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Pre Existing Conditions – Myth v. Fact

As you might remember, the House passed the American Health Care Act (AHCA) on May 4, 2017. This legislation would have reformed some of the most broken parts of the Affordable Care Act (ACA) by increasing people’s access to quality and affordable care from a doctor of their choice.

Although this legislation was never signed into law since it was voted down in the Senate, I’ve recently heard from several of you with concerns about how pre-existing conditions would have been managed under the bill. I wanted to take a moment to address those anxieties by providing clarification on some of the most common misconceptions currently being circulated about the future of care for individuals with pre-existing conditions if the AHCA had been signed into law last year:

Myth: If passed, the American Health Care Act would have allowed insurance companies to discriminate against those with pre-existing conditions.

Myth: If passed, the AHCA would have stripped patient protections from millions of Americans with pre-existing conditions

Myth: Members who supported the AHCA, voted to let insurance companies go back to denying coverage for those with pre-existing conditions.

FACTS:  Under the AHCA, insurance companies are prohibited from:

  • Denying or not renewing coverage due to a pre-existing condition;
  • Rescinding coverage based on a pre-existing condition;
  • Excluding benefits based on a pre-existing condition; or
  • Raising premiums on individuals with pre-existing conditions who maintain continuous coverage.

Myth: If passed, provisions included in the AHCA would have pricedwomen who are pregnant, have a history of mental illness, substance abuse, breast cancer, or any other pre-existing condition out of purchasing insurance coverage.  

FACTS: Section 137 of the AHCA specifically states that:

  • Nothing in this Act shall be construed as permitting health insurance issuers to discriminate in rates for health insurance coverage by gender
  • Nothing in this Act shall be construed as permitting health insurance companies to limit access to health coverage for individuals with preexisting conditions
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