What is the deal with ‘pre-existing conditions’?

    Got questions about the Affordable Care Act? WHYY/NewsWorks Health and Science Desk provides “The Short Answer.”

    Question: Will I be able to get health insurance with a pre-existing condition?

    Got questions about the Affordable Care Act? In a regular feature, the WHYY/NewsWorks Health and Science Desk is providing “The Short Answer.”

    Today’s question

    • WHYY thanks our sponsors — become a WHYY sponsor

    Under the Affordable Care Act, will I be able to get health insurance if I have a pre-existing condition?

    The short answer


    More details

    In the lead-up to health care reform, the term “pre-existing conditions” was thrown around quite a bit — probably because it’s a real pain point for a lot of Americans.

    Currently, for example, if I was between jobs and I went on the individual market to buy health insurance, companies could deny me or jack up my premiums if I was or had been sick.

    But starting Jan. 1, 2014, insurers cannot deny coverage because of pre-existing health conditions.

    What counts?

    The term “pre-existing conditions” covers a lot of ground.

    It includes everything from taking allergy medication, to being pregnant, to having heart disease.

    For insurance companies, the rationale had been that some of these people are really expensive to treat. It’s just too costly to cover them.

    But what about the rest of us?

    There is some debate as to how this will affect premiums across the health care system. Many have asked, Will this make insurance more costly?

    According to a report from the Associated Press in late 2012, covering people with pre-existing conditions could cost you $63. The annual per-head fee is supposed to be in place for three years, starting in 2014.

    Other data indicate that the move could have little overall impact on premiums. The logic behind the health reform law is that the individual mandate will bring more “healthy” people into the health insurance market. The number of “healthy” people will outweigh the “sick,” and a healthier population is cheaper to insure.

    According to a recent article from the Washington Post’s Wonkblog, that’s likely the reason why insurance premiums in New York state recently fell by half.

    The 2010 health law goes into effect Jan. 1, 2014. How will it affect you, your wallet and your health? Email your questions to healthandscience@whyy.org or tweet us at @NewsWorksWHYY.

    WHYY is your source for fact-based, in-depth journalism and information. As a nonprofit organization, we rely on financial support from readers like you. Please give today.

    Want a digest of WHYY’s programs, events & stories? Sign up for our weekly newsletter.

    Together we can reach 100% of WHYY’s fiscal year goal