With the new American Health Care Act (AHCA) that was passed in Congress yesterday, with a margin of just 4 votes, the issue of pre-existing conditions has been put back into play.
A pre-existing condition is defined by insurance companies as any disease, injury, or condition that affected a patient before they were covered under an insurance plan. Previously, Obamacare protected those who would fall under this category. However, under this new bill’s mandate, states would be eligible to apply for waivers for insurers that would then allow them to increase charges for those with pre-existing conditions if their insurance plan was to lapse (which occurs after a timeframe of 63 days). To do this, states would have to agree to create a program to help subsidize these costs. While this may sound like a solid arrangement, this subsidization would most likely be done in the form of high-risk pools, which have proven in the past to be unable to provide adequate coverage.
Why are we repeating the same mistakes in healthcare and not progressing forward? Avalere Health released a report on May 4th that described their analysis that the funding set aside by the AHCA to cover these pre-existing conditions will only be sufficient to cover around 110,000 individuals. This is nowhere near enough in funds as it is noted that around 2.2 insurance enrollees today have a pre-existing condition.
What is even more troubling is that with the AHCA women continue to be major targets of the American healthcare system. This new bill will place pregnancy, cesarean sections, and postpartum depression under the category of pre-existing conditions. Many women will now be at incredibly high-risk for being required to pay large amounts of money out of pocket for healthcare since most would never think of pregnancy as being a pre-existing condition. Based on analysis by the Center for American Progress “Insurers would charge about $17,320 more in premiums for pregnancy”.
This is a devastating amount for at-risk women and low-income families.
It has yet to be seen whether this bill will make it to the Senate floor, but in a worst case scenario it is time for healthcare leaders to begin seriously thinking about the groups who are going to be most heavily impacted by these changes.
Women of all steps of life, especially future and current mothers, could potentially have an unequal burden shifted to their shoulders. If lawmakers are unable to design health policy that will protect all American regardless of gender it is time for the technology, startups, and other innovative spheres begin to develop solutions that can create a safety net for those without coverage. This could potentially be in the form of online health applications and symptom checkers beginning to screen and pay attention for early signs of postpartum depression or the development of alternative prenatal and maternal health options.