The ACA on Pre-Existing Conditions

May 7, 2010

Here’s the skinny (from Meredith Hughes at the New America Foundation’s health policy blog) on what the Affordable Care Act does (or will do) for people with pre-existing conditions:

  1. The first is establishing high risk pools. Starting at the end of June, individuals with pre-existing conditions who have been uninsured for the past six months will be eligible to enroll in a national high risk pool. The pools are intended to be temporary — they will expire when the health insurance exchanges launch. It’s not yet completely clear how many people will be able to get coverage this way, or what it will cost.
  2. The state-based Health Benefit Exchanges will start in 2014. The exchanges allow Americans, including individuals with pre-existing conditions who cannot get affordable coverage elsewhere, to shop for quality health insurance. In this new insurance marketplace envisioned by national health reform, everyone will be required to purchase insurance — which in turn means that no one can be denied insurance because of a pre-existing condition. Through the exchanges, consumers will have access to affordable, quality coverage and transparent information about benefit design.
  3. Also, starting this year, insurers cannot deny coverage to children with pre-existing conditions. The report estimates that five million children under age 18 have been diagnosed with such a condition. Though this requirement doesn’t become law until September, insurers capitulated to pressure from HHS and agreed to start covering children immediately.
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