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.

Introduction

On June 28, 2012, millions of Americans could breathe a sigh of relief. On this fateful day, the Supreme Court upheld the constitutionality of the health care law. Thanks to this decision and the protections offered by the law, people across the nation who have pre-existing conditions will be protected from discrimination based on their health status. Beginning in 2014, no American can 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.

To determine just how many people across the country will be helped by this part of the landmark decision, Families USA commissioned The Lewin Group to quantify the number of Americans who have been diagnosed with pre-existing conditions. Looking at only those serious conditions that are commonly linked to coverage denials, we found that more than 64.8 million non-elderly Americans have been diagnosed with pre-existing conditions that could lead to denials of coverage, absent health reform. This means that one in every four non-elderly Americans (24.9 percent) would be at risk of being denied coverage today without health reform. 

In addition to estimating the total number of people in the United States who will be helped by these protections, Families USA and The Lewin Group took a closer look at who these Americans are: We looked at diagnoses of pre-existing conditions by age group, income group, and racial and ethnic group. The findings of our analysis are clear: No group is immune to the effects of this pervasive problem. People across the state, young and old, black and white, rich and poor, all have a great deal to gain from health reform’s protections against discrimination based on pre-existing conditions.

Our analysis captures only those who have already been diagnosed with pre-existing conditions, focusing solely on those conditions that frequently result in denials of coverage. As our data show, the likelihood of being diagnosed with a pre-existing condition grows substantially with age, so these vital protections will aid many more Americans over time. Still more who will benefit were not captured in this analysis because they have a pre-existing condition that has yet to be diagnosed. This means that many more Americans have conditions that would leave them at risk of paying higher premiums or for having critical benefits excluded in the absence of health reform.

The bottom line is this: Whether they need these protections today or will be helped by them tomorrow, each and every American can rest a little easier knowing that he or she cannot be discriminated against because of health status, thanks to health reform.