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Worry No More

By Kate Blocher,


Do you have a pre-existing condition? Do you know someone that does? I bet you do-64.8 million Americans under the age of 64 have been diagnosed with a pre-existing condition. Whether it’s diabetes, or cancer-all of these conditions and more are considered “pre-existing” by insurance companies and are grounds for charging higher premiums, excluding coverage for your condition, or downright denying you health coverage.

For years, our insurance system has operated under these rules. If you’re sick, or have been sick, we don’t have to give you coverage. You’re too expensive, too much of a risk. And yet, these are the people that need insurance the most.

Not anymore. Thanks to Obamacare, starting in 2014, people with pre-existing conditions will be protected from discrimination based on their health status. No American can be denied coverage, charged a higher premium, or sold a policy that excludes coverage of important health services simply because of a pre-existing condition.

Just how many people does this affect? To find out, Families USA commissioned The Lewin Group to quantify the number of Americans who have been diagnosed with pre-existing conditions. They also took a closer look at who exactly will be helped, in each state and in each county. They found no group is immune to the effects of this pervasive problem: young and old, black and white, rich and poor, all have a great deal to gain from health reform’s protections against discrimination based on pre-existing conditions.

Still not convinced of the need for these reforms? Maybe Donna C.’s story will help.

Donna’s son has two pre-existing conditions-high blood pressure and acute pancreatitis-conditions he was managing, until he lost his job. With his job, he lost his health coverage and within two weeks he was hospitalized with a medical emergency. Luckily, he had his insurance coverage until the end of the month. Unluckily, they kept him in the hospital 29 days, almost two weeks after his insurance had lapsed. As a result, he accrued a $60,000 medical bill-a price most Americans couldn’t cover, let alone someone who had just lost their job.

Sadly, six months later, her son was again admitted to the hospital. He was still jobless and without insurance. As a result, the hospital only kept him three days, sending him home still very sick and in a lot of pain.

Like many Americans with pre-existing conditions, Donna’s family looked into insurance for her son, but all they were offered were very expensive plans ($1200-$1600) that still wouldn’t cover his pre-existing conditions. This was not an option.

Luckily, the passage of health reform created a new insurance program, known as the Pre-Existing Condition Insurance Plan, or PCIP. Donna’s son was able to find coverage through this plan that not only covered his pre-existing conditions, but was affordable at $188 per month. And starting in 2014, he will be able to apply for insurance through the individual market that will no longer be able to discriminate against him because of his health status.

Donna is thankful for Obamacare; Obamacare gave her son a lifeline.

Do you have a pre-existing condition story, or a story of how you’ve been helped by Obamacare, or will be helped? Share it with us at www.HeartofObamacare.org.