Pre-existing conditions, the ACA and the AHCA

Under the Affordable Care Act (ACA) of 2014, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer. They cannot limit benefits for that condition either. Once you have insurance, they can’t refuse to cover treatment for your pre-existing condition.
— U.S. Department of Health and Human Services https://www.hhs.gov/healthcare/about-the-aca/pre-existing-conditions/index.html

On May 4, 217 Republican Representatives voted to approve the American Health Care Act.  This Act is meant to repeal and replace the ACA.  One provision of this act is a change to the way pre-existing conditions are treated.  The bill in its current state does continue to cover pre-existing conditions under certain circumstances.  You must have continuous care.  Because this plan also removes the mandate that everyone must have health insurance, you can choose to not buy health insurance.  If you get cancer, you will have to pay a penalty and then you are allowed to get coverage.  The insurance company can CHARGE YOU whatever they want.  Let's just say that again.

Yes, you can have health insurance if you have a pre-existing condition but the health insurance company can charge you a lot of money. many people will not be able to afford that coverage.

High Risk Pools: We've been here before 

Click the image above to go to the video from Kaiser Health News 

Click the image above to go to the video from Kaiser Health News 

What about the high risk pools (HRP)?  What about them?  In the past, many states had high risk pools. They were extremely expensive, and many people did not get the care they need. Julie Rovner explains why this "sounds like a good idea" but isn't.  Sounds Like A Good Idea: High Risk Pools

 

 

If you are wondering what's included in the list of pre-existing conditions, so are we.  This is a partial pre-existing conditions list from CNN:  

Acne

Acromegaly

AIDS or ARC

Alzheimer's Disease

Amyotrophic Lateral Sclerosis

Anemia (Aplastic, Cooley's, Hemolytic, Mediterranean or Sickle Cell)

Anxiety

Aortic or Mitral Valve Stenosis

Arteriosclerosis

Arteritis

Asbestosis

Asthma

Bipolar disease

Cancer

Cardiomyopathy

Cerebral Palsy (infantile)

Chronic Obstructive Pulmonary Disease

Cirrhosis of the Liver

Coagulation Defects

Congestive Heart Failure

Cystic Fibrosis

Demyelinating Disease

Depression

Dermatomyositis

Diabetes

Dialysis

Esophageal Varicosities

Friedreich's Ataxia

Hepatitis (Type B, C or Chronic)

Menstrual irregularities

Multiple Sclerosis

Muscular Dystrophy

Myasthenia Gravis

Obesity

Organ transplants

Paraplegia

Parkinson's Disease

Polycythemia Vera

Pregnancy

Psoriatic Arthritis

Pulmonary Fibrosis

Renal Failure

Sarcoidosis

Scleroderma

Sex reassignment

Sjogren's Syndrome

Sleep apnea

Transsexualism

Tuberculosis

The Kaiser Family Foundation, a nonpartisan research group, has estimated that 27 percent of Americans younger than 65 have health conditions that would likely leave them uninsurable if they applied for individual market coverage under the system that existed before the Affordable Care Act. (New York Times, 5/6/17)  

One last point, this bill was passed by the House of Representatives and has a long way to go before it is signed by the President and becomes law.  Please make your voice and opinion heard by your elected officials.  It does make a difference. 

If you have questions, post them in the comments section and we will do our best to answer.  

-Meredith Buhalis

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