on this part of the healthcare law? What ever else is in the bill—good or bad—do you agree that we need to fix the pre-existing conditions part of the healthcare problem? Are there other provisions you think would do a better job?

( Photo from Flickr by Asbestos Bill )

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2 Responses to New Health Insurance Law takes aim at Pre-existing Conditions

  1. I have to agree with you on Obamacare. while there are certain questionable things to it, overall, the advantages will outweigh the drawbacks;-)

  2. Hi Maria–None of us can determine how Obamacare will play out, since it’s still untested and so far reaching. But so much of what’s in the bill needed to happen.

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