How to Penalize Pre-Existing Conditions under Obamacare

Health insurance penalties for pre-existing conditions are supposed to be a thing of the past under the Affordable Care Act (the ACA or Obamacare). And things are clearly much better for people who used to be all but uninsurable because of a pre-existing condition. Even so, ingenious insurers are finding ways to make people pay extra for their pre-existing health conditions.

In a case that will be watched closely, two advocacy groups for HIV patients filed a complaint with the Office for Civil Rights in the department of Health and Human Services against four health plans. The AIDS Institute and the National Health Law Program filed a complaint saying that CoventryOne, Cigna, Humana, and Preferred Medical Plan are systematically discriminating against people with HIV by imposing higher out of pocket costs for HIV treatments those for other treatments. Said Wayne Turner of the National Health Law Program:

The ACA provides robust consumer protections, including putting an end to discriminatory practices by health insurers. But these insurance plans are running afoul of that by placing all HIV/AIDS medications in the highest tiers with exorbitant co-insurance and co-pays, and instituting other barriers to obtaining commonly prescribed HIV/AIDS medications. The companies are going out of their way to discourage people with HIV/AIDS from enrolling in their plans — a blatantly illegal practice.

The Obesity Action Coalition (OAC) and other advocates for access to evidence-based obesity treatment have seen similar practices. Said OAC CEO Joe Nadglowski:

Some policies that we have seen under the ACA include broad exclusions for “any treatment for obesity, regardless of potential benefits for co-morbid conditions” and “treating a sickness or bodily injury caused by, complicated by, or exacerbated by obesity.”

Such practices must be rooted out, lest we see a race to the bottom and a return to deplorable abuses that were once common.

Click here to read more in the New York Times.

Go to Jail, photograph © Ken Teegardin / flickr

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.