Part 2 includes an expanded update as well as addressing the potential impacts of COVID-19.

In Part 1 of this two-part series, we outlined the definition of a pre-existing condition.

Definition: Most insurance companies use one of two definitions: Objective standard definition, a pre-existing condition is any condition for which the patient has already received medical advice or treatment before enrolling in a new medical insurance plan (think job change). Under the broadest definition of a prudent person, a pre-existing condition is anything for which symptoms were present and a prudent person would have sought treatment.

Before ACA/Obamacare: The definition that may be used was sometimes governed by state law. Ten states specified neither definition, 21 required the prudent person standard, and 18 required the objective standard. Every state, every insurance plan could make its own decision. Prior to the ACA, there were no pre-existing protections at the insurance industry level.

The Patient Protection and Affordable Care Act (aka Obamacare) was enacted on March 23, 2010. It included a delayed implementation period that allowed for the grandparenting of some exclusions. However, effective January 1, 2014, the full enactment included for individual and group health insurance plans a ban on preexisting condition exclusions in all health insurance plans. Prohibited all exclusions, waiting periods and conditions without exception.

The top 10 diagnoses are diabetes, acne, anxiety, asthma, sleep apnea, depression, pregnancy (when changing health insurance), cancer, heart disease, and COPD. Other common conditions are extreme obesity, lupus, celiac disease/autoimmune disease/gluten sensitivity, high blood pressure, and any medical injuries or illnesses you had before starting a new health plan.

With more than 134 million Americans with preexisting conditions, ACA/Obamacares protections are significant.

COVID-19 has identified a new group of pre-existing conditions. With the ever-increasing number of patients infected with COVID-19, the impact of their long-term health effects is still being determined. The new numbers also include more than five million children infected with COVID since the pandemic began. What will be their impact on long-term health? The legacy security for this new group is a new dynamic in the legacy security category.

The term Long Haulers speaks directly to people who have had COVID and have new, long-term or short-term health impacts after their initial diagnosis. These people will have new health bills and a new list of potential pre-existing conditions.

Without the protection of the ACA/Obamacare, an insurance plan or an employer-sponsored plan could exclude these new costs. This pre-existing protection continues.