As part of our #WorstTBTEver blog series, this week we focus on a central part of the Affordable Care Act (ACA) that protects people with pre-existing conditions – in other words, people who get sick or have a health need before their health coverage kicks in. Thanks to the ACA, also known as Obamacare, health insurance plans can no longer deny coverage or charge higher premiums to people with a pre-existing condition. Even better, this part of the law protects you whether you get your insurance through your employer or in the Marketplace. This is a good thing since an estimated 1 in 4 Americans has a pre-existing condition, including about 65 million women.
While pre-existing conditions include life-threatening illnesses like cancer or chronic conditions like asthma or diabetes, insurance companies frequently consider care specific to women as a pre-existing condition and an excuse to deny health coverage. In other words, just being a woman could be considered a preexisting condition. For example, insurance companies have denied women coverage for having a cesarean delivery or for seeking medical treatment for domestic or sexual violence. Before the ACA, health insurance plans flat out denied coverage for people with pre-existing conditions or charged them much more for their health coverage. Back then plans even denied coverage to women for a prior pregnancy. I know this because I was one of them.
Yes, I was denied health insurance coverage because my pregnancy was considered a pre-existing condition.
It was the mid-00’s and I had just landed my first job with health insurance coverage, which was great because at the time I was one of about 47 million Americans (about 16% of the US population) who didn’t have health insurance (now about 91% of Americans have coverage according to most recent Census numbers). Unfortunately, I couldn’t sign up right away. My employer’s insurance company had a 90 day waiting period which meant I had to wait three months for coverage to kick-in. It was about a week from my three month work anniversary when I found out I was pregnant. Though somewhat unexpected, I was happy about the prospect of becoming a mom and decided to continue my pregnancy. I had a strong support system, plus in a week or so I would be eligible for health insurance coverage through my work so I could afford the healthcare I’d need for a healthy pregnancy and birth.
But the excitement I felt was shattered when I found out our health insurance plan considered my pregnancy a pre-existing condition, which meant I would not be getting health insurance coverage. I was panicked. I was overdue for my first prenatal appointment and had to scramble to find coverage elsewhere so I wouldn’t be thousands of dollars in debt before my baby was even born. Instead of worrying about what kind of diapers to buy or which breast pump to use, I was worrying about getting basic healthcare during my pregnancy.
Denying me coverage because I was pregnant was not okay and highlights why Congress’ plan to repeal Obamacare is a terrible idea.
If Congress repeals Obamacare, millions of people with pre-existing conditions will lose their health coverage with no other option of getting the healthcare they need. Even worse, this will unfairly impact women who could again be denied health coverage because of things like seeking treatment for domestic or sexual violence, having a cesarean birth, or being pregnant. This is one of the most popular provisions in the healthcare law – 69% of voters have a favorable opinion of it and even 39% of those who favor ACA repeal change their mind when they find out this provision would go away.
President Elect Trump has mentioned he would keep this part of the ACA intact. However his pick for Secretary of Health and Human Services, Tom Price, did not include this important protection intact in his ACA replacement plan, and in his confirmation hearing yesterday, refused to commit to making sure surviving domestic violence wouldn’t be considered a preexisting condition. Plus, you can’t really keep this provision and repeal other parts of the law, like the requirement that people have insurance, without destabilizing the health insurance market for everyone. I know what it was like before the ACA to have unstable health coverage and then to be denied health insurance coverage when I needed it the most. I don’t really want to go back to the days when being a woman was a pre-existing condition.