Ending Discrimination Against Pre-Existing Conditions

By Paul Gagliardi


The U.S. House and Senate have taken major steps in passing health insurance reform.  In my opinion, the reforms cannot come soon enough.  Stopping health insurers from discriminating against people with pre-existing conditions is something I know a little bit about.


I was diagnosed with acute myeloid leukemia last April.  The prognosis was not good.  But an aggressive form of treatment was recommended. 


When I arrived at the hospital to begin treatment the insurance coordinator met my daughter and myself in the waiting area to let me know that my insurance company had denied my coverage because of a “preexisting condition.”


I was devastated, as most of us would be at this vulnerable time.  When I caught my breath, I realized this was just an attempt to get me on Medicare or Medicaid by their denial of coverage.  The social worker explained that this is not an isolated happening.


I decided I was not going to sit still with this decision.  I got the claim manager’s number and dialed it from the waiting room.  I explained that I knew he had my records which showed that I was disease free the month before the diagnosis.  There was nothing in the record showing anything pre-existing.  Plus, I had been a subscriber with this health insurance company for over ten years.  I said if this were not resolved in three minutes, I would seek his and his associate’s job.  I got a call back in three minutes and I had coverage. 


This was a defining moment for me.  I wasn’t angry for myself, but for those that had this experience before and after me and weren’t able to defend themselves. I realized that I was lucky because I am a trial lawyer.  I was able to fight back.


Unfortunately my experience is repeated daily across this country. 


For unexplainable reasons, I have done better than expected with my treatment.  This is a hope for other Americans similarly diagnosed.  But this may not have happened if treatment had been delayed because my insurance company had denied coverage. That is why it is so important that all Americans have access to affordable healthcare that cannot be denied because one becomes sick. 


Because of my experience, I have vowed to work for healthcare issues as well as other insurance coverage related matters. 


I am a living example of why healthcare reform is needed in this country.  Let’s hope Congress can finish the job and pass the legislation so desperately needed by millions of Americans.


Paul Gagliardi is the President of the Wisconsin Association for Justice, the state’s largest statewide voluntary bar organization. WAJ is committed to a fair and effective justice system that ensures justice for all, not just the privileged few.

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