Health Insurance Market Reforms: Guaranteed Issue
Guaranteed issue laws require insurance companies to issue a health plan to any applicant – an individual or a group – regardless of the applicant’s health status or other factors. Currently, in most states, insurance companies can deny nongroup coverage to people based on their health status or their medical expenses over the past year. This means that an uninsured person who develops a certain condition, such as breast cancer, might not be able to buy health insurance. In such an instance, insurance companies can (and often do) refuse to issue a health insurance policy to that individual.
The ACA requires significant changes to guaranteed issue laws. Beginning January 1, 2014, all individual and group health plans must guarantee issue policies to all applicants, regardless of health status or other factors. This fact sheet examines guaranteed issue laws in the individual and small group markets across the nation and how the transition to 2014 will change those markets.
Fact Sheet (.pdf)