ACA to Greatly Benefit those with Pre-existing Conditions

July 2, 2013 at 10:07 AM 2 comments


With many of the Affordable Care Act’s revisions taking effect in January 2014, there are millions of Americans who will be affected by them. Those with pre-existing health conditions are among those who are expected to benefit from the Act.

Q:  About what percent of Americans under the age of 65 have identified either themselves or someone in their household as having a pre-existing health condition?

a) 10%

b) 30%

c) 50%

d) 80%

A:  49% of this specified population falls under this category in 20131 and 52% in 20112.

Denied coverage

As you can see from the figure above, the number of people with pre-existing conditions has remained about the same over the past two years. However, even with this balance, there is an increasing amount of this population who have had trouble obtaining health insurance due to their conditions. In a poll1 taken in June 2013, 25% of those with pre-existing conditions have had a difficult time getting insurance, while a survey in September 20112 shows 21% were struggling with this.

These people said the problems they were having with obtaining insurance mainly consisted of being denied coverage or having their premiums increased due to their conditions.

In January of 2014, insurance companies will no longer be able to deny coverage to people with pre-existing medical conditions, nor will they be able to charge them higher premiums. As a result, it is possible that other people, like those who are young and healthy, will see an increase in their premiums to balance out the costs.

Coverage of pre-existing conditions offers implications for healthcare manufacturers. Those who manufacture devices and therapies for patients with pre-existing conditions are likely to experience an increase in market size and opportunity. Since people with pre-existing conditions might see their premiums go down, they may be more likely to have money left over to cover costs like deductibles and co-pays.

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1http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-june-2013/\
2http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-september-2011/

Other articles you might be interested in:

What does the U.S Spend on Healthcare?
You’re Customers are Living in the Wrong State!
Do You Know Which Type of Health Insurance Exchange Your State Will Have?

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Entry filed under: Healthcare Economics, Healthcare Reform, Insurance Design. Tags: , , , .

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2 Comments Add your own

  • […] 1http://kff.org/medicare/perspective/projecting-medicare-advantage-enrollment-expect-the-unexpected/ 2http://www.upi.com/Health_News/2012/10/17/Medicare-Advantage-14-subsidy-reduced/UPI-43271350492618/ ______________________________________________________________________________________________________ For more blog entries like this one, click on the links below: Why Market Access is Crucial for Healthcare Marketers Today Differentiating a Core Hospital-based Therapy ACA to Greatly Benefit those with Pre-existing Conditions […]

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  • […] Will Medicare Advantage Developments Affect your Products? ACA to Greatly Benefit Those with Pre-existing Conditions Keeping Up with the Changes in Accountable Care […]

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