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Protections for Floridians with Pre-Existing Conditions

Protecting Access to Coverage

Insurance companies should be prohibited from:

  • Denying any eligible individual from coverage;

  • Imposing any preexisting condition exclusion to coverage; and

  • Establishing differentials in premium rates for coverage based on a preexisting condition.

Keeping Coverage Affordable

Insurance companies should be limited to pricing based on four factors, including:

  • Whether the policy coverage is an individual or family coverage

  • The geographic rating area that is established in accordance with federal law

  • Age (may not charge an adult in the oldest age band more than 3 times the rate the issuer charges an adult in the youngest age band for the same coverage)

  • Tobacco use (may not charge a tobacco user more than 1 1/15 times the rate the issuer charges a non-tobacco user for the same coverage)

"In Florida, an estimated 8,443,600 people (52% of all non-elderly adults), have a pre-existing condition."

Source: Center for American Progress

  • 1 in 2 Floridians (15 million people) suffer from a chronic condition.

  • During the 2020 Florida legislative session, lawmakers ignored a bill prohibiting insurance companies from dropping coverage for people with pre-existing conditions (SB 1724/HB 1293).

  • The threat to pre-existing condition protections is REAL! On December 18, 2019 a judge (Texas v Azar) struck down a central provision of the Affordable Care Act.

  • The key points of the ruling are:

    • The ACA’s individual mandate provision is unconstitutional.

    • The appeals court did not decide what parts of the ACA should stay or go.

    • The court ordered Judge O’Conner to reconsider what exact provisions of the ACA should remain intact.

  • Judge O’Connor is likely to strike key coverage and consumer protection provisions, including pre-existing condition protections, given his anti-ACA position.

  • Passing a protections bill in our state legislature would keep Floridians protected if the ACA is ever repealed.

What You Can Do

  • Urge Florida legislators to take action and provide real protection for Floridians with pre-existing conditions.

  • Share your health care stories!

Join the Sign-on Letter for Pre-Existing Conditions Protections in Florida

This letter will be shared with elected officials, the media, and the community to advance policies that improve oral health in Florida. 


High Deductibles Put Prevention Out of Reach

I would like to see a dentist, but right now I can’t afford another bill. They offer the dental coverage through the Marketplace, but they want too much on a monthly basis. I get lots of phone calls from dental insurance companies, but the cost is too high. I can get a cleaning in my local community for $30, which is what the dental insurance companies are asking for a monthly premium. I need a molar replaced, but that will cost me much more.


E.B., Pinellas County

Read the full story here. 

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