There’s no denying that Obamacare, or the Affordable Care Act (ACA), has dramatically reformed health care in the United States, or at least health insurance. With the enactment of Obamacare, U.S. citizens (and certain other residents) must now meet mandatory minimums for coverage or face penalties, while businesses over a certain size must provide health insurance options for employees.
On the other hand, insurance providers have also had to undergo a series of reforms, all for the benefit of members. Under ACA rules, insurance policies must meet mandatory minimums regarding essential coverage, including a variety of preventive care services for adults, women, children, and seniors.
In addition, they are no longer allowed to discriminate against applicants due to preexisting conditions. What are preexisting conditions and what has changed in regards to health insurance coverage under Obamacare?
What Are Preexisting Conditions?
According to the U.S. Department of Health and Human Services, preexisting conditions are defined as health problems that existed in a patient prior to the start date of new health coverage. This could include anything from asthma or severe allergies to more serious conditions like diabetes or even diseases that have been cured, such as cancer. Disabilities (inborn or otherwise) would be considered preexisting conditions.
Preexisting conditions are not only known health issues, but they are health issues for which patients have received medical advice and/or treatment prior to enrolling in a new health plan.
Preexisting Conditions before Obamacare
In the past, people with preexisting medical conditions found themselves in a precarious position. Not only could insurance companies levy additional charges for premiums because of these conditions, but they could also use them as an excuse to limit or deny coverage, or even to drop members that were paying in good faith for coverage.
In addition, the conditions that some insurance providers cited as preexisting conditions could be viewed as inherently unfair and discriminatory. For example, pregnant women who signed up for health care were often considered to have a preexisting condition (i.e. pregnancy).
In fact, many women were routinely charged more for health insurance coverage because of the fact that they might become pregnant and incur prenatal, delivery, and other expenses related to pregnancy and childbirth. In other words, simply being a woman was treated as a preexisting condition.
Those with disabilities, chronic conditions, diseases, or other preexisting conditions could also be treated unfairly with outrageous fees for coverage, strict limitations on services covered by insurance policies, and outright denial of coverage due to preexisting conditions.
Changes for Those with Preexisting Conditions
Thanks to Obamacare, those with preexisting conditions no longer have to worry about unfair treatment by health insurance providers. The ACA no longer allows the denial of benefits due to preexisting conditions, nor are insurance providers allowed to continue discriminatory practices like charging more for applicants that suffer preexisting conditions.
Of course, there is one loophole: grandfathered plans. However, it is extremely unlikely that those with preexisting conditions would choose to keep their former coverage, likely at a much higher rate and with more restrictions for coverage, when so many more appealing health insurance options now exist.