Are You One of the 27 Percent?
Posted December, 20 2016 by Amanda Dunker
Twenty-seven percent of people under 65 have a pre-existing condition that would make them uninsurable without the Affordable Care Act (the ACA, or “ObamaCare”) and they’ve been talking about it using the hashtag the27percent.
Not sure if you are one of those people? The Kaiser Family Foundation just released a partial list of conditions that used to make people uninsurable in the private individual market. They included cancer, diabetes, epilepsy, multiple sclerosis, paralysis, Parkinson’s disease, pregnancy, and sleep apnea.
The situation for people with pre-existing conditions was one of the most serious barriers in our pre-ACA health care system and was a major reason we needed health reform. New York had a state law before the ACA that prevented the most serious consequences, and that law will likely take effect again if the ACA is repealed. So New Yorkers don’t have to fear outright denials of coverage. However, our law allowed a year-long waiting period in which insurance companies could exclude coverage for any treatment related to pre-existing conditions. That means that if you had something like diabetes or even cancer, you would have to pay for that care on your own for an entire year, even when you had insurance.
There’s another problem with reverting back to our state law – it ended up undermining our individual market because it was not coupled with an individual mandate or other incentives for healthy people to buy insurance, such as premium subsidies and tax credits. It costs insurance companies more money to cover people with pre-existing conditions. They need something like the mandate or premium assistance to encourage enough healthy customers into their market.
Some of the people who are most opposed to the ACA have said that they’d like to keep the pre-existing condition protection as is and just remove some parts of the law. The parts slated for immediate repeal include the individual mandate and the subsidies that help people pay their premiums based on income. In New York, we know that won’t work.
So read people’s stories, and consider sharing yours. And don’t accept simplistic assurances on the pre-existing conditions issue. ACA-opponents have promised to immediately repeal the mandate and funding for things like premium subsidies that make the pre-existing condition protection feasible. Opponents have had years to come up with a strategy to address this issue that is different from the ACA, avoids major disruptions to the market, and does not place unfair burdens on people experiencing health problems. It’s past time for them to reveal some details.