Premiums No Longer Tied to Pre-Existing Medical Conditions

Beginning in 2014, insurers can no longer deny coverage or charge higher premiums to adults with pre-existing medical conditions, or poor health. In 2010, a similar law was enacted for children.

Until 2014, the federal government is operating a nationwide network of temporary exchanges that provide insurance coverage to people with pre-existing conditions. After that, people with pre-existing conditions should be able to purchase policies through the permanent network of exchanges or the private market.

When the new rule takes effect, it will essentially mean the end of a process called medical underwriting, or evaluating applicants for coverage. Medical underwriting is far more prevalent when insurers sell policies to individuals or small groups. When selling policies to large groups, insurers can rely upon spreading costs more broadly.