As the midterm election approaches, protecting people with pre-existing has emerged as major political issue. Here is how various proposals considered in recent years by Congress would have affected the ACA’s protections.
The House has voted on several occasions since the ACA passed to repeal the entire law, including its pre-existing condition protections.
The House passed the AHCA repeal and replace bill in 2017, which would have allowed states to waive the ACA’s benefit requirements and let insurers charge higher premiums to people with pre-existing conditions with a gap in coverage.
The Graham-Cassidy-Heller-Johnson plan in the Senate would have allowed states to alter the ACA’s benefit requirements and let insurers charge unlimited premiums based on pre-existing conditions and age. Insurers could not deny coverage or exclude pre-existing conditions.
The BCRA plan, voted on in the Senate but not passed, would have made it easier for states to waive the ACA’s benefit requirements and imposed a 6-month waiting period for people with a gap in insurance. Insurers could not deny coverage or exclude pre-existing conditions.
Outside of Congress, 20 Republican state attorneys general (some of whom are running for office) filed a lawsuit arguing that the entire ACA should be invalidated. The Trump administration is arguing in the case that only the ACA's pre-existing conditions should be thrown out.
If you'd like to relive the ACA repeal and replace debate from last year, here are our summaries of all the major bills.
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The ACA isn't the only way to protect pre-existing conditions. Medicare for all does it. High-risk pools could also (with decent coverage and adequate funding, which was historically not the case). But, saying you do it and actually doing it are not necessarily the same thing.
For low-income people with pre-existing conditions, the ACA's Medicaid expansion was the key to coverage. Republican repeal and replace bills would have rolled that expansion back.
