What Is A Pre-Existing Condition

What Is A Pre-Existing Condition

Take a look at this list to find out.

By Locke Hughes
May 9, 2017

If you’ve been feeling nervous about the future of your health since House Republicans passed a new health-care bill on Thursday, May 4, you’re certainly not alone. In its current form, the bill would largely dismantle Barack Obama’s Affordable Care Act, which offered health-care coverage to between 61 to 133 million Americans previously denied insurance due to pre-existing conditions, according to the Department of Health and Human Services.

Now, many Americans are voicing concerns about what the bill actually means for their individual health—especially since the new legislation give states the power to waive coverage for people with these “conditions.” In place of coverage, the states would set up “high-risk pools,” funded by $8 billion from the federal government, which can help provide coverage for people with existing illnesses or injuries at a premium. Only problem? That’s probably not going to be enough money, according to the AARP. 

The fate of the bill is still very uncertain, but about 61 million Americans—or 23 percent—under age 65 likely have at least one pre-existing condition, according to a 2017 report from the Department of Health and Human Services. Among women, 35 million or 26 percent have one.

What’s even scarier: Those stats only take into consideration a more narrow definition of pre-existing conditions—conditions serious enough that, pre-Affordable Care Act, people who had them could be outright denied coverage by insurers. If you look at a broader definition of the term, which factors in more common health conditions like arthritis, asthma, obesity, and mental health disorders, an estimated 133 million Americans—and a startling 51 percent of us women—would have one.

Wondering if you have a pre-existing condition? Here’s a list from the Kaiser Family Foundation of only some of the things that could make you vulnerable if the bill becomes a law. But remember: Many other conditions could be deemed uninsurable, too. It all depends on the specific insurance company that sets the premiums. (Subscribe To Women’s Health’s newsletter So This Happened to get the latest trending news and stories.)

1. Cancer: Nearly 14.5 million Americans were living beyond a cancer diagnosis as of 2014. About 39.6 percent of women will be diagnosed with cancer in their lifetime, according to the National Institute of Health.

2. Heart Disease: Over 43 million women currently have some form of cardiovascular disease, while 6.6 million are living coronary heart disease. Heart disease is the number-one killer of women, causing one in three deaths each year, according to data from the National Coalition for Women with Heart Disease.

3. Diabetes: About 13 million women—or one in 10 of us—have diabetes, according to the U.S. Department of Health and Human Services.

4. Obesity: About 40 percent of women are obese—and rates are on the rise, according to data from the Centers for Disease Control and Prevention.

5. Arthritis: This condition affects 25.9 percent of women, compared to 18.3 percent of men. And while you may think it mainly affects older women, nearly three out of five people with arthritis is under age 65, according to the Arthritis Foundation.

6. Mental Disorders: According to the Kaiser Family Foundation, “severe” mental illnesses such as bipolar and eating disorders would be considered pre-existing conditions. Other reports from the Department of Health and Human Services say that behavioral disorders, including depression, ADD, and alcohol and substance use, could be included as well.

This is what it’s like to live with depression:

7. Multiple Sclerosis: About 400,00 people in the U.S. have MS. The autoimmune disorder is two to three times more common in women than men, according to the Multiple Sclerosis Foundation.

8. Alzheimer’s/Dementia: Sixteen percent of women ages 71 and older have Alzheimer’s and other dementias, versus 11 percent of men, the Alzheimer’s Association reports. In their 60s, women are two times as likely to develop Alzheimer’s disease as they are to develop breast cancer.

9. Pregnancy: Nearly four million babies are born in the U.S. each year, according to the CDC.

10. Asthma: One in 13 people have asthma, according to the Asthma and Allergy Foundation of America, and it’s more common in women than men. In 2011, eight million women had an asthma attack, compared to only 5.1 million men.

11. Migraines: Here’s another condition where we get the short end of the stick. Out of the 38 million Americans who get migraines, 28 million are women, the Migraine Research Foundation reports. Women suffer from migraines three times more often than men, and roughly one in four will experience a migraine in her life.

12. Acne: While not technically considered a “pre-existing condition,” experiencing acne could make it harder to purchase a health insurance plan, Business Insider reports, as it could require more trips to the doctor, services, and medications. That’s bad news for the 50 million Americans who experience it annually—and yet again, women are more likely than men to experience the skin condition as adults, according to the American Academy of Dermatology.

13. Treatment Sought Following Sexual Assault: As Politifact reports, “sexual assault” isn’t necessarily listed as a condition that insurance providers can take into consideration when evaluating eligibility. But treatments that women may seek following rape or sexual assault, such as therapy or HIV-preventative medication, could prevent them from obtaining coverage.

14. Transsexualism: An estimated 1.4 million Americans identify as transgender, and that number is on the rise in younger adults ages 18 to 24, according to the University of California, Los Angeles.

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