Currently, millions of Americans with a history of illness face discrimination in the private individual health insurance market. They might face higher premiums, limitations in coverage, or be denied coverage altogether because they have high blood pressure, asthma, cancer, diabetes, or have ever taken certain prescription drugs—so-called “pre-existing conditions.”
The map below shows state-by-state the number and percentage of adults, aged 18-64, who have a history of asthma, high blood pressure, or diabetes—three conditions that private insurance companies use as a pretext to raise rates, restrict coverage, or deny insurance altogether.
Employers who provide health insurance are required to offer the same coverage to all their employees regardless of medical history. But in these tough economic times, hundreds of thousands of Americans are losing their job every month, and people with pre-existing conditions who lose their insurance through work may have a tough time finding coverage for themselves on the individual market.
The extent of this discrimination varies from state to state based on regulations. However, according to the Georgetown University’s Health Policy Institute analysis of state protections, there are only six states—Maine, Massachusetts, New Jersey, New York, Vermont, and Washington—in which these populations are guaranteed the issuance of private insurance at the same rates as others regardless of medical history (so-called “community rating”). In New Jersey and New York, discrimination based on age, gender, and occupation are also explicitly prohibited.
For people in most states who are already uninsured, a pre-existing condition could mean the difference between finding affordable insurance or not.
Substantial health care reform, however, could prevent private insurers from denying coverage to people based on their medical history. People with medical conditions in their past will be able to pay a fair price for full coverage that will keep families from being overloaded with out-of-pocket medical expenses.
For more on health reform please see:
- The Cost Shift from the Uninsured by Ben Furnas and Peter Harbage (CAP Action)
- The Inefficient Individual Health Insurance Market by Peter Harbage (CAP Action)
- Competitive Health Care by Peter Harbage and Karen Davenport (CAP Action)