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New Report: Health Reform Protects 57 Million Americans with Pre-Existing Conditions

Posted on by Karina

The Affordable Care Act will help ensure that all Americans have access to quality, affordable health care and significantly reduce long-term health care costs. Congressional Republicans continue to call for the repeal of the Affordable Care Act, including the essential protections for Americans with pre-existing conditions, and would return American workers, their families and small businesses to an uncertain future in a broken system with coverage gaps, denied care, and skyrocketing costs.

A new report released by Families USA underscores the essential protections for Americans with pre-existing conditions included in the Affordable Care Act by President Obama in March. Without reform, the 57 million Americans under the age of 65–more than one in five people–with pre-existing conditions would be at risk of being denied coverage by health insurance companies.

From the report:

One in five Americans is at risk of being denied insurance coverage as a result of a pre-existing condition — including nearly 5 million children under the age of 18, and 4.5 million young adults aged 18 to 24.

Adults between the age of 45 and 64 — 28 percent of the non-elderly population — make up half of those with pre-existing conditions.

The Affordable Care Act puts an end to this costly and unfair practice that allowed health insurance companies to cherry-pick the healthiest beneficiaries while denying coverage to individuals with pre-existing conditions or charging more based on gender, health status, family history, or occupation. Key provisions that protect Americans with pre-existing conditions in the new law:

NO DISCRIMINATON AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS
Prohibits all employer plans and new plans in the individual market from denying coverage to children with pre”existing conditions. Effective for plan years beginning on or after September 23, 2010.

IMMEDIATE HELP FOR THE UNINSURED WITH PRE-EXISTING CONDITIONS (INTERIM HIGH-RISK POOL)
Provides immediate access to insurance for Americans who are uninsured because of a pre”existing condition ” through a temporary high”risk pool — until the Exchanges are up and running in 2014. Effective on July 1, 2010.

NO DISCRIMINATION FOR PRE-EXISTING CONDITIONS, GENDER OR OTHER CHARACTERISTICS
Prohibits insurers and health plans from denying individuals health insurance coverage due to a pre”existing condition and from charging individuals with pre”existing conditions higher premiums or excluding coverage for specific conditions. Insurers and health plans selling to individuals and small businesses will also be prohibited from charging higher premiums due to gender, health status, family history, or occupation. Effective in 2014 (when the Exchanges are up and running).

In addition to the prescription drug help for seniors going out ahead of schedule, early adoption of the ban on rescissions, expanded coverage for young adults and the tax credits for small businesses, news reports detail more benefits coming soon:

The Columbian (Washington state) — Health reform to be felt soon in state
Washington is gearing up to begin implementing the federal health reform law, and several kinds of people who lack adequate health coverage will reap benefits soon.

Among them are people who suffer from a serious health problem, lack employer-provided health coverage and can't buy a private policy at any price…

For Keiser and other state officials who have struggled to address health care reform at the state level in a time of yawning budget shortfalls, the federal help that is starting to arrive is welcome indeed.

“It's happening so fast, it's mind-boggling,” Keiser said, “after years of slogging through.”

Columbus Dispatch — Ohio acts to help high-risk patients

A popular piece of the health-care overhaul bans insurance companies from denying individual coverage or charging high premiums to people with pre-existing medical conditions.

But for adults younger than age 65, that provision doesn't kick in until 2014.

In the meantime, the federal government wants states to create temporary high-risk pools through which people with cancer, multiple sclerosis and diabetes who have been uninsured for at least six months can buy affordable coverage…

There's $5 billion in federal dollars to fund a pool in every state until 2014. Ohio is estimated to be in line for $152 million.

The money will pay claims for high-risk people beyond what their premiums cover. State officials estimate 6,000 to 15,000 Ohioans could be in a high-risk pool.

San Diego Business Journal — Health Care Reform Package Provides $1B Tax Credit for Biotechs

Small biotech and medical device companies in San Diego are looking into a new grant opportunity that would provide up to $5 million apiece to offset a portion of their research and development costs.

Signed into law with the rest of the health care reform package was a $1 billion therapeutic discovery tax credit aimed at biomedical research projects that show potential in advancing life-saving treatments for unmet medical needs, including cancer, and in lowering the long-term costs of health care and supporting jobs.

Read Families USA’s national report and state-specific reports»

Learn more about the consumer protections and insurance market reforms in the Affordable Care Act»

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