Health Care Reform and Pre-Existing Conditions

I actually have to agree with the president’s signing statement when it comes to pre-existing conditions. I know, I know, I’m a squish, but it’s TRUE.


“For too long, tens of millions of Americans have been denied health insurance coverage because they have preexisting conditions. We have all heard their stories. A husband and his pregnant wife lose their insurance and then find they cannot buy new coverage because her pregnancy is considered a preexisting condition. A young woman starting out in her career cannot accept a promotion with another company because its health insurance policy won’t cover her diabetes. A small business owner faithfully pays his group health insurance premiums for years only to learn that his coverage won’t be renewed after one of his employees develops a heart condition. Since taking office, I have been fighting for changes that would stop this kind of unfairness and make health insurance more accessible for all people, including the most needy.”

Of course we should all agree with this. He also said:

“This legislation will set into motion several key reforms. First, it will eliminate the possibility that individuals can be denied coverage because they have a preexisting medical condition. Second, it will require insurance companies to sell coverage to small employer groups and to individuals who lose group coverage without regard to their health risk status. Finally, it will require insurers to renew the policies they sell to groups and individuals.”

As PRI’s John Graham pointed out, and as you may have guessed, I’m playing a game with you. The president I’m quoting is Bill Clinton, when he signed the Health Insurance Portability and Accountability Act in August 1996. It had just passed the House of Representatives by a vote of 421-2, with leading Democrats like Nancy Pelosi onboard at the time. The Senate passed it unanimously by 98-0.


Now, HIPAA’s a flawed effort for reform, and supporters like Dick Armey have acknowledged that. But the fact is that many of the most popular aspects of Obamacare have been the law of the land for a long time, and don’t go away when it’s eventually repealed.

As Avik Roy, Peter Suderman, and Michael Cannon have written, this week’s claim by HHS that those with pre-existing conditions will be unfairly penalized — and that this number amounts to millions upon millions of Americans, as many as “1 out of 2” elderly persons — is just exaggeration. HHS’s own data show that less than 1% of Americans have ever been denied coverage for any reason, including fraud (which is usually the reason). That’s just one of the reasons that only 8,000 Americans have applied for the vaunted new risk pools.

Of course, the repeal bill passing tonight is just the beginning. There are plenty of questions that come next, and Republicans need to be prepared to answer them.

Benjamin Domenech is a research fellow for The Heartland Institute and managing editor of Health Care News.


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