How does the legislation help those who are uninsured and have been unable to obtain health insurance coverage because of their health or because of affordability?
The legislation contains key provisions to ensure that people who have had trouble getting health insurance coverage in the past—either by being priced out of the market or because they are “uninsurable” at any price—have more health insurance options. Consistent with AMA policy opposing pre-existing condition exclusions, and supporting modified community rating and guaranteed issue in the context of an individual mandate, insurance companies will no longer be able to deny coverage based on pre-existing conditions, and premiums will no longer be allowed to be based on gender and health status. The affordability of health insurance coverage is addressed in a manner that is consistent with AMA policy: Individuals and families with incomes up to 400 percent of FPL would be eligible for assistance in the form of refundable, advanceable, and sliding-scale premium credits, as well as cost-sharing subsidies.
