43% of U.S. Households Report Preexisting Conditions

WASHINGTON, D.C. -- About one in four Americans (24%) report that they personally (15%) or they and a member of their household (9%) "have a long-term medical condition, illness or disease that would be considered a 'preexisting' condition by a health insurance company." Factoring in the additional 19% who say another family member has such an illness or disease, the total percentage of U.S. households in which at least one member reports having a preexisting condition is 43%.

	Nov 1-11, 2018	Nov 1-14, 2019
	%	%
Respondent	16	15
Respondent and a family member	11	9
Family member	17	19
No one in family	54	57
Gallup

These data are from Gallup's annual Health and Healthcare survey, conducted Nov. 1-14, and are based on respondents' self-reports. The survey does not probe about the nature of a respondent's preexisting condition. Definitions of such conditions vary because individual insurance companies primarily determine what qualifies as a preexisting condition and what does not. They can include cancer or heart disease, but also asthma, high blood pressure or obesity.

Protecting individuals with preexisting conditions from being denied coverage by their insurers was a key tenet in Democrats' campaign for and passage of the Affordable Care Act in 2010. It became a powerful election-year issue in the 2018 midterms for Democrats after President Donald Trump and Republicans in Congress tried to repeal the law. Gallup has found that Americans who report having a preexisting condition are somewhat more approving of the ACA than are those who do not report having such a condition.

Age Is the Biggest Differentiator in Reported Preexisting Conditions

Across key demographic groups, age stands out as the biggest factor in self-reports of preexisting conditions; the older individual Americans are, the more likely they are to report having one. About one in three adults aged 65 and older (33%) and 50 to 64 (31%) report having a preexisting condition -- a rate about twice as high as what young adults aged 18 to 29 report (16%).

Aggregated data from Gallup's 2018 and 2019 measures reveal other key differences across subgroups:

• About a third of U.S. adults who are overweight report having a preexisting condition (32%) -- much higher than the 21% among those whose self-reported weight is normal or underweight.

• U.S. whites (29%) are more likely to report having such an illness or disease than are nonwhites (20%).

• Women (29%) report having a preexisting condition at a higher rate than do men (21%).

• U.S. adults living in low- (26%) and middle-income households (29%) are more likely to report having a preexisting condition than are those in upper-income households (21%).

	Respondent personally	Respondent or family member
	%	%
65+ years old	33	50
Overweight	32	50
50-64 years old	31	49
Democrat	31	50
Women	29	49
White	29	46
Middle household income ($40,000-$99,999/year)	29	45
Lower household income (less than $40,000/year)	26	43
Independent	24	42
30-49 years old	23	40
Republican	22	40
Men	21	38
Upper household income ($100,000 or more/year)	21	45
Normal weight/Underweight	21	39
Nonwhite	20	38
18-29 years old	16	38
Data aggregated from 2018 and 2019 polls
Gallup

Across political party groups, Democrats (31%) are more likely to report having a preexisting condition than are independents (24%) and Republicans (22%). A Gallup analysis finds that across age and weight groups, Democrats are more likely than Republicans to report having a preexisting condition. This might suggest that some respondents are answering the question through a political lens -- with Democrats more sensitive to the issue of preexisting conditions and therefore more likely to report having one, and Republicans more inclined to downplay the issue and less likely to report having such a condition themselves.

Bottom Line

As many Americans shop for healthcare plans in the current ACA open enrollment period, a sizable percentage of them will need to navigate a market that includes plans that may not provide them with coverage for preexisting conditions. The Trump administration is encouraging consumers currently on the ACA individual market to seek out short-term private plans that in many cases do not protect those with preexisting conditions. These new, non-ACA plans are now available during the ACA's seventh annual open enrollment period after the administration loosened restrictions on them last year in an effort to offer more affordable alternatives to ACA plans.

The ACA's provision on preexisting conditions has survived many challenges. Public officials of both major political parties have expressed commitment to the issue and have offered various plans to protect Americans with preexisting conditions from being denied coverage. But Americans have been lukewarm about the law that made the largest breakthrough on the issue -- though it is a bit more popular among those who report having a preexisting condition themselves.

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