Source: Centers for Disease Control and Prevention, “Behavioral Risk Factor Surveillance System Survey Data” (2009).
Note: Some states have “guaranteed issue” statutes that prevent insurers from denying coverage on the basis of pre-existing conditions.
Nearly 72 million American adults live with chronic conditions such as asthma and diabetes. And these individuals often struggled, until recently, to maintain stable coverage—particularly those without employer-sponsored health insurance. Passage of the Affordable Care Act provides these Americans with new rights and protections, which will prevent insurance companies from refusing to issue coverage or otherwise discriminating against older, sicker individuals, as well as women. Yet opponents of the Affordable Care Act are trying to undermine these new gains by unraveling these reforms.
Individuals and small businesses could do little prior to reform to stop insurance companies from denying or limiting coverage based on any combination of health status, age, and gender. The Affordable Care Act when fully implemented will put an end to a number of notorious insurance company practices including:
- Denial of coverage based on pre-existing conditions
- Exclusion of coverage for a pre-existing condition
- Annual and lifetime limits on how much a health plan spends on an individual’s health care
- Premiums that vary based on health status and gender, and vary dramatically based on age
The above map shows state-by-state numbers and prevalence rates of adults who have a history of asthma, diabetes, or high blood pressure—three conditions insurance companies have used to limit or flat out deny coverage. Individuals with these conditions are now assured that they can obtain affordable, stable coverage, whether they purchase coverage on their own, receive coverage through a small business, or work for a large employer.
Nearly a third of all American adults have high blood pressure. Asthma and diabetes, though less prevalent, still affect up to a fifth and tenth of the adult population, respectively. These conditions, if left untreated, can lead to more serious health consequences, such as heart disease and kidney disease, and higher health care costs for both patients and payers.
If, for example, a patient with diabetes does not seek the requisite care to monitor his blood sugar, he is at a higher risk of kidney failure, amputation, and blindness—all of which are preventable. But reform opponents would put the 72 million Americans with chronic conditions at renewed risk of going without health insurance, and the health care it makes possible.
Asthma, diabetes, and high blood pressure are just a few examples from a long list of chronic conditions such as cancer, heart disease, and mental health problems that potentially prevented millions of Americans from obtaining quality, affordable health coverage. Consider that:
- About a quarter of working adults with pre-existing conditions delay or forgo needed medical care because of cost related access barriers.
- Among uninsured working adults, 38 percent go without needed care, 65 percent delay care, and 73 percent did not fill a prescription because of cost concerns.
Health reform provides new security and stability for Americans with chronic illnesses. The Affordable Care Act protects all Americans from bad insurance company practices, ensures coverage is affordable regardless of health status, and strives to stabilize the rise in health care costs by ensuring that both healthy and sick people have coverage.
Sonia Sekhar is a Research Assistant for Health Policy at American Progress.
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