Estimates of the Share of Adults with Pre-Existing Conditions
UNITED HEALTHCARE DIABETES PILOT MANUALS
We consulted field underwriting manuals used in the individual market prior to passage of the ACA as a reference for commonly declinable conditions.
We examine data from two large government surveys: The National Health Interview Survey (NHIS) and the Behavioral Risk Factor Surveillance System (BRFSS), both of which can be used to estimate rates of various health conditions (NHIS at the national level and BRFSS at the state level).
This brief reviews medical underwriting practices by private insurers in the individual health insurance market prior to 2014, and estimates how many American adults could face difficulty obtaining private individual market insurance if the ACA were repealed or amended and such practices resumed. To what extent people with pre-existing health conditions are protected is likely to be a central issue in the debate over repealing and replacing the ACA. 1 That means insurers evaluated the health status, health history, and other risk factors of applicants to determine whether and under what terms to issue coverage. It includes estimates for non-elderly adults and households, with some breakouts by state, age and gender.īefore private insurance market rules in the Affordable Care Act (ACA) took effect in 2014, health insurance sold in the individual market in most states was medically underwritten. UPDATE: An updated version of this analysis based on 2018 data is now available.
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