Would Health Insurers Embrace Underwriting Again?

Since at least the 2017 saga when Republicans tried to repeal and replace the Affordable Care Act (ACA), one of the law’s most visible — and politically charged — components has become its protections for people with preexisting conditions. Now, with the makeup of the Supreme Court slated to shift, some experts believe those same provisions are the most at risk from being struck down alongside the law’s now-defunct individual mandate (see story, p. 1).

But that begs the question: Would health insurers actually want to go back to a pre-ACA world?

“No, they so do not want that to happen,” says Chris Sloan, an associate principal at Avalere Health. Before the ACA was enacted, “it wasn’t that they [insurers] liked medically underwriting — they didn’t like the bad press, they didn’t like that sort of perception of their industry — it’s just that anybody who didn’t would get all the bad risk and their health plan would collapse,” Sloan explains.

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