Health Coverage Before the ACA, And Why All Americans Are Better Off Now

Far too often before the Affordable Care Act came into effect, health insurance did not provide peace of mind – it provided anxiety, panic, and dread. Up to 129 million Americans – that’s nearly one in two people – could be discriminated against because of a pre-existing condition like heart disease, diabetes, or cancer, or for that matter pregnancy or even something as ridiculous as acne.

And for the rest of Americans, they knew that coming down with any illness could mark them with that scarlet letter, where they could be unable to get affordable coverage, be trapped in a job, or even be dropped from their coverage because they got sick and have nowhere to turn. As the Vice President said in a speech to this morning, every family was one job loss or one illness away from seeing the worst of the insurance system – “There but for the grace of God.” Just consider some of these headlines – from before the health care law’s provisions took effect:

Those headlines weren’t flukes, they were emblematic of broad, systemic problems. That’s why we put together this presentation as a reminder of what we’ve left behind now that the Affordable Care Act has come into full effect. You can also find a lot of that same information in this shareable infographic.

This was the individual insurance market before the ACA. This insecurity was a profound hindrance to the American ideal that every American can make it if they work hard. For a family that didn't have coverage, or adequate coverage, or guaranteed coverage, it was a constant worry in the back of their minds, if not an immediate source of financial strain or outright disaster. Even those who felt their health insurance was fine for years often suddenly found out it was an illusion when serious illness came to their families.

Now that is changing. No longer will health insurance be a source of perpetual doubt, no longer will those with pre-existing issues be uninsurable. If you lose coverage or lose a job that had coverage, there will be a way to access care. There is a new way for families to have peace of mind about finding care.

And again, this is not just for the previously uninsured, or even the half of Americans with pre-existing conditions – it is for every American that was one illness or one job-loss away from health coverage purgatory. Which is every American – it is you, it is me, it is our families, colleagues, friends and neighbors.

While progress is being made day by day, more and more Americans are enrolling and transitioning into new plans, it is important to remember we are moving away from a very broken system and what life was for millions of Americans before the ACA. As the Vice President said in closing his speech today, “We will not go back to the day when patients lying in a hospital bed, fighting for their lives are told that, sorry, your coverage is over. We cannot cover you anymore. We will not go back. America will not go back.

David Simas is Assistant to the President and Deputy Senior Advisor for Communications and Strategy
Related Topics: Health Care
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