Policy-ish

Defending Overhaul, Administration Says Pre-Existing Conditions Are Common

Look at your friends and family. Look at yourself in the mirror.

Chances are good that quite a few people in your social circle have health trouble that would make it a lot more expensive or impossible to get health insurance, according to an analysis the Department of Health and Human Services released Tuesday morning.

doctor i

Starting in 2014, insurers can no longer carve out needed benefits, charge higher premiums, set lifetime limits on benefits, or deny coverage due to a person’s preexisting condition. AP hide caption

toggle caption AP
doctor

Starting in 2014, insurers can no longer carve out needed benefits, charge higher premiums, set lifetime limits on benefits, or deny coverage due to a person’s preexisting condition.

AP

The report, timed to come out just as the Republican-controlled House moves ahead with a bill to repeal the federal health overhaul, estimates that as many as 129 million Americans younger than 65 have some sort of pre-existing condition.

All told, 19 to 50 percent of those people have a health issue that would complicate the purchase of private health insurance. Asthma and high blood pressure could drive the costs up. More serious health problems could scotch private insurance altogether.

About 25 million people who don't yet qualify for Medicare with a pre-existing condition are uninsured, the analysis says.

The administration is using the findings to bolster the need for overhaul:

Starting in 2014, insurers can no longer carve out needed benefits, charge higher premiums, set lifetime limits on benefits, or deny coverage due to a person’s preexisting condition.

The insurance industry disputed the estimates, saying they make the problem look worse than it is. Most  non-elderly people with a health issue do get insurance through their employer plans — as many as 82 million, according to the report. "We have long agreed that the individual insurance market needs to be reformed, but this report significantly exaggerates the number of people whose coverage is impacted by pre-existing conditions," America's Health Insurance Plans spokesman Robert Zirkelbach said in a statement e-mailed to Shots.

An unnamed Republican House aide told The Washington Post, which first reported on the administration's study, "When a new analysis is released on the eve of a vote in Congress, it's hard to view it as anything but politics and public relations."

Comments

 

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

NPR thanks our sponsors

Become an NPR sponsor

Support comes from