Monday, December 22nd, 2014

The Obameter

Require insurance companies to cover pre-existing conditions

Require insurance companies "to cover pre-existing conditions so all Americans, regardless of their health status or history, can get comprehensive benefits at fair and stable premiums."

Updates

Ban on denying insurance because of a pre-existing condition is achieved

Requiring insurance companies to accept people with pre-existing conditions is one of the cornerstones of the health care reform bill passed by Congress and signed by President Barack Obama on March 23, 2010.

The issue is addressed in Section 2704 of the bill, which states very clearly, "A group health plan and a health insurance issuer offering group or individual health insurance coverage may not impose any pre-existing condition exclusion with respect to such plan."

And Section 2705 spells the prohibition out in even more detail:

"A group health plan and a health insurance issuer offering group or individual health insurance coverage may not establish rules for eligibility (including continued eligibility) of any individual to enroll under the terms of the plan or coverage based on any of the following health status-related factors in relation to the individual or a dependent of the individual: health status; medical condition (including both physical and mental illnesses); claims experience; receipt of health care; medical history; genetic information; evidence of insurability (including conditions arising out of acts of domestic violence); disability; any other health status-related factor determined appropriate by the Secretary."

In addition, the bill makes clear that insurance companies cannot charge more for people with pre-existing medical conditions; nor can they charge more for women.

The requirement to cover people with pre-existing conditions doesn't kick in until 2014. Until then, a new high-risk pool will offer coverage to uninsured people with pre-existing medical problems.

Republicans have vowed they will try to repeal the health reform bill -- and if they are successful, it's unclear how things might shake out on covering people with pre-existing conditions -- but unless or until that happens, the bill signed by the president is the law. And so we rate this one a Promise Kept.

Sources:

Patient Protection and Affordable Care Act, as passed by Congress, and signed by President Obama, March 23, 2010

Health reform bill ends pre-existing condition exclusions

After months of talking about health care reform, the U.S. House of Representatives introduced major legislation to overhaul the nation's health care system. House Democrats unveiled the 1,000-plus-page bill, called America's Affordable Health Choices Act of 2009, on July 14, and it includes most of President Barack Obama's key proposals on health reform.

One of Obama's promises was to require insurance companies to cover pre-existing health conditions. The House legislation states that "qualified health benefits plan may not impose any pre-existing condition exclusion."

We should be clear that there's a long way to go — maybe months — before this bill becomes law. It has to pass the House and get through the Senate, where many changes could be made.

Nevertheless, the bill marks significant, measurable progress on Obama's promise, and we rate it In the Works.

Sources:

Thomas, HR 3200 , introduced July 14, 2009

U.S. House of Representatives Energy and Commerce Committee, House Democrats Introduce Bill to Provide Quality, Affordable Health Care for All Americans , July 14, 2009

U.S. House of Representatives Committee on Ways and Means, Markup of H.R. 3200, America"s Affordable Health Choices Act , July 16, 2009