People who have any kind of medical condition are at the heart of the debate over repealing and replacing the Affordable Care Act. About a quarter of adults under 65 have these so-called preexisting conditions, and they are most vulnerable to any change in the current law, which prohibits charging sick people more for insurance. The replacement bill that passed the House of Representatives, the American Health Care Act, would allow states to do just that for people with a gap of 63 days in their insurance coverage. It would also allow insurers to stop covering certain services, even for people with continuous coverage. An estimated 23 percent of people who had a gap in their insurance coverage in 2015 also had a preexisting condition.
Under the House bill, insurers couldn’t deny customers policies altogether—something that happened to 18 percent of people who applied for coverage before the ACA. Here’s the rather infamous example from 2009 of “Baby Alex”—a 4-month-old who was, at 17 pounds, deemed uninsurably fat, according to ABC News:
Baby Alex, who is 25 inches long and weighs about 17 pounds, falls into the 99th percentile for height and weight for his age, according to Centers for Disease Control and Prevention guidelines. Rocky Mountain Health Plans insurance underwriters used those guidelines to deny coverage for Alex since he was above the 95th percentile, saying he had a “preexisting condition” of obesity.
(In that case, media scorn saved the day, and Alex got his coverage in the end.)