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.
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