Some 52 million working-age adults have a pre-existing medical condition that would likely have left them unable to get health coverage before the Affordable Care Act, according to a new analysis by the Kaiser Family Foundation.
Millions of others with similar conditions would likely have faced higher premiums, coverage exclusions or coverage limitations because of stiff underwriting standards faced by people buying insurance outside the workplace before the health law was enacted.
This individual insurance market had long been problematic for consumers. It was known for high customer dissatisfaction and turnover, high coverage denial rates, lean benefits and premiums subject to frequent increases.
The ACA guaranteed access to individual and small-group health coverage regardless of current or past health problems. The law also limited the amount that older plan members could be charged; outlawed annual benefit-spending limits and stopped insurers from varying rates based on gender, occupation and medical claims history.
The ACA guaranteed access to individual and small-group health coverage regardless of current or past health problems. The law also limited the amount that older plan members could be charged; outlawed annual benefit-spending limits and stopped insurers from varying rates based on gender, occupation and medical claims history.
In 11 states, at least 30 percent of non-elderly adults are estimated to have a declinable medical condition like high blood pressure or diabetes, the study found. The 11 are: West Virginia (36%), Mississippi (34%), Kentucky (33%), Alabama (33%), Arkansas (32%), Tennessee (32%), Oklahoma (31%), Louisiana (30%), Missouri (30%), Indiana (30%) and Kansas (30%).
When measured by number of people affected, California led all states with nearly 5.9 million people with declinable conditions followed by Texas with more than 4.5 million and Florida with more than 3.1 million.
President-elect Donald Trump and congressional Republicans have vowed to repeal the Affordable Care Act, but haven’t laid out a plan to replace it.
A previous Kaiser poll reported that 53 percent of people said they themselves or a household member had a pre-existing condition.
Tony Pugh: 202-383-6013, @TonyPughDC
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