Report: 2.5 million in Illinois will benefit from health reform law prohibiting insurance coverage denials based on pre-existing health conditions

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New Study Shows Nearly 1 in 4 Non-Elderly Illinoisans Have Diagnosed
Pre-Existing Health Conditions
 
 
Chicago – A report released today (May 19) for the Campaign for Better Health Care by Families USA shows that currently 23 percent – approximately 2.5 million – Illinoisans under the age of 65 have a diagnosed pre-existing condition that could lead to a denial of coverage in the individual insurance market.
 
Upon implementation, the newly enacted health reform law will give these Illinoisans significant protections.  The new law prohibits insurance companies from using several of their most discriminatory practices:  denying people with pre-existing conditions health coverage, charging inflated premiums based on health status, and excluding benefits that would treat their health conditions.
 
Jim Duffett, Executive Director of the Campaign for Better Health Care said, “At the core, the new federal health reform law is about providing fairness, and how the states implement federal reforms is what will ensure it.  There is legislation pending in Springfield to allow Illinois to form an expanded high-risk pool with approximately $200 million in federal funds that will be made available this summer. The high-risk pool will provide affordable coverage for uninsured persons with pre-existing conditions and means fewer Illinoisans will be denied coverage because they had the misfortune to get sick in the past.” 
 
He continued, “It will make health care coverage more secure by ensuring that working families cannot be denied coverage due to a pre-existing condition, or lose their coverage or be forced into bankruptcy when someone gets sick.  Both the existing risk pool and the new one should operate at the same level.  We urge Speaker Madigan and President Cullerton to take action this month to make Illinois‘ existing risk pool compatible with the new federal one.”
 
“As an organization that advocates for the health of women and children, we enthusiastically welcome these changes that will eradicate the many discriminatory practices of the private health insurance system. While this report only focuses on diagnosed conditions, federal reform will also ensure that pregnancy, a previous cesarean section or injuries related to domestic violence will no longer be considered pre-existing conditions in America,” said Kathy Chan, associate director of the Illinois Maternal and Child Health Coalition.
 
The report breaks down information on those diagnosed with pre-existing conditions and shows that individuals in every age, income, and racial/ethnic bracket have pre-existing conditions that, without reform, could lead to a denial of coverage.
  • Age:  The potential to be denied coverage because of a diagnosed pre-existing condition affects Illinoisans of all age groups.  16.7 percent of young adults aged 18-24, almost 36 percent of adults aged 45 to 54, and almost half – 46.7 percent – of adults aged 55 to 64, as well as 226.900 children under 18 years old have a diagnosed pre-existing condition that could lead to a denial of coverage.
  • Income:  The report shows that higher income is not necessarily a barrier to denial of coverage due to pre-existing conditions. 22.1 percent of individuals in Illinois families with incomes between 100 and 199 percent of poverty—between $22,050 and $44,100—are affected, and nearly three-quarters (72.9 percent) of those with pre-existing conditions that could lead to a denial of coverage are middle class and higher-income Americans. These are individuals in families with incomes above 200 percent of poverty, or more than $44,100 for a family of four in 2010.
  • Race: Individuals in every racial and ethnic group in Illinois have diagnosed pre-existing conditions that, absent reform, could lead to a denial of coverage, including one-quarter (24.9%)  of whites, one-quarter (24.6) African-Americans, and almost a third (30.7%) of the American Indian and Alaska Native population in Illinois.  The Hispanic population shows a lower percentage (17.3%) of those with diagnosed pre-existing conditions, but this is likely because many individuals have pre-existing conditions that have not been diagnosed.
“As our study shows, nearly one-quarter of the non-elderly population of Illinois will now gain protections that they need to secure affordable health coverage,” said Ron Pollack, Families USA’s Executive Director. “Thankfully, the new health reform legislation will protect all these individuals from the most harmful insurance company abuses that deny such critical coverage.” 
 
The report for Illinois with an analysis of the groups with pre-existing conditions in that state can be found at http://www.familiesusa.org/assets/pdfs/health-reform/pre-existing-conditions/illinois.pdf
 
 About the Campaign for Better Health Care
We believe that accessible, affordable, quality health care is a basic human right for all people.  The Campaign for Better Health Care is the state’s largest coalition representing over 300 diverse organizations, organizing to help create and advocate for an accessible, quality health care system for all.  For more information, visit www.cbhconline.org

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