The Health and Human Services Department (HHS) says without the Affordable Care Act, up to 129 million non-elderly people who have some type of pre-existing health condition could be denied health care.

According to an analysis released HHS Secretary Kathleen Sebelius those with conditions like heart disease, high blood pressure, arthritis or cancer, would be at risk of losing health insurance when they need it most, or be denied coverage altogether.  The report was released just hours before the House was to begin debate on a Republican effort to repeal the law.

Providing protection

Under the full range of policies in the law, to be enacted by 2014, people living with pre-existing conditions are free from discrimination and can get the health coverage they need.  Repealing the law, according to HHS, would once again leave millions worrying about whether coverage will be there when they need it.

“The Affordable Care Act is stopping insurance companies from discriminating against Americans with pre-existing conditions and is giving us all more freedom and control over our health care decisions,” said Secretary Sebelius.  “The new law is already helping to free Americans from the fear that an insurer will drop, limit or cap their coverage when they need it most.  And Americans living with pre-existing conditions are being freed from discrimination in order to get the health coverage they need.”

The analysis found:

  • Anywhere from 50 to 129 million (19 to 50 percent) of people under age 65 have some type of pre-existing condition.  Examples of what may be considered a pre-existing condition include:

          o Heart disease

          o Cancer

          o Asthma

          o High blood pressure

          o Arthritis  

  • Older individuals between ages 55 and 64 are at particular risk; 48 to 86 percent of people in that age bracket live with a pre-existing condition.
  • 15 to 30 percent of people under age 65 in perfectly good health today are likely to develop a pre-existing condition over the next eight years.
  • Up to one in five people under age 65 with a pre-existing condition – 25 million individuals -- is uninsured.

Safety net

Prior to the Affordable Care Act, insurance companies in the individual market in most states could deny coverage, charge higher premiums, and/or limit benefits based on pre-existing conditions.  Surveys have found that 36 percent of those who tried to purchase health insurance directly from an insurance company in the individual insurance market encountered challenges purchasing health insurance for these reasons.

In an interview with The Washington Post, Robert Zirkelbach, a spokesman for America's Health Insurance Plans, the industry's main lobbying group, said the report "exaggerates the number of people who are impacted."

He says most of those included in the figure currently have insurance and would be at risk only if they needed to change coverage and buy it on their own. Zirkelbach stressed that people who get insurance through their jobs are guaranteed coverage.