More than six million people with pre-existing conditions could face higher premiums under the American Health Care Act (AHCA) that passed through the U.S. House last month.

This number comes from a brief published by the Kaiser Family Foundation (KFF) Wednesday.

The reason these people may face higher insurance costs is due to a provision added in the AHCA which changes the community rating waivers for people who have a gap in insurance coverage for more than 63 consecutive days.

The community rating waivers were a part of the Affordable Care Act that prevented insurers for charging those with pre-existing conditions more on their premiums.

This new provision under the AHCA only allows insurers to charge higher premiums for those with the 63 day gap in coverage, which the Kaiser Family Foundation analysis estimates was 27 million people in 2015, six million of those having pre-existing conditions.

The KFF analysis explains how gaps in insurance declined under the ACA because of expanded Medicaid eligibility and the tax credits many used for premiums. Before this part of the ACA went into effect, 38 million people had long gaps in insurance, almost nine million of those with pre-existing conditions.

States that choose to take this route and get rid of the community waiver would be required to set up a system for subsidizing high-risk patients, like high-risk pools or reinsurance arrangements that directly pays insurers. The KFF brief says states are “not required to set up an alternative source of coverage for people who face higher premiums based on their health.”

The AHCA set aside $100 billion for states for these purposes. The Senate is currently drafting its version of a health care replacement bill, so the future of this provision is still unknown.

Instant Insights /

6M people with pre-existing conditions face higher premiums under AHCA

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