You May Be Denied Coverage for Your Pre-Existing Medical Condition by Your Employer’s Health Plan If the ACA Is Canceled
Earlier this week, I wrote about how people in the individual marketplace with pre-existing conditions could lose their health coverage if a judge ruled in favor of 20 states filing a constitutional claim for the Affordable Care Act. But I missed an important point in this story: it’s not just people in a particular market that can lose coverage. Those who are enrolled in employer plans can too.
The Justice Department supports states by arguing in court that ACA’s guaranteed release and community rating provisions, which ensure that everyone working in the same field is charged the same premiums as everyone else, regardless of their health status. are unconstitutional.
If the Trump administration succeeds, many tens of millions of people may be denied coverage, or higher premiums charged in a particular market, or their pre-existing conditions may be excluded from their coverage.
But that goes beyond that. If you are not worried about this problem because you have insurance through your employer, this may affect you too. That’s because the provisions that the Trump administration is challenging apply to all private health insurance, including employers’ plans.
Before the ACA, your employer’s plan could not deny coverage or charge you an additional fee, but it could exclude coverage for your preexisting conditions for a year if you do not maintain continuous coverage. This is where the plans will return if the ACA regulations are lifted. (Plans for large and small groups can lead to worse results.)
As Timothy Yosta, professor emeritus of law at Washington DC and Lee University, writes , the biggest influence on those who insure an employer is that he will “lock you in” assignments again. The ACA gave some people more freedom to quit their jobs and pursue entrepreneurial or freelance work as they were guaranteed health insurance. ( The survey of 5400 small business owners, conducted in October 2017 showed that one-third “was sure to open own business, because it has access to health care through the ACA».) It also gives more freedom to leave you on the unsatisfactory performance ” … I will repeat myself just for the sake of profit. This has never happened before, and it could be on the line again.
“Anyone with a pre-existing medical condition who loses or quits a job – perhaps to take advantage of an opportunity in the gig economy – may not be able to find affordable insurance in the individual market or insurance to cover pre-existing conditions,” Yost writes. … You are less likely to take risks if you cannot afford health insurance, especially if you have a chronic medical condition.