A court case now under deliberation in the 5th U.S. Circuit Court of Appeals could have devastating consequences for people with preexisting health conditions. In Texas v. United States, 18 states’ attorneys general—with support from the Trump administration—are challenging the constitutionality of the Affordable Care Act (ACA), including the law’s consumer protections that prevent insurance companies in the individual market from discriminating against people with preexisting conditions. These protections include a ban on varying rates according to gender or health status, a guarantee that plans issue coverage to anyone who wants to enroll, and a requirement that all plans cover 10 categories of essential health benefits. If the court rules in the plaintiffs’ favor, the lawsuit could bring down the entire ACA in the plaintiff states or for the whole country.
Among those who would suffer from nationwide repeal of the ACA through the courts are the 20 million people who would become uninsured and those, whether uninsured or not, with preexisting conditions. According to new estimates from the Center for American Progress, 135 million people under age 65, or about half of nonelderly people, have a preexisting condition that an insurer could use to discriminate against them if they ever sought coverage through the individual market in the absence of ACA protections. Each congressional district is home to nearly 310,000 people with preexisting conditions, on average. Estimates for each district are in the table available for download at the top of this column and are detailed in the Methodology section.
Before the ACA, people with illnesses, disabilities, or a history of health problems found it difficult, if not impossible, to purchase affordable health insurance on their own. Most states had no restrictions on rating in the individual market, giving insurers unlimited ability to charge more based on characteristics including gender, age, health status, and occupational industry. Insurance companies could charge higher premiums or even deny coverage altogether because of a person’s medical history. The near-elderly were typically charged five times more than young adults, and women faced premiums up to 50 percent higher than those for men.
View the complete October 2 article by Emily Gee on the Center for American Progress website here.