Dive Brief:
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More than one-quarter (27%) of adult Americans under the age of 65 have pre-existing conditions that would have prevented them from purchasing health coverage in the individual insurance market before the Affordable Care Act (ACA), according to a Kaiser Family Foundation report published Monday.
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Before the ACA banned denials based on pre-existing conditions, payers routinely denied coverage or charged higher premiums to patients with conditions like HIV, arthritis, substance abuse disorders, diabetes and more.
- Some Republicans, including President-elect Donald Trump have announced support for the ACA provision that bans denials based on pre-existing conditions, but it is unclear how this would fit in a Republican replacement plan.
Dive Insight:
The Kaiser Family Foundation used data from the National Health Interview Survey and the Behavioral Risk Factor Surveillance System to reach its conclusion. More than one-half of respondents to a separate Kaiser Family Foundation poll reported that they or someone in their household had a pre-existing condition.
The report did not include figures on the number of patients with pre-existing conditions who were able to receive coverage due to the ACA ban on denials for pre-existing conditions. However, it did note 8% of the non-elderly population received health coverage through the individual insurance market. Before the ACA went into effect, nearly one-fifth of individual insurance market applications were denied.
The Kaiser Family Foundation is not the first to point out consequences of repealing the ACA without a replacement plan in place. Last week, the Urban Institute issued a report that determined the uninsured rate would double if the ACA were repealed and no other action were taken.
Some Republicans have voiced support for certain ACA provisions, such as the one that bans denials based on pre-existing conditions. However, popular provisions like these are unlikely to be effective without unpopular provisions, such as the individual and employer mandates. As Uwe Reinhardt wrote for Vox in November, the ACA uses these provisions to fund health coverage for high-cost patients, such as those with multiple chronic conditions.
