Pre-Existing Conditions and Health Care

Pre-Existing Conditions and Health Care Policy

Pre-existing condition is a health condition that client had before he enrolled in an insurance plan. Many insurance companies across the country can deny coverage to people with pre-existing conditions or for that particular condition. Pregnancy, for example, if seen as a pre-existing condition and while a person may coverage for other health issues, she may be denied coverage for her existing pregnancy based on pre-existing clause. This problem affects millions of Americans and each year, a large number of people find themselves without insurance coverage due to some existing health issue. But denial, which works well for insurance companies, hurt those with chronic or prevalent conditions like heart diseases which affect 1 in 3 Americans. [1] It is very more disturbing when a condition like cancer or some other life altering health problem surfaces and a person is denied insurance.

In some cases, the companies may not totally deny coverage but would charge very high premiums for pre-existing on-going condition like asthma or a lingering injury.

Americans are faced with this problem in one a few states. In fact 45 states across the country would discriminate against people with pre-existing conditions by either denying coverage or charging exorbitant premiums or refuse to offer coverage for that precise problem.

In pure statistical terms, 12.6 millions adults were denied coverage recently according to a survey. This is about 36% of adults who sought coverage directly from an insurance company in the last three years. [2]

Another survey showed 10% of all those suffering from cancer were denied coverage or their insurance was cancelled because of this life-changing diagnosis. [3]

In about nine states, even domestic violence is considered a pre-existing condition and a person who has been injured in such an incident will not be covered by their insurance policy because domestic violence existed before they applied for insurance. [4]

There have been solutions to this problem but none has worked well and hence health care reform is strongly needed. For example in some states, there is a high-risk pool that offers medical insurance to otherwise uninsurable adults. However they charge very high rates and generally don't work for most individuals with pre-existing conditions. It was found that only 8% of all uninsurable adults were able to get coverage and the rate was still incredibly high and generally unaffordable. [5] Other problems like annuals caps on enrollment can also leave many uninsured people without any solution.

For this reason, we need to bring changes to our national health care policy by introducing reforms that would allow people with certain conditions to get coverage at reasonable rates. A new health care policy must make it mandatory for insurance companies to offer coverage to every individual who otherwise qualifies for insurance. Pre-existing condition must not be an excuse for denial. The new policy would prohibit companies from denying coverage to people with medical history or a chronic health problem. All existing policies would also be updated to accommodate the new changes. This means that people who already are suffering from a condition and have not been covered by their insurance companies will now be given coverage as long as they pay their premium on time and in full.

Similarly companies will not be allowed to leave people high and dry when they are found with an illness that is likely to affect them for some time. Benefits will not be watered down after diagnosis.