I posted earlier about Atul Gawande’s piece in the New Yorker on the importance of incremental care in medicine. One of the things that the Affordable Care Act1 did was to make it illegal for insurance companies to deny coverage to people with “preexisting conditions”, which makes it difficult for those people to receive the type of incremental care Gawande touts. And who has these preexisting conditions? An estimated 27% of US adults under 65, including Gawande’s own son:
In the next few months, the worry is whether Walker and others like him will be able to have health-care coverage of any kind. His heart condition makes him, essentially, uninsurable. Until he’s twenty-six, he can stay on our family policy. But after that? In the work he’s done in his field, he’s had the status of a freelancer. Without the Affordable Care Act’s protections requiring all insurers to provide coverage to people regardless of their health history and at the same price as others their age, he’d be unable to find health insurance. Republican replacement plans threaten to weaken or drop these requirements, and leave no meaningful solution for people like him. And data indicate that twenty-seven per cent of adults under sixty-five are like him, with past health conditions that make them uninsurable without the protections.
That’s 52 million people, potentially ineligible for health insurance. And that’s not counting children. Spurred on by Gawande, people have been sharing their preexisting conditions stories on Twitter with the hashtag #the27Percent.
The 27% figure comes from a recent analysis by the Kaiser Family Foundation:
A new Kaiser Family Foundation analysis finds that 52 million adults under 65 — or 27 percent of that population — have pre-existing health conditions that would likely make them uninsurable if they applied for health coverage under medical underwriting practices that existed in most states before insurance regulation changes made by the Affordable Care Act.
In eleven states, at least three in ten non-elderly adults would have a declinable condition, according to the analysis: West Virginia (36%), Mississippi (34%), Kentucky (33%), Alabama (33%), Arkansas (32%), Tennessee (32%), Oklahoma (31%), Louisiana (30%), Missouri (30%), Indiana (30%) and Kansas (30%).
36% uninsurable in West Virginia! You’ll note that all 11 of those states voted for Trump in the recent election and in West Virginia, Trump carried the day with 68.7% of the vote, the highest percentage of any state. The states whose people need the ACA’s protection the most voted most heavily against their own interest.
Oh and one last thing. I feel like what’s getting lost in the shuffle here is that the prohibition of insuring people with preexisting conditions is completely on the insurance companies. They could totally offer healthcare coverage to everyone but they don’t because of perceived economic reasons. What the federal government asserted with the ACA is that healthcare should be available to everyone as a right. Yes, we should be pissed at the Republican dickheads n Congress who want to repeal the ACA without replacing it with something better2 but we should also be furious at the insurance companies who don’t want to give certain people health insurance. They are literally putting profits over lives. Cigarette and car companies did this too…until the government made them stop because it was outrageous! It’s still outrageous! We should be outraged!
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I hope, for the love of Pete, that everyone reading this site is aware that the Affordable Care Act (the ACA) is Obamacare. Obamacare is the derogatory name the Republicans gave to the ACA that everyone, including Obama himself, ended up using. Which is unfortunate. President Obama and his administration deserve neither all of the credit nor should shoulder all of the blame for the ACA.
I would also like to add that I, as a (very) small business owner, rely on the protections afforded by the ACA to get insurance coverage for me and my family. Something to keep in mind if you otherwise don’t know anyone who would be affected by the ACA’s repeal. (Of course, the cushy insurance policy you get through work might be affected as well, you never know.)↩
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I am all for this, BTW. If Paul Ryan and Donald Trump come up with a plan to give better and cheaper healthcare coverage to everyone in America, let’s do it.↩
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