Gordon & Vitale Introduce Legislation Prohibiting Insurers from Charging More for Pre-Existing Conditions

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TRENTON – Responding to efforts by Congressional Republicans to eliminate the prohibition on insurers charging people with pre-existing conditions more for health coverage, Senator Bob Gordon and Senate Health Chairman Joseph F. Vitale introduced legislation to protect New Jersey residents by requiring that no health insurer may exclude, impose a waiting period or charge more for coverage due to a pre-existing condition.

“We don’t know the fate of this ill-conceived legislation, but if Congressional Republicans are successful in amending or repealing the Affordable Care Act, we can’t allow New Jersey residents to be the victims of practices that prevent them from getting needed health coverage. The proposal to permit states to waive protections that prohibit insurers from charging some people more for insurance is cruel and will price out those who need health coverage the most,” said Senator Gordon (D-Bergen, Passaic). “This bill will make sure that insurers in New Jersey continue to provide coverage for pre-existing conditions without discriminating against consumers.”

“The Republicans’ proposal would have a devastating impact on millions of Americans and their ability to afford and access health care, including in New Jersey. It eliminates protections for those with pre-existing health conditions by allowing states to seek waivers from the ACA’s current requirement that insurers charge people the same for coverage regardless of any health conditions they have,” said Senator Vitale (D-Middlesex). “Our residents deserve better and this legislation sets a standard in New Jersey that will protect them.”

An amendment sponsored by Rep. Tom MacArthur and included in the Republican-sponsored American Health Care Act, approved by the House of Representatives last week, would permit states to seek a waiver from the prohibition on charging consumers more for coverage if they have a pre-existing health condition such as asthma, diabetes, cancer and pregnancy.   In New Jersey, there are an estimated 3.8 million non-elderly residents with pre-existing conditions, nearly half a million (476,800) are children, according to an analysis by New Jersey Policy Perspective. That means about one of every four Garden State kids (24 percent) have a pre-existing condition, NJPP noted.

While the federal Affordable Care Act mandates that health insurers, except in certain grandfathered plans, may not include an exclusion for a pre-existing condition in any insurance policy, New Jersey law was never changed to conform to the federal law.  The bill clarifies that a health insurer shall not impose, or include in their health insurance policies, any provision excluding coverage, putting certain waiting periods on coverage, or charging more for coverage due to a pre-existing condition. The bill would revise the New Jersey law concerning group health insurance, the Individual Health Coverage Program, the Small Employer Health Benefits Program, hospital confinement plans, and certain hospital service corporation plans to conform to the federal law regarding pre-existing conditions.