Last updated on: 1/19/2011 | Author:

Can I get coverage despite having a pre-existing condition?

PRO (yes)


The US Department of Health and Human Services (HHS), stated the following in its Jan. 18, 2011 study, “At Risk: Pre-Existing Conditions Could Effect 1 in 2 Americans,” available on its website

“According to a new analysis by the Department of Health and Human Services, 50 to 129 million (19 to 50 percent of) non-elderly Americans have some type of pre-existing health condition.  Up to one in five non-elderly Americans with a pre-existing condition – 25 million individuals – is uninsured.  Under the Affordable Care Act, starting in 2014, these Americans cannot be denied coverage, be charged significantly higher premiums, be subjected to an extended waiting period, or have their benefits curtailed by insurance companies…

As many as 82 million Americans with employer-based coverage have a pre-existing condition, ranging from life-threatening illnesses like cancer to chronic conditions like diabetes, asthma, or heart disease.  Without the Affordable Care Act, such conditions limit the ability to obtain affordable health insurance if they become self-employed, take a job with a company that does not offer coverage, or experience a change in life circumstance, such as divorce, retirement, or moving to a different state.  Older Americans between ages 55 and 64 are at particular risk: 48 to 86 percent of people in that age bracket have some type of pre-existing condition.  And 15 to 30 percent of people in perfectly good health today are likely to develop a pre-existing condition over the next eight years, severely limiting their choices without the protections of the Affordable Care Act.”

[Editors Note:  According to a Mar. 26, 2004 US Department of Health and Human Services (HHS) survey , the percentage of the total US population that had ever been denied medical insurance was 0.6% or 1.7 million people.] Jan. 18, 2011 - At Risk: Pre-Existing Conditions Could Affect 1 in 2 Americans


National Public Radio (NPR), wrote on its May 26, 2010 article “What the Health Law Means to You” on

“If you have a medical condition, the law will make it easier for you to get coverage. Health insurers will be barred from rejecting applicants based on health status in 2014.

Until the new exchanges are up and running in 2014, the law created temporary high-risk insurance pools for people with medical problems who have been uninsured at least six months. The new risk pools – which will be run by the states and the federal government – are scheduled to start accepting members in September [2010].

Also, starting Sept. 23, 2010 insurers can no longer deny coverage to children with pre-existing conditions and insurers will be banned from setting lifetime coverage limits for adults and kids.”

May 26, 2010


The Kaiser Family Foundation (KFF), wrote in its July 2010 brief “Explaining Health Reform: Questions about the Temporary-High Risk Pool” on

“The Patient and Protection Affordable Care Act, signed by President Obama on March 23, 2010, creates a temporary national high-risk pool to provide health coverage to people with pre-existing medical conditions who have been uninsured for six months. This high-risk pool, officially known as the Pre-existing Condition Insurance Plan, is being implemented relatively quickly and will provide temporary coverage until the broader coverage provisions take effect in January 2014. The health reform law establishes basic requirements for the high-risk pool program… The federal government will begin accepting applications for enrollment in their high-risk pool on July 1, 2010, with coverage beginning on August 1, 2010…

When the temporary national high-risk pool terminates on January 1, 2014, high-risk pool enrollees will transition into receiving health coverage through the state-based American Health Benefit Exchanges. Procedures will be developed to ensure that there are no lapses in coverage. Individuals without employer health coverage and small businesses with up to 100 employees will be able to purchase coverage through the Exchanges. Premium and cost-sharing subsidies will be available for individuals with incomes between $14,404 – $57,616 and for families of four with incomes between $29,327 – $88,200. People will also be able to choose to purchase coverage in the individual market. As of 2014, insurers will not be able to deny people coverage or charge higher premiums based on health status.”

July 2010

CON (no)


[Editor’s Note: We have been unable to find any cons to this question, and if you know of any, please let us know. Aug. 23, 2010]