From Acne to EcZema: The Return of Medical Underwriting Puts Millions at Risk for Losing Coverage or Higher Premiums

It’s a blast from the past, but not a welcome one. With the Affordable Care Act (ACA) at risk of repeal, Americans may be forced to get reacquainted with medical underwriting.

What is underwriting? In health insurance, it is a practice used by insurance companies to assess a consumer’s health status, including any pre-existing conditions, to determine whether or not to offer coverage and at what cost. Before this discriminatory practice was outlawed by the ACA, insurance companies required medical history forms for potential enrollees. All individuals and dependents applying for coverage were required to disclose their health history of the past five years, including all diagnoses (even if they were found to be incorrect), treatment and testing regimens (or even just recommendations), prescriptions, and all hospitalizations for a number of health conditions. Any dark mark on your medical record could result in higher premiums, exclusions and limitations, or a denial of coverage.

An estimated 129 million Americans have some kind of pre-existing condition that could result in disqualification from coverage. Here is an example of an underwriting application from Illinois, which required disclosure of the following conditions:

Heart attack
Chest pain
Heart murmur
Irregular heartbeat
High/elevated blood pressure
High/elevated cholesterol
Anemia
Bleeding/clotting disorder
Varicose/spider veins
Phlebitis
Lymphadenopathy
Enlarged lymph nodes
Disease of the spleen
Cancer
Tumors
Cysts
Polyps
Lumps
Other abnormal growths
Asthma
Bronchitis
Emphysema
Sleep apnea
Pneumonia
Tuberculosis
Chronic obstructive pulmonary disease
Acid reflux
Ulcers
Hernia
Colitis
Hemorrhoids
Rectal bleeding
Gallstones
Irritable bowel syndrome
Chronic diarrhea
Hepatitis
Elevated liver function test
Jaundice
Cirrhosis
Gallbladder infection or inflammation
Pancreatitis
Crohn’s disease
Kidney infection
Kidney stones
Bladder infection
Cystitis
Urinary influx
Urinary tract infection
Diabetes
Thyroid disorder
High/low blood sugar
Adrenal, pituitary, or other glandular disorder
Chronic fatigue syndrome
Obesity/weight loss surgery
Seizures
Migraine headaches/chronic severe headaches
Head injury
Paralysis
Epilepsy
Tremor
Stroke or TIA
Multiple sclerosis
Parkinson’s
Restless leg syndrome
Lou Gehrig’s disease (ALS)
HIV positive
AIDS
Diseases associated with AIDS
Arthritis
Gout
Lupus
Herniated disc
Temporomandibular joint disorder (TMJ)
Carpal tunnel syndrome
Disease/disorder of the back or spine
Other bone or joint disorder
Depression
Anxiety disorder
Attention deficit disorder
Chemical imbalance
Bipolar disorder
Obsessive compulsive disorder
Eating disorder
Allergies in any form
Hay fever
Hives
Anaphylaxis
Glaucoma
Cataracts
Strabismus (cross eyes)
Detached retina
Hearing disorder
Ear infection
Loss of hearing
Deviated septum
Adenoiditis
Sinusitis
Tonsillitis
Strep throat
Acne
Psoriasis
Eczema
Keratosis
Pre-cancerous lesions
Herpes
Melanoma
Cleft palate/lip
Club foot
Heart/lung/kidney defect or malformation
Pervasive development disorder
Down’s syndrome
Autism spectrum disorder
Learning disability
Infertility
Abnormal menstrual bleeding
Abnormal PAP smear
Endometriosis
Ovarian cyst
Sexually transmitted disease
Human papillomavirus (HPV)
Pregnancy complications
Uterine fibroid
Breast infection or inflammation
Erectile Dysfunction
Prostate disorder
Gynecomastia

Is your head spinning? Cold sweats? Better get to the doctor before the draconian days of health status discrimination return. If the ACA is repealed, many people with a pre-existing condition could be denied health insurance, charged dramatically higher premiums than healthier peers, or be offered policies that don’t cover essential health services. Based on the laundry list of conditions that could disqualify individuals or their children, that’s a lot of us.

One thought on “From Acne to EcZema: The Return of Medical Underwriting Puts Millions at Risk for Losing Coverage or Higher Premiums

  1. Pingback: Prior to the ACA, Where You Lived Determined How Accessible and Affordable Coverage Would Be - Center on Health Insurance Reforms

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