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Starting 2014, US Health Insurers Will Have to Cover Pre-existing Conditions

Beginning in 2014, health insurers in the US will no longer be permitted to refuse coverage to people because of a pre-existing medical condition

by Lakshmi Gopal on September 5, 2011 at 4:19 PM

Beginning in 2014, health insurers in the US will no longer be permitted to refuse coverage to people because of a pre-existing medical condition.


This is, most people agree, a progressive step in the Affordable Care Act, which has been derided for making it mandatory for the majority of Americans to obtain health insurance coverage. The Act has been criticized on the grounds of making health insurance compulsory and required by law, just like car insurance.

There are currently a total of 26 different federal lawsuits working to try to reverse the law pertaining to this requirement. The very foundation of the battle is the "individual mandate", around which there is significant debate as to whether or not it is constitutional.

That said, many experts are agreeing that whether Americans are for or against the mandatory health insurance aspect of the Act, the legality and appropriateness of this factor written within the health care reform law, has an important financial and economic rationale to support it, which is the coverage of pre-existing health conditions.

Vice President Sara Collins of the Commonwealth Fund, a private healthcare foundation from New York City, said that one of the primary reasons that health insurance companies refuse coverage to people who have pre-existing medical conditions is because they are the ones who are most likely to purchase a policy on their own, as they are the ones who will actually use it. Those individuals require more services and will, therefore, be more expensive to cover than people who do not have a pre-existing condition.

According to Collins, this explains why, when people who have health issues and obtain a policy, the insurance company goes out of its way to underwrite and to charge a higher rate.

Source: Medindia

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