REPORTS: TRUMP ADMINISTRATION ACTIONS THREATEN PEOPLE WITH PRE-EXISTING CONDITIONS
Before the Patient Protection and Affordable Care Act (ACA) was enacted in 2010, one of the most devastating experiences for Americans with pre-existing health conditions was the refusal by insurance companies to cover them, or to charge them rates that were exorbitantly higher than for people without pre-existing conditions.
This discrimination by insurance companies was allowed under federal law, and it was a leading cause of bankruptcies as families often lost their homes and their entire savings.
Congress ended this legalized discrimination by establishing a set of new statutory protections for people with pre-existing conditions.
Among these protections, insurance companies are now required to offer coverage to everyone, regardless of health status—a protection known as “guaranteed issue.” Insurance companies are also barred from charging higher premiums on the basis of health status—a protection known as “community rating.” In addition, insurance companies are now prohibited from selling policies that do not cover pre-existing health conditions—a protection known as the “coverage exclusion prohibition.”
On June 7, 2018, Attorney General Jeff Sessions sent a letter informing House Speaker Paul Ryan that the Department of Justice no longer will defend in federal court the ACA’s requirement that individuals maintain insurance coverage and that the guaranteed issue, community rating, and coverage exclusion provisions should no longer remain in effect. He explained that he was acting “with the approval of the President of the United States.”
The Trump Administration has yet to offer any alternative proposals for individuals with pre-existing conditions who may lose federal protections as a result of the Administration’s actions.
In order to assess the potential effects of the Trump Administration’s decision not to defend these protections, Ranking Member Cummings directed his staff to prepare the following national and state-level reports.