Report: More than 1.3 Million Wisconsinites with Pre-Existing Conditions Gain Needed Protection from Insurance Denials under Health Care Law

Included are 214,600 in Milwaukee County; 114,000 in Dane County; 93,300 in Calumet, Outagamie, and Winnebago Counties; and 90,600 in Waukesha County

As Wisconsinites Age, the Likelihood They Will Need These New Protections Grows Substantially

Washington, D.C.—The Supreme Court’s upholding of the Affordable Care Act will provide significant new protections for a huge number of Wisconsinites, including more than 1.3 million non-elderly people in the state who have pre-existing conditions and who were at risk of insurance company denials. These Wisconsinites constitute more than one in four (27.9 percent of) non-elderly people in the state.

This is the key finding of a report issued today by the consumer health group Families USA. According to the report, the number of people receiving these new protections includes 214,600 people in Milwaukee County, 114,000 people in Dane County, 93,300 people in Calumet, Outagamie, and Winnebago Counties, and 90,600 people in Waukesha County.

Under the Affordable Care Act, all of these Wisconsinites can no longer be denied coverage, charged a higher premium, or sold a policy that excludes coverage of important health services simply because of a pre-existing condition. These protections begin in January 2014, but children with pre-existing conditions are already protected against coverage denials through the new law.

The likelihood that Wisconsinites have pre-existing conditions grows as they age: more than one in five (21.5 percent of) people aged 18-24 have a pre-existing condition, more than a third (34.7 percent of) of 35-44 year-olds have such a condition, as do half (50.8 percent of) of those aged 55-64.

“More than 1.3 million Wisconsinites will now have the peace of mind and security they want for themselves and their families because they can no longer be denied coverage by an insurance company just because their doctor diagnosed a health problem,” Ron Pollack, Executive Director of Families USA, said today.

“Teachers, policemen, firefighters, businessmen,laborers, and professionals in all walks of life have for decades faced the threat of physical and financial devastation because they could not buy a health insurance policy due to their pre-existing conditions,” Pollack said. “The Affordable Care Act, Obamacare, stops this discrimination and opens the door to quality coverage for all Wisconsinites.”

The report details the health and financial risks that people face when they can’t obtain health coverage: They delay or forgo care due to cost, and they are less likely to get preventive care and cancer screenings. They are also less likely to have a usual source of care outside of an emergency room. And, because medical debt is strongly linked to bankruptcy, uninsured Americans are more likely to suffer financial catastrophe because of medical bills.

According to Families USA, the numbers in the report are conservative for two reasons. First, the analysis looks only at people with diagnosed conditions that are most likely to result in a denial of coverage; many other conditions could also lead to a denial of coverage or a discriminatory premium. Second, many more Wisconsinites likely have similar health conditions, but they have not yet been diagnosed because they are uninsured and haven't seen a doctor.

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Families USA is the national organization for health care consumers. It is nonprofit and nonpartisan and advocates for high-quality, affordable health care for all Americans.

1201 New York Avenue NW, Suite 1100 · Washington, DC 20005
202-628-3030 · Email: info@familiesusa.org · www.familiesusa.org