Worry No More: Americans with Pre-Existing Conditions
Are Protected by the Health Care Law
A report from Families USA, July 2012. State reports are also available.

Key Findings

A Pervasive Problem

More than 64.8 million Americans under the age of 65 have been diagnosed with pre-existing conditions that, without health reform, could lead to denials of coverage in the individual health insurance market.

Without health reform, one in four (24.9 percent of) non-elderly Americans is at risk of being denied coverage.

A Problem that Grows with Age

Americans in every age group are affected by pre-existing conditions that, without health reform, could lead to a denial of coverage in the individual insurance market (Figure 1 and Table 2). However, those who are older are much more likely to have such a condition.

• One in five (19.4 percent of) young adults aged 18 to 24 has a pre-existing condition that could lead to a denial of coverage.
• Nearly two in five (37.2 percent of) adults aged 45 to 54 have a pre-existing condition that could result in a denial of coverage.
• Nearly half (47.8 percent) of adults aged 55 to 64 have a pre-existing condition that could lead to a denial of coverage.
• Adults aged 45 to 64 account for less than 30 percent of the non-elderly population, but they make up nearly half (48.4 percent) of those with pre-existing conditions.

Every Income Group Is Affected

Americans of all incomes have pre-existing conditions that, without health reform, could lead to a denial of coverage. By income group, we found the following:

• Among the lowest-income Americans, 25.3 percent of people in families with incomes below 100 percent of the federal poverty level (less than $23,050 for a family of four in 2012) are affected, and 23.7 percent of people with incomes between 100 and 199 percent of poverty (between $23,050 and $46,100 for a family of four in 2012) are affected.
• Among middle-income Americans, we see that similar proportions are affected. Approximately 24.2 percent of people in families with incomes between 200 and 299 percent of poverty (between $46,100 and $69,150 for a family of four in 2012) and 25.9 percent of people in families with incomes between 300 and 399 percent of poverty (between $69,150 and $92,200 for a family of four in 2012) are affected.
• Among higher-income Americans (people in families with incomes above 400 percent of poverty, or $92,200 for a family of four in 2012), 25.3 percent are affected.

Every Racial and Ethnic Group Is Affected

Americans of every racial and ethnic group have pre-existing conditions that, without health reform, could lead to a denial of coverage. By racial and ethnic group, we found the following:

• More than one-quarter (28.3 percent) of white, non-Hispanic Americans have such a condition.
• Nearly one-quarter (24.1 percent) of black, non-Hispanic Americans have such a condition.
• More than one in six (18.1 percent of) Hispanic Americans is affected.
• Just over one in 10 (11.5 percent of) Asian, Hawaiian, or Pacific Islander Americans is affected.
• Nearly one-quarter (24.1 percent) of Americans who identify themselves as being of multiple races or of another racial or ethnic group are affected.
• White, non-Hispanic Americans account for 69.8 percent of the non-elderly state residents who have been diagnosed with a pre-existing condition.