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Pre-Existing Conditions Becoming a Thing of the Past

What is a pre-existing condition? It is a term used by insurance companies to deny coverage to people who have health needs. A pre-existing condition may be a condition a woman has received treatment for previously or a condition she does not even know about when she applied for insurance coverage. It may be a condition that occurred at any time in a woman’s life:

  • From Birth: A pre-existing condition can be a condition a woman has had since birth, like my friend Abby. Abby was born with a congenital condition that has no cure. She has been lucky to always have health insurance through her parents’ plan, but she always had concerns about what would happen in the future. Come January 1, Abby no longer has to worry about her health condition being a pre-existing condition.
  • From Childhood: I was eleven years old when I was taken to the emergency room because I was having trouble breathing. That was my first asthma attack. I had a pre-existing condition as of the age of eleven and if I ever had to apply for insurance on the individual market, that asthma diagnosis would be right there with me. Like Abby, I’ve been lucky to always have insurance through my parents, my work or my school. But I have also known that my life choices were limited by my access to health insurance. Come January 1, I will have a wave of relief to know that it no longer matters that I have a pre-existing condition.
  • From Pregnancy: Until now, insurance plans have denied women coverage for their pregnancy by using pre-existing condition exclusions. A woman who is pregnant when she enrolls in individual market coverage – even if she did not know she was pregnant – could have the insurer deny coverage for the pregnancy even if she is paying extra for a maternity rider. Plans have also considered having a c-section or receiving fertility treatment a pre-existing condition and therefore denied coverage altogether or refused to cover medical claims they consider related to the condition.

Pre-existing condition exclusions hurt women in two important ways.

  • First, insurance companies have been able to deny insurance coverage to a woman with a pre-existing condition. Because a woman had a c-section or received treatment following a sexual assault, insurance companies could deny her application for insurance leaving her with no coverage options.
  • Second, insurance companies could refuse to pay claims related to a pre-existing condition. If a woman had a cancerous tumor that had not been discovered prior to her enrollment or had taken a medication that increased her risk of cancer, an insurance company may have refused to pay claims related to her cancer treatment.

All new health plans are prohibited from using pre-existing conditions to deny coverage starting this January. As women, we no longer need to worry that our existing health conditions will prevent our access to health care. Mothers no longer need to worry that their adult children are not able to access insurance (and they can help their children learn about new options for coverage whether or not they have a pre-existing condition). Women will no longer be pre-existing conditions.

It's time for change, and we must act now. Time's up.