Fast Facts on Pre-Existing Conditions

There are some false and misleading narratives being spread about pre-existing conditions and how healthcare reforms could affect them. We realized it is important to clear the air and give you the truth about this important topic.

Here are the facts about pre-existing conditions:

  • In the insurance world, a pre-existing condition specifically means one that existed before someone was insured. (Sources: Department of Labor, Healthcare.gov)
  • With the proposed healthcare reforms, people with pre-existing conditions would be protected. States would set their own policies on pre-existing conditions and establish safety-net programs using financial support from federal grants. (Source: American Health Care Choices proposal)
  • Before the Affordable Care Act, about 500,000 people faced barriers to coverage because of a pre-existing condition. Even before the ACA, employer-based insurance plans could not deny coverage to anyone or exclude a pre-existing condition. People on Medicare and Medicaid similarly did not (and do not) face barriers to coverage due to pre-existing conditions. Some states also had rules forbidding coverage denials or exclusions in the market for individually-purchased plans, and some other states guaranteed coverage through safety-net programs. (Sources: The Wall Street Journal, U.S. Department of Health and Human Services)

Under the proposed healthcare reforms, uninsured people with pre-existing conditions could be added to a Guaranteed Protection Program year-round. (Source: Congressional Budget Office)



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