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This is the page of Healthcare.Gov that will answer this question:
 What if I have a pre-existing health condition?

The answer from the page is as follows:

Being sick doesn't keep you from getting coverage

Starting in 2014, being sick won't keep you from getting health coverage. An insurance company can't turn you down or charge you more because of your condition.

Once you have insurance, the plan can't refuse to cover treatment for pre-existing conditions. Coverage for your pre-existing conditions begins immediately.

This is true even if you have been turned down or refused coverage due to a pre-existing condition in the past.

It goes on to mention that some grandfathered policies do not cover pre- existing conditions.  And this is "one exception" to what is said above, as these are the policies that have not been rescinded because they were issued before the date the bill was signed in 2010.  Unlike those that have been cancelled, these are still in effect, and if they excluded coverage for pre-existing conditions, that exclusion is not nullified by ACA  

The page closes with the admonition: "Be sure not to miss open enrollment"  Giving the dates of this period for this year.

There was some question about this promise of no refusal for existing conditions in the law, and I have done a bit of research. To make my work more meaningful,  I would first appreciate a quick answer to the poll.  Of course, any comments would be welcomed

If you have a pre-existing medical condition, illness or recent trauma

It's clear, you can never be denied coverage for such conditions
Maybe certain types of conditions can cause upcharge
It may be easier and faster during open enrollment period
You can't get insurance with above condition outside of open enrollment


If you have a pre-existing medical condition, illness or recent trauma

71%37 votes
1%1 votes
5%3 votes
21%11 votes

| 52 votes | Vote | Results

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Comment Preferences

  •  it is true, you can't be turned down or (2+ / 0-)
    Recommended by:
    arodb, Lujane

    charged more for having a pre-existing medical issue.

    They will charge you more for something else or turn you down for some other reason like bad credit or being a left-handed tap dancer.

    Stupid question hour starts now and ends in five minutes.

    by DrillSgtK on Sat Dec 21, 2013 at 02:17:12 PM PST

    •  Thank you for this comment..... (1+ / 0-)
      Recommended by:

      I will try to repost this with more information on Sunday,

    •  Actually spells out when they can charge more (0+ / 0-)

      As I remember, the law actually lists the situations where the insurance companies can charge different fees. They cannot distinguish based on pre-existing conditions or gender. They can have age categories (although the cost differences are limited) and a few other things, such as whether the person smokes.

      •  age category is significant (1+ / 0-)
        Recommended by:

        I believe the 60-64 group can be charged up to 2.5x the premium for the youngest group. That's a lot of moolah. The subsidies blunt it for those eligible, but I suspect that many of the people who are screaming about huge premium increases are in that highest age group.

        It's as if Medicare charged 85 year olds three times what it charged 65 year olds. There's actuarial evidence for it, but it would hit hard.

        I assume it was done so that the 18-34 premiums would be attractive enough to get the kids to enroll, assuming that 50-64s have had enough health scares that they don't need much convincing. It may also be based on the (erroneous) assumption that older people have higher more stable incomes -- used to be true, perhaps, but isn't now.

    •  I don't think you're right (0+ / 0-)
      They will charge you more for something else or turn you down for some other reason like bad credit or being a left-handed tap dancer.
      The ACA makes the individual insurance market more similar to the group insurance market. When joining a group insurance plan, you couldn't be charged more for insurance than the other members of your group just as you couldn't be excluded for pre-existing conditions.
  •  An alternative poll answer (6+ / 0-)
    Recommended by:
    arodb, Lujane, bull8807, ban nock, Chi, ladybug53

    If you have a pre-existing medical condition -

    -- You cannot be denied coverage for a new HI policy purchased for 2014 or beyond.

    (All the other qualifiers about recent trauma or illness are not really needed to help understand the issue).

  •  You can't get insurance (5+ / 0-)

    outside of enrollment, healthy or not, unless you have a "qualifying event": you move, you have or adopt a baby, you lose your job, you get a job and no longer qualify for Medicaid, you lose your COBRA coverage, you get married or divorced, something like that.

    •  Yes, if you do have a qualifying event..... (3+ / 0-)
      Recommended by:
      Cardinal Fang, ban nock, sewaneepat

      Lets say you lose your job and thus become uninsured.  At that point you may procure ACA insurance without any underwriting,  any need to show no pre-existing conditions.

      Anyone can  still buy non ACA short term insuranceoutside of the open enrollment period.

       Devil in the details of qualifying event clause.  If too lax, in case of immediate onset of high cost illness, moving out of state seems to be enough.  

  •  All mixed up (1+ / 0-)
    Recommended by:

    The only conditions in the ACA compliant policies that cause an up charge are age and smoking.  A grandfathered pre-2010 policy can do whatever the policy says.

    How are you mixing up the open enrollment time period with pre-existing health conditions?  Unless your coma causes you to miss the open enrollment period, they have no connection.

  •  As I told my brother when he said one of his (3+ / 0-)
    Recommended by:
    auapplemac, ladybug53, arodb

    sons might just wait to get insurance when he needs it -
    neither President Obama, Congress, nor the insurance companies are so stupid that the law allows you to wait until you have an illness to get insurance. If you miss the open enrollment, you will have to wait until the next open enrollment to be guaranteed a policy (barring the life changes spelled out in the bill - none of which is that you just got sick). Meanwhile, you are responsible for all your medical costs.

    Whether you would be able to find a non-ACA compliant policy or not is something I don't know, but the likelihood of an insurance company selling you a policy if you have just been diagnosed with a variety of conditions is slim to none.

    At least that is my understanding.

    You can't scare me, I'm sticking to the Union - Woody Guthrie

    by sewaneepat on Sun Dec 22, 2013 at 05:03:03 AM PST

    •  Don't forget the penalties (3+ / 0-)
      Recommended by:
      sewaneepat, auapplemac, arodb

      which are another way the law penalizes those who want to wait until they "need" the coverage. Every month that you go without coverage, you will pay a penalty on your taxes, that's geared to your income.

      And my understanding is that the non-ACA-compliant policies do not "count" as satisfying the individual mandate, so if you buy one of those you will still have to pay the penalty.

      In Massachusetts it took a couple of years before the penalties began to bite (people won't get it until Winter 2015 when they are doing their 2014 taxes), and people figured out it was cheaper to get the insurance than to keep paying the penalties.

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