A new study by the Department of Health and Human Services indicates 129 million Americans under age 65 have a pre-existing condition that could render them unable to afford or to qualify for health insurance without the safety provided under the Affordable Care Act.
"Under the full range of policies in the Affordable Care Act to be in place by 2014, Americans living with pre-existing conditions are free from discrimination and can get the health coverage they need at a price they can afford," said Richard Sorian, HHS assistant secretary for public affairs. "And families are free from the worry of having their insurance cancelled or capped when a family member gets sick or going broke because of the medical costs of an accident or disease."
According to Sorian, insurance companies may include as pre-existing conditions heart disease, cancer, asthma, high blood pressure and arthritis.
"Prior to the enactment of the Affordable Care Act, your insurance company can decide what is a pre-existing condition and refuse to sell you a policy, charge you two or three times more, or limit your benefits so that your condition is excluded," he said.
The study comes as the House prepares to vote to repeal the ACA. Republicans have called the new HHS study a political tactic to persuade those voting for the repeal.
The study also found that the percentage of people with pre-existing conditions varies by insurance status, with the highest rates among those with employer-sponsored insurance, ranging from 21 precent to 54 percent. Pre-existing conditions matter less for people insured through employers that have a large risk pool and can therefore spread the cost of workers' illnesses or injuries, and some insurance protections already exist for people changing jobs, the study said.
According to the HHS, between 32 million and 82 million people with health problems and job-based coverage would be vulnerable without the ACA. In 2009, roughly 94 million Americans were in employer-sponsored insurance with a lifetime limit. The ACA has already banned lifetime limits in private insurance and has restricted annual limits for group and new individual market plans before banning such limits in 2014.
"This protects those whose coverage may have otherwise run out with a serious accident, disease that involves intense care, or other high-cost illness," Sorian said.
The study also said workers with a pre-existing condition may be less able to change jobs for fear of losing their coverage. Also, people who work in small businesses, along with their employers, may be discriminated against by their insurers due to a pre-existing condition.
About 25 percent of people with employer-based coverage are in small group policies, the HHS found.
The entire HHS study is available here.