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Defending Overhaul, Administration Says Pre-Existing Conditions Are Common

Look at your friends and family. Look at yourself in the mirror.

Chances are good that quite a few people in your social circle have health trouble that would make it a lot more expensive or impossible to get health insurance, according to an analysis the Department of Health and Human Services released Tuesday morning.

The report, timed to come out just as the Republican-controlled House moves ahead with a bill to repeal the federal health overhaul, estimates that as many as 129 million Americans younger than 65 have some sort of pre-existing condition .

All told, 19 to 50 percent of those people have a health issue that would complicate the purchase of private health insurance. Asthma and high blood pressure could drive the costs up. More serious health problems could scotch private insurance altogether.

About 25 million people who don't yet qualify for Medicare with a pre-existing condition are uninsured, the analysis says.

The administration is using the findings to bolster the need for overhaul:

Starting in 2014, insurers can no longer carve out needed benefits, charge higher premiums, set lifetime limits on benefits, or deny coverage due to a person’s preexisting condition.

The insurance industry disputed the estimates, saying they make the problem look worse than it is. Most  non-elderly people with a health issue do get insurance through their employer plans -- as many as 82 million, according to the report. "We have long agreed that the individual insurance market needs to be reformed, but this report significantly exaggerates the number of people whose coverage is impacted by pre-existing conditions," America's Health Insurance Plans spokesman Robert Zirkelbach said in a statement e-mailed to Shots.

An unnamed Republican House aide told The Washington Post, which first reported on the administration's study, "When a new analysis is released on the eve of a vote in Congress, it's hard to view it as anything but politics and public relations."

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Scott Hensley edits stories about health, biomedical research and pharmaceuticals for NPR's Science desk. During the COVID-19 pandemic, he has led the desk's reporting on the development of vaccines against the coronavirus.