Under the AHCA, heavy periods could once again become a preexisting condition

In a narrow 217-213 vote, the House just passed a health reform bill that will most certainly disproportionately discriminate against women.

Before the Affordable Care Act, it was perfectly legal for insurance companies to charge women on the individual market more for their health insurance — or even deny them coverage altogether for a “preexisting condition” like pregnancy.

That’s because insurance underwriters were allowed to use people’s personal health histories to decide whether they’d approve their application for coverage or simply drive their premiums to unaffordable heights.

Several of these “conditions” happen to be things only women experience — such as menstrual problems and pregnancy — which is why critics have have long argued that being a woman in America is a preexisting condition.

The ACA changed that by making it illegal for insurers to engage in this practice. But with the newly passed American Health Care Act — the GOP’s bill to replace Obamacare — states can once again allow insurers to charge people with preexisting conditions more on the individual market (although they can’t deny people coverage outright, as they could in the pre-ACA days).

Amanda Northrop/Vox

There’s been some discussion on Twitter and elsewhere about whether a history of sexual assault could also be considered a preexisting condition. The Kaiser Family Foundation researchers who have analyzed insurance underwriting data told me that while they never saw sexual assault listed as a factor, they wouldn’t be surprised if underwriters considered that in their price assessment, and the National Women’s Law Center said they’ve seen those exclusions.

And under federal law today, insurers can’t rate based on domestic violence — but if a state were to allow insurers to charge higher premiums based on health status, women who weren’t continuously covered with health insurance might be charged more because of a history of domestic violence.

So if the AHCA passes the Senate and becomes law, women may soon be paying more for their health insurance once again — though this is not only a women’s issue, of course. The Kaiser researchers found 27 percent of adults under the age of 65 have preexisting conditions, which routinely led to people being denied coverage before the ACA. Here’s a rundown of the pre-ACA conditions that were commonly declinable or that caused insurance premiums to go up.

The American Health Care Act could once again allow insurers to charge people more with these “preexisting conditions”

• Breast cancer
• Uterine cancer
• Pregnancy or expectant parent
• A Cesarean delivery
• Being a survivor of domestic violence
• Medical treatment for sexual assault
• Mental disorders (severe, e.g., bipolar, eating disorder)
• AIDS/HIV
• Lupus
• Alcohol abuse/drug abuse with recent treatment
• Alzheimer’s/dementia
• Multiple sclerosis
• Arthritis (rheumatoid), fibromyalgia, other inflammatory joint disease
• Muscular dystrophy
• Any cancer within some period of time (e.g., 10 years, often other than basal skin cancer)
• Obesity, severe
• Cerebral palsy
• Organ transplant
• Congestive heart failure
• Paraplegia
• Coronary artery/heart disease, bypass surgery
• Paralysis
• Crohn’s disease/ ulcerative colitis
• Parkinson’s disease
• Chronic obstructive pulmonary disease (COPD)/emphysema
• Pending surgery or hospitalization
• Diabetes mellitus
• Pneumocystic pneumonia
• Epilepsy
• Hemophilia
• Sleep apnea
• Hepatitis (hep C)
• Stroke
• Kidney disease, renal failure
• Transsexualism

Other conditions insurers could use to increase the cost of insurance

• Urinary tract infections
• Menstrual irregularities
• Migraine headaches
• Acne
• Allergies
• Anxiety
• Asthma
• Basal cell skin cancer
• Depression
• Ear infections
• Fractures
• High cholesterol
• Hypertension
• Incontinence
• Joint injuries
• Kidney stones
• Overweight
• Restless leg syndrome
• Tonsillitis
• Varicose veins
• Vertigo

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