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57 Pre-Existing Conditions You Could Be Charged More for Under Trumpcare

Including acne, migraines, and depression.
Shikhar Bhattarai/Stocksy

While Donald Trump continues to insist that the bill to repeal Obamacare covers people with pre-existing conditions, the fact of the matter is that the bill that the House narrowly passed yesterday would allow states to choose whether insurers can charge those people higher rates if they have a lapse in coverage. The MacArthur amendment to the bill also says that states can define their own set of essential health benefits that are currently covered in full, which could result in plans that look cheaper but cost more overall when you add on the services you need.


So, no, an insurance company can't outright deny you coverage under Trumpcare, but they can make it so expensive that you can't afford it. That's a point that a lot of Republicans are ignoring. (Yes, they're promising additional money for so-called high-risk pools, but multiple think tanks say it isn't nearly enough.)

Before Obamacare, people with pre-existing conditions who tried to buy their own health insurance (that is, they didn't get it through work) were regularly denied coverage because they had health conditions like diabetes and sleep apnea or had simply been pregnant in the past. This is because of the practice of individual rating, where an insurer could ask an applicant about their health history. Obamacare banned individual rating in favor of community rating; the AHCA says states can choose to reinstate individual rating if they set aside extra money to help cover these people, and can only rate people who've had a lapse in coverage.

So what kinds of conditions and life events have, in the past, led insurers to deny people coverage or charge them more? Here's an incomplete list, in alphabetical order, according to the Kaiser Family Foundation and other sources:

Alcohol or drug abuse with recent treatment
Alzheimer's or dementia
Anemia (if taking Epoetin/Epogen)
Arthritis or other inflammatory joint diseases
Caesarean section
Cancer within a certain time period, eg 10 years
Cerebral palsy
Chronic obstructive pulmonary disease (COPD) including emphysema
Congestive heart failure
Crohn's disease
Cystic fibrosis
Domestic violence Ear infections
Gender reassignment surgery
Heart or coronary artery disease and bypass surgery
High cholesterol
High blood pressure
Kidney stones
Kidney disease or renal failure
Mental disorders (including anxiety, autism, bipolar disorder, depression, obsessive compulsive disorder, postpartum depression, schizophrenia)
Menstrual irregularities
Multiple sclerosis
Muscular dystrophy
Narcolepsy (if taking Xyrem)
Obesity (BMI of 40 or more)
Organ transplant
Parkinson's disease
Pending surgery or hospitalization
Pneumocystic pneumonia
Pregnancy or expectant parent (including men)
Rape and sexual assault (e.g. for taking anti-retroviral drugs or having been raped another time in the past)
Restless leg syndrome
Sleep apnea
Ulcerative colitis
Urinary tract infections
Varicose veins

Allowing states to opt out of pre-existing condition protections was a concession to get the ultra-conservative House Freedom Caucus on board with the bill after Paul Ryan had to pull it before a planned March 24 vote because it didn't have enough support. The AHCA now moves to the Senate where it will almost definitely be changed, but it remains to be seen what Senators will do about pre-existing conditions.

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