General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region Forums27% of people under age 65 have pre-existing conditions, would be uninsurable absent ACA
http://kff.org/health-reform/issue-brief/pre-existing-conditions-and-medical-underwriting-in-the-individual-insurance-market-prior-to-the-aca/"Before private insurance market rules in the Affordable Care Act (ACA) took effect in 2014, health insurance sold in the individual market in most states was medically underwritten.1 That means insurers evaluated the health status, health history, and other risk factors of applicants to determine whether and under what terms to issue coverage. To what extent people with pre-existing health conditions are protected is likely to be a central issue in the debate over repealing and replacing the ACA.
This brief reviews medical underwriting practices by private insurers in the individual health insurance market prior to 2014, and estimates how many American adults could face difficulty obtaining private individual market insurance if the ACA were repealed or amended and such practices resumed. We examine data from two large government surveys: The National Health Interview Survey (NHIS) and the Behavioral Risk Factor Surveillance System (BRFSS), both of which can be used to estimate rates of various health conditions (NHIS at the national level and BRFSS at the state level). We consulted field underwriting manuals used in the individual market prior to passage of the ACA as a reference for commonly declinable conditions.
Estimates of the Share of Adults with Pre-Existing Conditions
We estimate that 27% of adult Americans under the age of 65 have health conditions that would likely leave them uninsurable if they applied for individual market coverage under pre-ACA underwriting practices that existed in nearly all states. While a large share of this group has coverage through an employer or public coverage where they do not face medical underwriting, these estimates quantify how many people could be ineligible for individual market insurance under pre-ACA practices if they were to ever lose this coverage. This is a conservative estimate as these surveys do not include sufficient detail on several conditions that would have been declinable before the ACA (such as HIV/AIDS, or hepatitis C). Additionally, millions more have other conditions that could be either declinable by some insurers based on their pre-ACA underwriting guidelines or grounds for higher premiums, exclusions, or limitations under pre-ACA underwriting practices. In a separate Kaiser Family Foundation poll, most people (53%) report that they or someone in their household has a pre-existing condition.
The rates of declinable pre-existing conditions vary from state to state. On the low end, in Colorado and Minnesota, at least 22% of non-elderly adults have conditions that would likely be declinable if they were to seek coverage in the individual market under pre-ACA underwriting practices. Rates are higher in other states particularly in the South such as Tennessee (32%), Arkansas (32%), Alabama (33%), Kentucky (33%), Mississippi (34%), and West Virginia (36%), where at least a third of the non-elderly population would have declinable conditions."
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Vinca
(50,288 posts)unc70
(6,115 posts)In most states, a small business (<50 employees) also had to buy in the individual market, subject to those difficult underwriting requirements.
MoonRiver
(36,926 posts)Sayeth our Repuke overlords.
Pachamama
(16,887 posts)Even I can be insured privately, my premium and costs are higher than most peoples rent, food and utilities.
Glimmer of Hope
(5,823 posts)I just moved to California where I hope it is safe.
workinclasszero
(28,270 posts)Death to the non-rich and decrease the surplus population.
TheOther95Percent
(1,035 posts)I had life-saving surgery in July. The bill came to over $200K not counting the three other hospitalizations in 2016. Shit. One week of the at-home IV was $2000.
Turn CO Blue
(4,221 posts)Hubby had a very curable form of lymphoma, but it will not matter - any form of blood or lymph cancer used to be an AUTOMATIC denial by Blue Cross & Blue Shield, even outside of 7 years of remission. (on edit: I'm sure UHC had a similar list of conditions but couldn't find it.)
I'm sure the bloodsuckers are digging up their old lists of conditions and getting ready to do a mass mailing of DROPPED COVERAGE when Congress pulls the trigger.