ACA Facts: Ending Pre-existing Condition Exclusions and Discrimination

March 13, 2013

Eliminates Pre-existing Condition Exclusions and Discrimination Policies

Before the ACA, insurers could limit benefits or deny coverage to any individual who had a pre-existing condition that was discovered or treated before the insured applied for coverage.  Many insurance plans could decide, on their own, what qualified as a pre-existing condition (e.g. cancer, heart disease, and asthma).  But now under the ACA, plans that cover children can no longer exclude, limit, or deny coverage to any child under age 19 solely based on a pre-existing health condition or disability.  Starting in 2014, this protection will apply to all Americans, regardless of age, gender, or health status.   Also, in the individual and small group market, insurance companies will no longer be able to charge higher rates due to gender or health status.