Health Care Blog

Insurance for Americans with Pre-Existing Conditions

For too long, too many Americans with pre-existing conditions were left out of the health insurance marketplace. Health insurance companies could charge these Americans more or simply refuse to cover them. But thanks to the Affordable Care Act, the health care system will no longer leave out the people who need care the most.

Starting September 23, the new law makes it illegal for insurance companies to discriminate against children under 19 with preexisting conditions. In 2014, discriminating against anyone with a pre-existing condition will be illegal, but we know Americans need relief now. That’s why the new law created the Pre-Existing Condition Insurance Plan. This plan offers coverage to uninsured Americans who have been uninsured for at least six months and unable to obtain health coverage because of a pre-existing health condition like cancer, diabetes or lupus.

Giving Our Kids the Care they Need

Since the Affordable Care Act was signed into law on March 23, the President’s team has worked diligently to implement the new law. As part of this effort, we’ve held countless meetings with individuals and organizations to hear their thoughts and suggestions for how we can best deliver the benefits of reform to the American people. 

One important change in the new law is a provision that prevents insurance companies from discriminating against children with pre-existing conditions. This new provision takes effect on September 23 and will bring welcome relief to parents of children with medical conditions who often were denied access to health insurance.

Since this policy was announced, we have had helpful discussions on how to ensure children with pre-existing conditions have access to care, while not disrupting the insurance marketplace.   Some state insurance commissioners expressed concern that, without an open enrollment period that was widely communicated, people might wait until their children got sick to enroll them in coverage, causing plans’ costs to increase. And we were concerned when last week, some indicated that insurance companies would choose to stop offering policies for children rather than cover kids with pre-existing conditions.

Today, the Administration is releasing new guidance to health insurance plans to help ensure children get the high-quality care they need. The new FAQ document notes that insurance companies may establish an open enrollment period for children with pre-existing conditions and makes clear that the Administration will not hesitate to issue regulations if insurance companies unfairly limit access to insurance for children who need it most.   The document also signals that kids with pre-existing conditions should not be shifted from the Children’s’ Health Insurance Program to the individual market in an attempt to reduce State health care spending and that these policies will apply to health plans that start on or after September 23.

Insurance companies have pledged to conduct a significant consumer education campaign to ensure more Americans and their children know about the coverage options that are available to them. And some of the companies that reportedly planned to stop offering policies for children have reversed course and committed to continuing to provide coverage for the youngest Americans.

The Blue Cross Blue Shield Association said the “policy will ensure that children get the comprehensive coverage they need,” and pledged to “work with our Blue Cross and Blue Shield companies on outreach efforts to educate consumers about this new provision.” Blue Cross Blue Shield of Florida said they were “pleased to announce that it will establish a process to resume the sale of Child Only policies.”  

For too long, parents have been forced to worry about what they would do if their child developed a serious medical condition. Others have found that children born with illnesses were forever ineligible for insurance. Thanks the Affordable Care Act, kids will get the care they need and parents will have one less thing to worry about.

To learn more, read the FAQ document.

Nancy-Ann DeParle is Director of the White House Office of Health Reform