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Wrench thrown into policy applications: a preexisting condition

On Behalf of | Jun 26, 2018 | Denied Insurance Claims

Americans “deserve better.”

It is hard to disagree with that assertion made by a writer in a recent article discussing what has been a long-time and frightening scourge for scores of millions of people across the country.

Namely, that is a so-called “preexisting medical condition.” If you’re of a certain age and have ever been on the receiving end of such a tag from an insurance company, you can identify immediately with that individual’s expressed concerns.

Until the advent of the Affordable Care Act a few years back, American insurers flatly denied health care coverage to individuals on what was arguably even a whim. A family history regarding a certain condition could close the door on a policyholder even if he or she had never shown any symptoms of that ailment. A one-time “problem” from years ago could serve as the catalyst to deny an applicant time and again.

The magnitude of denial owing to preexisting conditions in past years can hardly be overstated, notes Dough Hirsch, the author of the above-cited piece. Hirsch is a dad whose own child suffered seizures as an infant. The child was thereafter denied coverage repeatedly, until federal law changes mandated universal coverage without regard to preexisting conditions.

Hirsch references this glaring number: Reportedly, more than 130 million Americans have one or more preexisting conditions. “It’s surprisingly easy to become part of that group,” Hirsch notes, adding that membership could again become problematic in light of recent changes that have eliminated Affordable Care Act tenets. Conceivably, that legislation’s guaranteed coverage for preexisting conditions is now “on the chopping block” and imminently imperiled.

The bottom line for Hirsch and many health care advocates and reformers is that preexisting conditions could once again become a top-tier concern and a preferred checkbox for insurers to tick to deny coverage.

That would unquestionably mark a step backwards for equity and logic in the American health system. As Hirsch notes, taking such a step would mock “basic tenets of what it means to be an American – fairness and social security for all.”