Study: Overturning the ACA could prolong COVID-19 pandemic

Insurers could refuse to cover applicants with preexisting conditions

A Supreme Court decision to strike down the Affordable Care Act (ACA) could prolong the impact of the COVID-19 pandemic, according to researchers at The Commonwealth Fund.

Among its other provisions, the ACA prohibits insurance companies from denying coverage to people with preexisting health conditions. But if the Court strikes down that part of the law, or the entire law­, insurers could reinstate the practices of refusing to cover applicants with preexisting conditions, providing only partial coverage, or charging higher premiums for them. The Court is scheduled to hear a case challenging the law’s constitutionality in November.

What would such an outcome mean for people with COVID-19, and the health system generally? To find out, Commonwealth Fund researchers used data from the Centers for Disease Control and Prevention and Johns Hopkins University to estimate that about 3.4 million adults ages 18-64 had contracted COVID-19 as of early October, joining the 133 million other Americans with at least one pre-existing condition. They further calculated that about 20,000 additional non-elderly adults are contracting the virus each day.

Given that little is known about the long-term health effects of COVID-19, the authors say, it’s likely that commercial insurers will designate it as a preexisting condition, and not offer coverage to people who have or had the disease. They note that prior to passage of the ACA, many people avoided seeking health care so as not to be labeled as having a preexisting condition and thereby lose their coverage or see their premiums raised.

“If we return to those days, health people might avoid COVID-19 testing altogether,” they say. “And that is exactly the opposite of what must happen if we are ever to get this pandemic under control.”

The posting “Will the Pandemic Increase the Number of Americans with Preexisting Conditions?” appears on The Commonwealth Fund’s blog “To The Point.”

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