Pre-existing conditions complicate health care replacement

CHICAGO (AP) — As Republicans try to unite around a replacement for the Affordable Care Act, one of the most popular parts of the law will be among the most difficult to replace: the guarantee of health coverage for people with pre-existing conditions.

The challenge of providing insurance for Americans who have no other alternative has some congressional Republicans considering whether to ask the states to reboot high-risk pools, an option with a rocky history.

The health care law requires insurance companies to cover people with serious medical problems at the same premium prices as everyone else.

People would have to maintain continuous coverage before earning the protection — for 18 months in the plan offered by former Rep. Tom Price, Trump's health secretary.

Sick people with problems ranging from arthritis to congestive heart failure were placed in a separate insurance pool, with government and insurance companies helping to cover costs.

[...] the health care overhaul, most states allowed insurers to quiz applicants for regular individual policies with lengthy questionnaires, including details about the health of each family member.

Insurers automatically denied individual coverage for people with cancer, cerebral palsy, congestive heart failure and many other conditions.

"High-risk pools have been government's attempt to get at the issue of access to health insurance," said Al Redmer Jr., Maryland's insurance commissioner and a leader in the National Association of Insurance Commissioners.

Under the law, the government set up a temporary program called the Pre-Existing Condition Insurance Plan, to serve as a bridge until the phase-in of the requirement that insurers accept people with health problems.