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Preexisting conditions: How ACA coverage would change under the House GOP plan

In an impassioned monologue, late-night TV show host Jimmy Kimmel talked Monday about how Congress might change insurance rules for individuals with preexisting medical conditions, like his newborn son. The boy was born 10 days ago with a heart defect.

Here’s the difference between provisions of the Affordable Care Act and what House Republicans propose to do:

The Affordable Care Act

The 2010 health-care law prohibits insurers from denying coverage to individuals based on a preexisting medical condition, such as cancer, asthma or depression. And the ACA requires insurers to offer “community rating,” meaning they cannot charge those with costly medical conditions more than other consumers in the general insurance pool.

House GOP plan

Under an amendment crafted by Rep. Tom MacArthur (R-N.J.), states would be able to obtain a waiver from the Health and Human Services Department that would allow them to charge customers with preexisting conditions more than other people. If HHS did not respond to a state’s waiver request within 60 days, the requested change would automatically go into effect.

Health experts predict that the result would be a sharp rise in premium increases for those with costly medical problems. Before the ACA became law, individuals with chronic diseases paid several times as much as others — if they could afford a policy in the first place.

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