WASHINGTON D.C. -More than 2.4 million Ohioans under the age of 65 have pre-existing conditions that can prevent them from receiving health coverage, according to a new Families USA report unveiled today by U.S. Sen. Sherrod Brown (D-OH) and members of the Ohio congressional delegation. The members of Congress discussed how the enactment of health reform, when fully implemented, will prevent insurance companies from discriminating against these Ohioans with pre-existing medical conditions.

"During the health care debate I would stand on the Senate floor and read letters that Ohioans would write to me about their struggles with our health care system. A common concern was how a pre-existing condition would result in either dropped or denied health insurance coverage," Brown said. "Pre-existing condition denials plague every income group, every racial or ethnic group, and every age group.  That's why enacting health reform was so critical."

The report comes as Congress is finalizing legislation to extend unemployment insurance and temporary COBRA health coverage. Following the call, Brown released county-by-county data on people who will lose unemployment insurance if these benefits are not extended.  If unemployment insurance is not extended by June 4, 2010 more than 110,000 Ohioans will lose their benefits in June, up from more than 14,500 in May.

Brown was joined on today's call by Families USA Executive Director Ron Pollack, U.S. Reps. Tim Ryan (OH-17), Mary Jo Kilroy (OH-15), Charlie Wilson (OH-6), UHCAN Ohio Executive Director Cathy Levine, and Sondra McCurry, a Euclid resident.

Ohioans at Risk of Denial of Coverage Due to Pre-Existing Conditions

Without historic health reform legislation passed earlier this year, more than 1 in 4 non-elderly Ohioans would be at risk of being denied coverage due to pre-existing conditions. The Families USA report explored how pre-existing conditions affect Ohioans across age, income, and racial variations:

Age Breakdown of Ohioans Who Have a Pre-Existing Condition That Could Lead To a Denial of Health Insurance Coverage

  • Children (under the age of 18): 209,800 
  • Young Adults (aged 18-24): Nearly 1 in 5 - 18.1 percent
  • Ohio Adults (aged 45-54): Nearly 2 in 5 - 39.1 percent
  • Ohio Adults (aged 55 to 64): Nearly Half - 49.1 percent

Income Variations

The lowest-income Ohioans are the most likely to have a pre-existing condition that could lead to a denial in coverage, with more than 1 in 4 individuals in families with incomes below 100 percent of the federal poverty level affected. While the lowest-income Ohioans are slightly more likely to be affected by a pre-existing condition, middle-class and higher-income Ohioans make up more than 70 percent of those with pre-existing conditions that could lead to a denial in coverage.

Racial Variations

In Ohio, American Indians and Alaska Natives are the most likely to have pre-existing conditions that could lead to a denial in coverage with more than one-quarter affected. More than 1 in 4 whites and African Americans have a pre-existing condition that could lead to a denial in coverage; and more than 1 in 7 Hispanics and 1 in 10 Asian Americans are affected.

How Health Reform Will Help

Immediately Banning Pre-Existing Condition Exclusions for Children

Effective six months after enactment, health insurers will be prohibited from excluding coverage of children (because of a pre-existing condition or from denying coverage of certain medical care because of a pre-existing condition.  This provision is effective for plan years beginning on or after 6 months after enactment of the law or September 23, 2010. This provision is similar to legislation Brown introduced in March of 2009 that would prevent insurers from denying coverage to children with pre-existing conditions.

Total Ban on Pre-Existing Condition Exclusions for Everyone

Beginning in 2014, health insurers will be prohibited from denying anyone coverage due to a pre-existing condition, from excluding coverage of medical care due to pre-existing conditions, or from charging individuals more in premiums because of pre-existing conditions.

Immediate High-Risk Pools

By mid-summer 2010, Ohio's high-risk pool should be up and running to provide immediate relief to uninsured Americans with pre-existing conditions. Premiums in the high risk pool will be affordable to ensure that those who have been priced-out of coverage have access to affordable, high-quality insurance. Ohio officials are currently working with the U.S. Department of Health and Human Services to establish an appropriate high-risk pool for the state.  The high risk pools will exist until the Exchanges are operational in 2014.  

More Congress Can Do

Last week, Sen. Sherrod Brown introduced the COBRA Health Benefits Extension Act of 2010 that would extend health insurance coverage for current COBRA enrollees until the major reforms in the new health law take effect. The legislation would provide a bridge for unemployed workers and early retirees by allowing them to stay on their former employer's health plan instead of entering the individual market or enrolling in a high risk pool. Former workers currently enrolled in COBRA would be able to keep their insurance beyond standard eligibility periods until another job that offers coverage is secured or they become eligible to participate in an insurance exchange in 2014.