Insurance Industry Acknowledges Problem with Pre-existing Conditions

America's Health Insurance Plans (AHIP) has released a proposal to establish "Guaranteed Access Plans", to provide coverage for uninsured individuals with the highest expected medical costs, in the individual market. The proposal intends to expand access to health insurance for all who seek coverage, including those with pre-existing medical conditions.

Under the plan, states would create "Guaranteed Access Plans" through which the most costly consumers could access health coverage. For those individuals who are not eligible for the "Guaranteed Access Plans," health insurance plans would provide coverage on a guaranteed issue basis, with premiums capped at one-and-one-half times the standard rate. However, health plans would only be required to cover individuals up to a predetermined level of 0.5% of the health plan's total individual market population.

As an organization that has been fighting to eliminate these barriers to health insurance coverage since January 2007, NPAF is pleased with AHIP's recommendation to waive the application of pre-existing condition exclusions for medical conditions disclosed by applicants. While this proposal could be another step forward in the effort to prevent denial of benefits based on health status, NPAF is concerned that the plan places too much responsibility on states, who are already burdened with expanding uninsured populations and funding obstacles associated with operating high-risk pools.

View NPAF Press Release

View AHIP Proposal

View NPAF Pre-Existing Condition Initiative

 

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