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Medicare 101

Preexisting Conditions Under Trumpcare

Christian Worstell

by Christian Worstell | Published April 22, 2021 | Reviewed by John Krahnert

One of the hottest topics surrounding Trumpcare – formally known as the American Health Care Act (HCA) – has been that of preexisting conditions.

The Affordable Care Act (ACA) enacted by President Obama barred insurance companies from refusing coverage or charging higher premiums for people with a preexisting condition.

But how might people with preexisting conditions be affected under Trumpcare?

Doctors consulting in hallway

Higher Premiums Are Possible

Under the American Health Care Act (Trumpcare) as originally proposed, insurance companies would still not be able to deny people coverage because of a preexisting condition. However, they may be allowed to place such people in a “high-risk pool” and could be able to charge a higher premium for a plan.

For some people, that increased cost could make the plan unaffordable.

A high-risk pool is where people with certain health conditions are grouped together and offered insurance plans in a market separate from other customers who do not have those conditions.

Prior to the protections put in place by the ACA, 35 states and the federal government had high-risk pools in place.

What Counts as a Preexisting Condition?

The U.S. Department of Health and Human Services defines a preexisting condition as “a health problem you had before the date that new health coverage starts.”

But what exactly would count as a preexisting condition under Trumpcare?

While it’s hard to say for sure, the list of conditions that counted as a preexisting condition prior to the ACA included such items as:

    • Alcohol and drug abuse
    • Arthritis
    • Cancer
    • Crohn’s disease
    • Diabetes
    • Mental disorders such as anxiety and depression
    • Obesity
    • Pregnancy
    • Sleep apnea


Christian Worstell is a health care and policy writer for He has written hundreds of articles helping people better understand their Medicare coverage options.

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