Mainers, here are the basics on pre-existing medical conditions

Much of the fevered debate about House Republicans’ plan to replace the Affordable Care Act is coalescing around its implications for people with pre-existing conditions.

The term is insurance company jargon but it’s quickly becoming part of the popular lexicon. So what exactly does it mean, and how many people in Maine have one?

A pre-existing condition is basically a health issue that an individual already has at the time their health insurance coverage starts. Before the Affordable Care Act, in many states insurers could quiz you about whether you had at least one of these conditions through a process called (more insurance jargon here) “medical underwriting.” They could then use that information to charge you more or deny you coverage altogether.

Insurers in the individual market — where people who don’t get coverage through the government or work can shop for a plan — used to keep lists of pre-existing conditions that they would automatically deny. According to the Kaiser Family Foundation, these conditions included:

  • Cancer
  • Epilepsy
  • Kidney failure
  • Stroke
  • Severe obesity
  • Congestive heart failure
  • Pregnancy

(Some also kept lists of occupations that made a person ineligible for coverage, according to Kaiser. Those jobs included loggers, pilots, cab drivers, law enforcement, and, not kidding, “strong man competitors.”)

The Fiddlehead Focus / St. John Valley Times is pleased to feature content from our sister company, Bangor Daily News. To read the rest of “Mainers, here are the basics on pre-existing medical conditions,” an article by contributing Bangor Daily News staff writer Jackie Farwell, please follow this link to the BDN online.

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