The Cost and Effect of Pre Existing Conditions Law
Randall S. Housman
Elms College The Affordable Care Act (ACA) was signed into law on March 23, 2010 by the Obama administration, and was the largest regulatory overhaul of the Healthcare system since the passage of Medicare and Medicaid in 1965. The law is seen as finalizing decades of efforts to provide predominantly low income Americans with affordable health insurance. It also mandates that all Americans have health insurance either privately, or through one of the exchanges provided by the law. One of the ACA’s main selling points during the health care reform debate was the need to provide insurance coverage to those with pre-existing conditions. A pre-existing condition is defined as a health problem that existed before you apply for a health insurance policy or enroll in a new health plan. Insurance companies and Insurance provided health plans being a for profit organization must be concerned about the financial bottom line, therefore it is in their best financial interest to exclude people with a pre-existing condition, or impose a waiting period before coverage starts, or charge higher premiums and out-of-pocket expenses. This has been a standard of practice on some shape or form, but varying from state to state. Data from a recent analysis by the Department of Health and Human Services shows that in the United States approximately 50 to 129 million people, or roughly 19 to 50 percent of non-elderly Americans suffer some sort of pre-existing health condition. Of those people, up to one in five, or roughly 25 million do not have health insurance. As of this year, the ACA prohibits insurance companies from excluding anyone with a pre-existing medical condition from coverage (called guaranteed issue). Leading up to this implementation, as of September 2010, children