Pre-existing conditions affect many: study

More than 57 million nonelderly Americans—or about 1 in 5—have diagnosed pre-existing health conditions that could lead to a denial of health coverage in today's insurance market, according to a new report from Families USA.

All of these people can potentially benefit from the new health reform legislation that prohibits insurance companies from denying health coverage because of pre-existing conditions and from charging discriminatory premiums based on health status, Ron Pollack, the advocacy group's executive director, said during a teleconference to release the report, Health Reform: Help for Americans with Pre-Existing Conditions.

“The tens of millions of Americans with diagnosed health conditions, and the many others who at some point may receive such a diagnosis, are the people most in need of healthcare coverage,” Pollack said.

Pollack said the estimate of 57.2 million people with pre-existing conditions probably understates the problem, as there are many uninsured and underinsured people who have yet to be diagnosed with pre-existing conditions.

While every age group is affected by such pre-existing conditions that today could lead to a denial of health coverage, the problem grows significantly as people age, the report found. According to Pollack, 1 in 6 nonelderly have a diagnosed pre-existing condition, but among those 55 to 64 years old, more than 2 in 5 have a diagnosed pre-existing condition.

The lowest-income Americans are slightly more likely to be affected by pre-existing conditions, Pollack said. However, more than two-thirds (69.8%) 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 the federal poverty level, or more than $44,100 for a family of four in 2010, the report noted.