Could contracting COVID-19 become a preexisting condition?

Posted at 11:35 AM, Oct 19, 2020

WASHINGTON, D.C. – The U.S. remains in the grip of the coronavirus pandemic with more than 8 million cases, spiking in multiple states, like Montana.

“There are many, many people not taking this seriously and not playing their part in mitigating the spread of this virus,” said Trisha Gardner, Cascade City-County, Montana health officer.

Now, there are concerns that getting COVID-19 could land you in the same category as someone with diabetes or high-blood pressure – having a preexisting condition.

“This has flown under the radar to some extent,” said Dr. Eric Schneider, senior vice president of policy and research at The Commonwealth Fund, a century-old foundation that examines health policy in the U.S.

Since COVID-19 can have lingering effects on people who contract it, Dr. Schenider says there’s a possibility it could be labeled as a preexisting condition.

So, who decides that?

“The preexisting condition language really traces to the insurance industry,” Dr. Schneider said, “really on a case by case basis, which diseases, which conditions, will actually count.”

That hasn’t mattered so much lately because the Affordable Care Act – Obamacare – prohibits health insurers from denying people coverage based on preexisting conditions.

Next month, though, a case before the U.S. Supreme Court could get Obamacare thrown out.

If that happens, there is no official plan yet from either party to replace it, nor to protect people with preexisting conditions.

“If the Supreme Court undoes that solution, there will definitely be a need for a new solution,” Dr. Schneider said.

How many could be affected?

The U.S. Department of Health and Human Services says about 133 million people in the country currently have a preexisting condition. The Commonwealth Fund looked at how COVID-19 survivors would affect that number.

Researchers excluded people who already had a preexisting condition before contracting the coronavirus, as well as anyone over the age of 65. They found that 3.4 million people who recovered from the coronavirus but never had a preexisting condition before could join the ranks of now having a preexisting condition.

What’s more, based on current COVID-19 infection rates, that number is growing in the U.S. by 20,000 people a day.

“That number is also tied to how well we control the pandemic,” Dr. Schneider said.

So far, no insurance company has indicated it will add COVID-19 as a potential preexisting condition.

However, health care policy experts warn it could all come down to what the justices decide about the health care law in next month’s case before the Supreme Court.