The Trump Administration’s support for invalidating the pre-existing condition protections of the ACA has triggered some odd reminiscences of what the pre-ACA individual market looked like. commonwealthfund.org/blog/2018/two-…
Some have even said that the market worked better then.
To refresh our memories, I looked back at the Commonwealth Fund Biennial Health Insurance Survey of 2010, before the ACA individual market reforms of 2014.
In our survey, we asked working-age adults who had coverage in the individual market or had tried to buy a plan over the prior three years about their experiences getting coverage.
Of those, 35%, or an estimated 9 million people, said they were turned down, charged a higher price, or had a condition excluded because of a pre-existing condition. 
Things were even worse for adults with health problems: 46% of adults in poor health or who had a chronic health condition were turned down, charged a higher price or had a pre-x condition excluded from their policy.
But even among people in better health, one of five were turned down, charged a higher price or had a condition excluded from their plan. And nearly half said they found it difficult or impossible to find a plan they could afford.
In contrast, this is how much things had improved when we asked a similar series of questions in 2016.
Things are clearly not perfect, and the current individual market could use some support from Congress and the Trump administration.
The repeal of the individual mandate or increasing the sale of plans that can deny coverage to people in poor health won’t help it function better.
But even with these actions, Congress has well known policy levers that will lower premiums and increase enrollment. commonwealthfund.org/publications/f…
But it is simply inaccurate to claim that the individual market worked better before the ACA.
