Americans are compassionate and rightfully concerned for our friends and neighbors with costly health conditions. That’s why there’s so much support for rules in the Affordable Care Act that prohibit insurance companies from denying coverage or charging higher premiums to anyone due to a pre-existing condition. More than 7 in 10 Americans say these protections are “very important.”
But there’s widespread misinformation and misunderstanding about the scope of the problem of pre-existing conditions and the impact of the ACA’s rules. Most Americans with health conditions, even newborns, were protected from medical underwriting and coverage denials before the ACA passed, either because they were insured through a large group plan, regulated by federal laws that predate the ACA, or through Medicare or Medicaid.
While the ACA’s rules helped a relatively small number of people, they wreaked havoc on insurance markets for everyone else. In fact, they fundamentally changed how health insurance works, from protecting people from unexpected loss to a voluntary (and unsuccessful) attempt at socializing everyone’s healthcare costs.
How has this played out? The ACA rules on pre-existing conditions were the biggest factor in premium increases, imbalanced insurance pools, and insurer exits from the ACA exchanges, ultimately leaving consumers with little or no choice in health plans. There are better ways to help those with pre-existing conditions. Americans should channel our concern for those facing costly health conditions toward a more focused solution that doesn’t come with the harms of the ACA rules.