What cutting protections for pre-existing conditions means for people with chronic diseases

Coverage for pre-existing conditions is critical for the millions of Americans living with chronic diseases, and it’s a matter of decency and existing law. Until the Affordable Care Act, people with pre-existing conditions were denied insurance coverage, charged higher premiums and offered limited benefits.

Friday’s decision by a federal judge in Texas that threatens coverage of pre-existing conditions leaves millions in jeopardy a month after the topic dominated the midterm elections.  

This fall, Republicans and Democrats alike focused on this issue, and support for people with pre-existing conditions to be free from concern when seeking health insurance is incredibly popular.

In a recent national poll, nearly two out of three people say it is “very important” that insurers do not deny insurance coverage because of a person’s medical history. Perhaps even more striking, support is broad and bipartisan— specifically, 70 percent of Democrats, 66 percent of independents, and 58 percent of Republicans support prohibiting insurance companies from denying coverage because of a person’s medical history.

The case in Texas that now threatens the future of pre-existing conditions coverage came about when, earlier this year, the attorneys general of 20 states sued to have the Affordable Care Act declared unconstitutional. The Department of Justice also filed a brief arguing that the law’s provisions that prevent people with pre-existing conditions from being denied insurance or charged higher rates are unconstitutional.

Health and Human Services Secretary Alex Azar told the Senate that the Justice Department’s stance was “a constitutional position … not a policy position.” He added, “We do believe in finding solutions on the matter of pre-existing conditions.”

We cannot say it strongly enough: It’s critical that the Administration and new Congress preserve insurance protections for people with pre-existing conditions. Reducing or eliminating the insurance coverage on which people with chronic diseases rely will lead to significantly higher and often unaffordable insurance costs for those who are affected by such diseases. Further, not having coverage means people will be unable to manage their disease properly, leading to more emergency room visits and medical complications, and ultimately driving up healthcare costs for all.

Type 1 diabetes is a chronic autoimmune disease in which insulin-producing cells in the pancreas are mistakenly destroyed by the body’s immune system. There is currently no way to prevent the development of Type 1 diabetes, and there is no cure. People with Type 1 diabetes need injected or pumped insulin to survive, and without affordable access to drugs and devices, their lives are in jeopardy.

Insulin prices have also increased dramatically in recent years: A study in the Journal of the American Medical Association found the average price of insulin was nearly three times higher in 2013 than in 2002. The surge in insulin costs has come as more Americans have moved to high-deductible health plans, causing many people living with Type 1 diabetes to pay the full list price for insulin during part of the year. To put that in perspective, one family who has two members with Type 1 diabetes spends an extra $3,500 every three months on insulin and other diabetes supplies needed to keep their family members alive.

For many years, our community was in the position where we had to battle with insurers that were allowed to deny coverage or charge significantly more to people with pre-existing conditions. We want to make certain that no one has to fight these same battles again, and that’s why we urge every member of Congress to publicly commit to defend protections for Americans with pre-existing conditions.

Americans with a chronic, serious and life-threatening disease like Type 1 diabetes should have access to comprehensive health insurance at rates similar to those without pre-existing conditions. Given the negative health consequences for millions of people living with chronic diseases, we ask Congress and the Administration to ensure that current legal protections for people with pre-existing conditions are preserved. It’s not only the right thing do, it’s the fiscally responsible thing to do, too.

Derek Rapp is the president and CEO of JDRF, a global organization funding Type 1 diabetes research.