[Congressional Record Volume 166, Number 184 (Sunday, October 25, 2020)]
[Senate]
[Page S6532]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]



            Americans with protected pre-existing conditions

  As many as 133 million Americans--roughly half the population under 
the age of 65--have pre-existing medical conditions that could 
disqualify them from buying a health insurance policy or cause them to 
pay significantly higher premiums if the health law were overturned, 
according to a government analysis done in 2017. An existing medical 
condition includes such common ailments as high blood pressure or 
asthma, any of which could require those buying insurance on their own 
to pay much more for a policy, if they could get one at all.
  The coronavirus, which has infected nearly seven million Americans to 
date and may have long-term health implications for many of those who 
become ill, could also become one of the many medical histories that 
would make it challenging for someone to find insurance.
  Under the A.C.A., no one can be denied coverage under any 
circumstance, and insurance companies cannot retroactively cancel a 
policy unless they find evidence of fraud. The Kaiser Family Foundation 
estimated that 54 million people have conditions serious enough that 
insurers would outright deny them coverage if the A.C.A. were not in 
effect, according to an analysis it did in 2019. Its estimates are 
based on the guidelines insurers had in place about whom to cover 
before the law was enacted.
  Most Americans would still be able to get coverage under a plan 
provided by an employer or under a federal program, as they did before 
the law was passed, but protections for pre-existing conditions are 
particularly important during an economic downturn or to those who want 
to start their own businesses or retire early. Before the A.C.A., 
employers would sometimes refuse to cover certain conditions. If the 
law went away, companies would have to decide if they would drop any of 
the conditions they are now required to cover.
  The need to protect people with existing medical conditions from 
discrimination by insurers was a central theme in the 2018 midterm 
elections, and Democrats attributed much of their success in reclaiming 
control of the House of Representatives to voters' desire to safeguard 
those protections. Mr. Trump and many Republicans promise to keep this 
provision of the law, but have not said how they would do that. Before 
the law, some individuals were sent to high-risk pools operated by 
states, but even that coverage was often inadequate.

                               21 Million