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HHS: Repeal of Reform Threatens Those with Pre-Existing Conditions

John Commins, for HealthLeaders Media, January 19, 2011

Before the Affordable Care Act, Sebelius said that insurance companies in most states could deny individual coverage, charge higher premiums, and/or limit benefits based on pre-existing conditions. Surveys have found that 36% of Americans who tried to purchase health insurance directly from an insurance company in the individual insurance market encountered challenges purchasing health insurance for these reasons.

Although most of the provisions of the Affordable Care Act don't take effect until 2014, several already are in place. For example, insurers can no longer limit lifetime coverage to a fixed dollar amount or take away coverage because of a mistake on an application. Young adults have the option of staying on their parents' coverage up to the age of 26 if they lack access to job-based insurance of their own, and insurers cannot deny coverage to children because of a pre-existing condition, HHS said. 

Many uninsured Americans with pre-existing conditions have already enrolled in the temporary high-risk pool program called the Pre-existing Condition Insurance Plan, which provides private insurance to those locked out of the insurance market because of a pre-existing condition. The PCIP program serves as a bridge until 2014, when insurance companies can no longer deny or limit coverage or charge higher premiums because of a pre-existing condition, HHS said.  


John Commins is a senior editor with HealthLeaders Media.

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1 comments on "HHS: Repeal of Reform Threatens Those with Pre-Existing Conditions"


Regina (1/19/2011 at 12:20 PM)
Does the DHHS report mention anything about the Portable Insurance Provisions of the Kennedy-Kassebaum law that was passed in 1996. The major focus of the legislation was an attempt to make health insurance more portable for people who lose their jobs. Under the bill, an individual who has had insurance coverage for the previous 12 months can move from one job to another without being subject to preexisting condition exclusions. He cannot be denied coverage or charged higher premiums than a healthy person. Individuals who lose their jobs are also guaranteed the right to convert their previous group policy to individual coverage.