How Does the American Health Care Act Handle Pre-existing Conditions?

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President Barack Obama delivers the State of the Union speech before members of Congress in the House chamber of the U.S. Capitol January 12, 2016 in Washington, DC. (Getty)

The United States House of Representatives is about to vote on the American Health Care Act. One of the most significant aspects of Obamacare is that it does not allow insurance companies to deny patients coverage based on whether they have a pre-existing condition. So how does the American Health Care Act address pre-existing conditions? Can those with these conditions be denied coverage again?

The version of the American Health Care Act that’s up for a vote in the House of Representatives today includes something called the McArthur Amendment, and this is the part of the bill that addresses pre-existing conditions.

The McArthur Amendment says that individual states may seek waivers from the rule that insurance companies can not charge more based on whether a person has a pre-existing condition.

However, in order to qualify for this waiver, the state must have an established high risk pool, or it must be participating in a federal high risk pool.

The rule could also only be waived for those patients who have a lapse in coverage of more than 63 days.

“No state may obtain a waiver for health status unless it has taken these efforts to protect those who might be affected,” Congressman MacArthur, who crafted this amendment, said in a press release. “In states with a waiver, individuals who maintain continuous coverage could not be rated based on health status.”

Therefore, assuming the American Health Care Act becomes law, it would be possible for some Americans with pre-existing conditions to be charged more for health insurance, but only if they purchase insurance on the individual market, live in a state that receives a waiver, and do not maintain continuous coverage. The increase would last for one year, and the state would have a high-risk pool available for them.