New report: 129 million Americans with a pre-existing condition could be denied coverage without new health reform law

Health and Human Services Secretary Kathleen Sebelius today released a new analysis showing that, without the Affordable Care Act, up to 129 million non-elderly Americans who have some type of pre-existing health condition, 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. Under the full range of policies in the Affordable Care Act to be enacted by 2014, Americans living with pre-existing conditions are free from discrimination and can get the health coverage they need, and families are free from the worry of having their insurance cancelled or capped when a family member gets sick, or going broke because of the medical costs of an accident or disease. Repealing the law would once again leave millions of Americans 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 that:

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

· Heart disease

· Cancer

· Asthma

· High blood pressure

· Arthritis

· Older Americans 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 Americans under age 65 with a pre-existing condition – 25 million individuals – is uninsured.

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

A number of protections are already in place thanks to the Affordable Care Act. Insurers can no longer limit lifetime coverage to a fixed dollar amount or take away coverage because of a mistake on an application. Young adults have the option of staying on their parents’ coverage up to the age of 26 if they lack access to job-based insurance of their own, and insurers cannot deny coverage to children because of a pre-existing condition.

Many uninsured Americans with pre-existing conditions have already enrolled in the temporary high-risk pool program called the Pre-existing Condition Insurance Plan (PCIP), which provides private insurance to those locked out of the insurance market because of a preexisting condition. The PCIP program – which has already saved people’s lives by covering services like chemotherapy – serves as a bridge until 2014, when insurance companies can no longer deny or limit coverage or charge higher premiums because of a preexisting condition. There is a Pre-existing Condition Insurance Plan available in every state, and more information can be found at www.HealthCare.gov or by calling 1-866-717-5826.

In addition to the ban on discrimination against people with preexisting conditions, in 2014, individuals and small businesses will have access to new, high-quality insurance choices through competitive marketplaces called health insurance exchanges.

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Affordable Care Act gives consumers new tools, makes health insurance market more transparent

The U.S. Department of Health and Human Services (HHS) today announced that new information and tools have been added to HHS' consumer website www.healthcare.gov that will make the health insurance market more transparent, increase competition and help lower costs for individuals.

For the first time ever, price estimates for private insurance policies are available, allowing consumers to easily compare health insurance plans - putting consumers, not their insurance companies, in charge by providing one-stop shopping and taking the guesswork and confusion out of buying insurance.

To help consumers make more informed choices, the site includes new information including two notable metrics never before made public:
* Insurance providers are required to provide the percentage of people who applied for insurance and were denied coverage.

* Insurance companies are required to provide the percentage of applicants who were charged higher premiums because of their health status.

"Millions of Americas have already logged-on to www.HealthCare.gov's Insurance Finder to see what health coverage options are available to them," said Secretary Kathleen Sebelius. "This already unprecedented ability to search and compare coverage options is getting better with the new benefits and price information now available. These changes will help Americans find coverage that meets their needs and that gives them value for their dollars now."

Created under the Affordable Care Act, www.HealthCare.gov was launched July 1, 2010, and is the first website of its kind to bring information and links to health insurance plans into one place to make it easy for consumers to learn about and compare their insurance choices. HHS' Office of Consumer Information and Insurance Oversight (OCIIO) worked to define and collect detailed benefits and premium rating information from insurers across the country, and starting October 1, 2010, consumers will also be able to find information about health insurance options such as:
* Monthly premium estimates;
* Cost-sharing information, including annual deductibles and out-of-pocket limits;
* Major categories of services covered;
* Consumer's share of cost for these services;
* Percent of people in the plan who pay more than the base premium estimate due to their health status; and
* Percent of people denied coverage from a health plan;

More than 225 insurance companies have provided information about their individual and family plans for more than 4,400 policies, including policies in every state and the District of Columbia. Consumers can search for and compare information on plans available to them based on their age, gender, family size, tobacco use and location.

"We applaud the insurance companies that have provided us this information about their products. Together, we are improving competition in the insurance marketplace," said Jay Angoff, director of the Office for Consumer Information and Insurance Oversight. "This type of transparent competition is critical to improving quality of coverage and lowering costs for consumers."

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Oxendine: Flood Insurance Program Resumes Issuing Policies

Insurance Commissioner John W. Oxendine said the National Flood Insurance Program has been reauthorized by Congress, and flood policies are again available through your homeowners insurance agent or company.

Flood coverage is federally backed by the NFIP. The National Flood Insurance Extension Act extends the NFIP through September 30 of this year, and is retroactive back to June 1, 2010. The program had been inactive since May 31.

Oxendine said a flood policy can be a valuable addition to standard homeowners coverage.
“Purchasing flood insurance is an important consideration for Georgia consumers, even if you think a flood is unlikely in your area,” Oxendine said. “Twenty-five percent of flood claims occur in areas considered medium or low-risk for floods.”

Oxendine said flood insurance is available for up to $250,000 for damage to your home. A standard flood policy will cover the basic structure as well as the furnace, water heater, air conditioner, floor surfaces (carpeting and tile) and debris clean up.

You can buy NFIP flood insurance directly from your property and casualty insurance agent or insurance company, if your community participates in the NFIP. Your insurance agent or insurance company can confirm whether flood insurance is available to you and what it would cost. You can buy flood insurance for your home or business regardless of whether the property is in or out of a floodplain, as long as the property is located in a participating community.

It is very important to plan ahead; a flood insurance policy will not go into effect until 30 days after you buy the policy. You can obtain more information about flood insurance at http://www.floodsmart.gov.

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