Around this time 10 years ago, an investigation by the U.S. House Energy and Commerce Committee found a 49% increase in the number of people with pre-existing conditions who were denied health insurance by four big insurers in the individual market between 2007 and 2009.
The denials of insurance by these four companies climbed from 172,400 in 2007 to 257,100 in 2009. Analysts said that this number of coverage denials was probably modest, because it didn’t include the number of sick people who were discouraged from applying in the first place.
Before the Affordable Care Act (ACA), health insurers continued to lower the bar for what was considered a pre-existing condition, making it difficult for many healthy patients to get affordable insurance. And there was no cut and dry definition of a “pre-existing condition.” The industry could use pre-existing conditions to limit the amount of money paid for medical claims. A congressional investigation during the health care reform debate found over 400 medical conditions that insurers used to deny coverage.
No matter your age— cradle to grave—health insurers could deny you coverage if you had a pre-existing condition.
If you were diagnosed with diabetes, cancer, allergies or a host of other conditions, you could be dropped by your insurance provider. And congratulations, you now had a pre-existing condition. An insurance plan could reject you, charge you more or refuse to pay for essential health benefits for any condition you had before your coverage started.
Imagine being a parent with a child with a pre-existing condition, before the ACA was passed. You were in for a real struggle. Maybe your son was diagnosed with asthma; your daughter was diagnosed with autism. Your health insurance provider could have dropped your coverage, increased your premiums or they could have imposed annual or lifetime benefit caps on the care your child received. Imagine watching your child grow, play and explore like all children do, knowing that at any time, there could be an emergency, or their condition could worsen, and you could lose the safety net of health insurance and face medical bills that could bankrupt your family.
It was in 2014 when it became federal law that you could not be denied coverage or charged significantly higher premiums, because you have a pre-existing condition.
That was only six years ago. Now, we find ourselves with a pseudo-state of amnesia.
People seem to have forgotten what life was like before it was illegal to discriminate based on illness.
Soon, the United States Supreme Court will rule on California v. Texas, a pending case dealing with the constitutionality of the ACA. The court announced that oral arguments would take place on Nov. 10. The lawsuit claims that the ACA is unconstitutional because the individual mandate was removed, invalidating the entire law. By invalidating the law, the protections of those with pre-existing conditions go with it.
It’s election season, and we’ve heard many candidates support the protection of health coverage for those with pre-existing conditions — even those who support the repeal of the ACA. We remember how hard those opposing the ACA fought against the coverage of pre-existing conditions. We remember their attempts to compromise. We know that the financial toll this coverage takes on the health insurance industry is escalating, and this industry maintains a significant influence over our policymakers.
Before you take any candidates at their word, please remember those families whose kids have been diagnosed with one of those over 400 medical conditions. Consider that 18% of the children in our country have a developmental disability. One in 13 has a food allergy. One in 12 has asthma. One in three children in West Virginia is obese.
Are these kids in danger of losing their health insurance? Are there parents a few paychecks away from bankruptcy if they have to pay for medical costs out-of-pocket?
Everyone deserves access to health insurance, especially those who need it most. At this time in our country, those who are medically fragile deserve peace of mind.
Promises to continue to cover pre-existing conditions while working to dismantle the ACA threatens the health of millions of Americans and hundreds of thousands of West Virginians. If the Supreme Court rules that the ACA is unconstitutional, a plan to protect those with pre-existing conditions must be in place. We remember the way it was before the ACA, and we’re not going back.