Insurance for people with pre-existing conditions is an issue of life or death
Next Tuesday, when I step into the ballot box to cast my votes in this year’s mid-term election, I will undoubtedly be thinking about young Delawareans battling opioid addiction, neighbors suffering from the effects of early onset Alzheimer’s disease, and friends visiting their premature baby in the intensive care unit.
These – and so many other pre-existing conditions — will be on my mind not only because I am a physician caring for such patients here in Delaware, but also because I, too, have a pre-existing condition.
In the summer of 1983, I was born prematurely and needed to spend several weeks in the Neonatal Intensive Care Unit (NICU) in order to survive. It was during that time that, through procedures and blood transfusions, I contracted the hepatitis C virus (HCV) — a diagnosis I would only learn of, incidentally, 26 years later while training to become a doctor.
I was fortunate to be diagnosed before severe complications from the virus had occurred, and to have insurance and financial access to specialists and expensive medications — all of which allowed me to be cured of my HCV by the summer of 2011.
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In Delaware alone, nearly 29 percent of the adult non-elderly population has a pre-existing condition. These include a wide range of common diagnoses ranging from cancer and congenital heart disease to substance abuse and depression, and even pregnancy.
Passage of the Affordable Care Act (ACA) or “Obamacare” in 2010 completely changed life for not only 163,000 Delawareans, but also for me. We could no longer be refused access to health insurance, charged more because of our previous health conditions, and finally had guaranteed coverage for essential health benefits. We could no longer be discriminated against because of our previous health conditions.
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Beginning in 2017, movement to reverse these protections began under Republican Congressional efforts to repeal the ACA. Replacement legislation, called the American Health Care Act, would have allowed insurance companies to charge higher premiums for sicker patients.
This year, the Trump administration supported a lawsuit in Texas by several states’ attorney generals (Delaware was not one of them) arguing that the ACA’s protections for pre-existing conditions were unconstitutional. And, within the last two weeks, the administration announced a new proposal to allow states to move patients out of comprehensive health plans into skimpier ones that could both deny coverage for pre-existing conditions and refuse coverage for things like prescriptions drugs, maternity care, and addiction treatment.
We are fortunate to be in Delaware, where state officials and our current U.S. congressional delegation have taken steps to try to ensure protections for pre-existing conditions. While Delaware law currently requires insurers to provide policies to individuals regardless of health status, if the Texas lawsuit succeeds, insurers in our state would be able to exclude pre-existing condition protections.
If this all sounds confusing, it’s because it is. Health care is indeed complicated, and there are endless debates related to the skyrocketing cost of medical care and how to increase timely access to medical providers.
As complex as these issues are, however, the issue of pre-existing conditions is clear-cut. We all know someone who has one or are one diagnosis away from becoming one ourselves.
As the next week moves forward, I ask that you think about your fellow Delawareans — the young adult with opioid addiction, the neighbor with Alzheimer’s, the family member expecting their first child, or even me – the doc with hepatitis C – and vote.
Your life and mine might depend on it.