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Cummings and Pallone Release Report Showing What Life Was Like for Americans with Pre-existing Conditions

May 3, 2017
Press Release

#BeforeTheACA:

 

 

Cummings and Pallone Release Report Showing What Life Was Like for Americans with Pre-existing Conditions

 

Washington, D.C. (May 3, 2017)—Today, Rep. Elijah E. Cummings, Ranking Member of the House Committee on Oversight and Government Reform, and Rep. Frank Pallone, Jr., Ranking Member of the House Committee on Energy and Commerce, released a report originally issued in 2010 by  former Rep. Henry A. Waxman, who served at the time as Chairman of the House Committee on Energy and Commerce, exposing the actions of insurance companies that denied health coverage based on pre-existing conditions before the Patient Protection and Affordable Care Act (ACA) was passed by Congress and signed into law by President Obama.

“People forget how incredibly bad things were before the Affordable Care Act became the law of the land, and this report reminds us what life was like for Americans with pre-existing medical conditions who could not afford adequate coverage,” said Cummings.  “This is one of the primary reasons we passed the ACA in the first place, but now President Trump and congressional Republicans want to return to those miserable days and place the lives of millions of Americans at risk.”

“What was old could be new again if President Trump and the House Republican leadership get their way,” Pallone said. “Chairman Waxman’s 2010 report highlights just how bad things were for people with pre-existing conditions before the Affordable Care Act.  Today, thanks to the ACA, more than 129 million Americans cannot be discriminated against because of their pre-existing conditions. The latest version of Trumpcare would return us to the days of the Wild West when insurance companies could charge people with pre-existing conditions whatever they want for health coverage.”

#BeforeTheACA, insurance companies discriminated against Americans with pre-existing conditions by refusing coverage or charging exorbitant amounts that effectively priced people out of the market:

  • From 2007 through 2009, the four largest health insurance companies denied coverage to more than 651,000 people and declined an additional 212,800 claims based on pre-existing medical conditions.  On average, these four companies denied coverage to one out of every seven people because of a pre-existing condition. 
  • Being a woman was a pre-existing condition.  One insurance company automatically denied coverage to any woman who was pregnant or had received infertility treatment within the past five years. 
  • Insurance companies maintained lengthy lists of medical conditions, lifestyle choices, and even professions that would result in coverage exclusions, expensive insurance riders, higher premiums and deductibles, or flat-out denials of coverage:

    

  • One insurance company maintained a list of over 425 medical conditions that would result in an applicant being permanently denied coverage.
  • Pregnancy, diabetes, and heart disease were considered declinable conditions.
  • Even young people were denied coverage.  One insurance company reported denying coverage to roughly 10% of applicants between the ages of 18 and 30.

 

  • One insurance company reported issuing insurance policy riders that excluded coverage or imposed additional charges for 14.7% of its individual market enrollees. The top four riders were for Caesarean section deliveries, back disorders, psychological and psychiatric disorders, and cholesterol treatment.
  • One insurance company likened providing health insurance to “gambling” and boasted, “We try to ‘win’ our bets.”
  • One insurance company lamented its “decreased ability to use pre-existing claim denials and rescind policies” as driving up losses and sought to maximize pre-existing coverage exclusions “to the extent allowed by law.”

The plan now being pushed by President Trump and House Republicans would take us back to life #BeforeTheACA.  It would let states waive critical protections that would in turn:

  • allow insurance companies to discriminate against Americans with pre-existing medical conditions by charging them as much as they want for insurance coverage, effectively pricing them out of the market;
  • quarantine sick people into high-risk pools known for long waiting lines, caps on enrollment, coverage exclusions, sky-high premiums, and outrageous deductibles; and
  • make Essential Health Benefits optional, including maternity coverage, mental health care, and prescription drug benefits.

For exactly these reasons, dozens of patient advocacy, provider, senior, and other groups have voiced their strong opposition to the Republican plan.

Watch a new video released by Cummings on life #BeforeTheACA when insurance companies could discriminate against Americans with pre-existing conditions.

115th Congress