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Pre-Existing Condition Exclusions Harm Women

How Pre-existing Condition Exclusions Harm Women under the Republican-backed health reform bill.

Pregnancy is one of many pre-existing conditions for which Republicans want to deny care.

Republicans have long promised to “repeal and replace” the law that made coverage for pre-existing medical conditions mandatory. Prior to the Affordable Care Act, people with medical issues dubbed pre-existing conditions were denied health care, even if they had paid for insurance for years. An $8 billion last-minute fix attempts to fund some care for people with pre-existing conditions. But health care experts say it’s not enough. And it doesn’t mandate (or fund) coverage for pre-existing conditions like the Affordable Care Act did.

 

So what exactly is a pre-existing condition? It’s any medical condition, no matter how trivial, that existed prior to a person’s plan. When coverage for these conditions isn’t mandated, insurers can deny coverage on the basis of a pre-existing condition. This means sick people often can’t get health insurance. But it also means that people who think they have no relevant pre-existing conditions might still be denied care. For example, a woman with ovarian cancer might be denied coverage because she had an ovarian cyst 10, 20, or 70 years before.

Pre-existing condition exclusions harm women especially. That’s not an accident. The Republican administration and Republican Congress have targeted women for months.

Pregnancy as a Pre-Existing Condition 

The Affordable Care Act required, for the first time ever, that insurers cover care for pregnant women. Prior to the ACA, pregnancy was treated as a pre-existing condition–unless the woman sought an abortion. Self-proclaimed pro-life Republicans never objected to this scheme. In fact, they continue to argue that maternity care should not be covered, and that men should not have to pay for “women’s healthcare.” After all, babies spontaneously appear in women’s uteruses. Men have nothing to do with the process.

 

Pre-existing condition exclusions didn’t just deny coverage for prenatal care. They could also deny coverage for life-threatening conditions arising from pregnancy. Ectopic pregnancies, for example, are not viable, and can kill the mother if not treated.

 

This means that, if Republicans have their way, abortion rights will become a thing of the past, and women will be forced into poverty paying the medical bills associated with unwanted–and uncovered–pregnancies.

 

Rape as a Pre-Existing Condition 

Republicans have long argued the untenable proposition that health care is a matter of personal responsibility. Alabama Representative Mo Brooks has even claimed that people who live good lives don’t get sick. But insurers have a long history of denying coverage even for “conditions” that aren’t medical conditions at all.

 

Before Obamacare, rape survivors could be denied coverage because they were raped. And now, the MacArthur-Meadows amendment to the Republican bill will again allow insurers to discriminate against rape victims.

 

Is Being a Woman a Pre-Existing Condition?

When insurers are allowed to deny coverage on the basis of pre-existing conditions, insurers can dream up a litany of reasons for claim denials. Women are significantly more likely to be denied healthcare coverage, especially for sex-specific conditions. Under new Republican legislation, insurers can also deny women’s claims based on previous Cesarean sections, domestic violence, and postpartum depression.

 

Insurers have previously denied claims for conditions as innocuous as a yeast infection, as common as urinary tract infections, and as easily treated as chlamydia–all conditions that disproportionately affect women. With a Congress uninterested in protecting women’s health care, a confessed sexual predator in the Oval Office, and state legislatures doing all they can to constrain women’s access to reproductive justice, equality in health care may be about to become a thing of the past. A world where women have to pay for their own rapes, or in which they are left to die because they can’t fund pregnancy care appears to be exactly what “pro-life” Republicans want.

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