Pre-existing condition, terminology used by insurance / healthcare industry , is a medical condition already suffered by a proposer before the starting date of an insurance policy.
In the context of healthcare in the United States, a pre-existing condition is a medical condition that started before a person’s health benefits went into effect. Before 2014 some insurance policies would not cover expenses due to pre-existing conditions.
Under the ACA (Affordable Care Act) or Obamacare, insurance companies couldn’t refuse or charge someone with pre-existing conditions. On May 4 2017, the U.S. House of Representatives passed the Republican replacement for the Affordable Care Act (ACA).
In the mean time they proposed plan called the American Health Care Act (AHCA), or Trumpcare, the that would repeal and replace many parts of the Affordable Care Act (ACA) or Obamacare.
If the American Health Care Act (AHCA is passed), insurance companies still won’t be able to deny pre-existing condition health coverage. But what they will be able to do, is put someone with pre-existing conditions in a “high-risk pool” and charge them more money for their insurance plan, in some cases, the price increase might be so great that they are unable to afford the insurance plan at all.
The AHCA (Trumpcare) would allow states to withdraw the pre-existing condition protections in ACA (Obamacare) and create high-risk pools instead.
Conceptively, AHCA (Trumpcare) were subsidized by fees to insurance companies and taxes to keep insurance premiums low and support the sickest Americans. In reality, insurance companies were still allowed to raise their premiums, which made premiums significantly higher for those in high-risk pools than for those not in high-risk pools that known were expensive.
American Association of Retired Persons (AARP) estimates that if the AHCA is passed its high-risk pools policy in 2019, as proposed, high-risk pool premiums for people with pre-existing conditions could be as high as $25,700 annually or about $2,140 monthly.
Prior to the ACA (Obamacare), there was a long list of pre-existing conditions same health problems would likely put someone in a high-risk pool if the AHCA is passed. Here’s a look at the most common conditions from that list :
• AIDS / HIV
• Alcohol or drug abuse (with recent treatment)
• Alzheimer’s / dementia
• Arthritis (rheumatoid), fibromyalgia), and other inflammatory joint disease
• Cancer within some period of time
• Cerebral palsy
• Congestive heart failure
• Coronary artery and heart disease (bypass surgery)
• Crohn’s disease / ulcerative colitis
• Chronic obstructive pulmonary disease (COPD) / emhysema
• Diabetes mellitus
• Hepatitis (C)
• Kidney disease, renal failure
• Mental disorders (including anxiety, bipolar disorder, depression, obsessive compulsive disorder, and schizophrenia)
• Multiple sclerosis
• Muscular dystrophy
• Obesity, severe
• Organ transplant
• Parkinson’s disease
• Pending surgery or hospitalization
• Pneumocystic pneumonia
• Pregnancy or expectant parent (including fathers)
• Sleep apnea
There are many other health problems that could count as pre-existing conditions under the AHCA. Following conditions might also result in higher insurance premiums :
• Acid reflux
• Adult acne
• Celiac disease
• Heart burn
• High cholesterol
• Kidney stones
• Knee surgery
• Lyme disease
• Postpartum depression
• Seasonal affective disorder
• “Sexual deviation or disorder”
This is not a comprehensive list, many conditions could count as pre-existing depend on the insurance companies.