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Report: 55 million with pre-existing conditions may get health insurance coverage Posted: September 11th, 2012

By Maryalene LaPonsie

Maryalene LaPonsie has been writing professionally for more than a decade on topics including education, insurance and personal finance. She holds a Bachelor's Degree in Political Science from Western Michigan University.

More than 55 million Americans who have pre-existing conditions will be able to get health insurance coverage thanks to the Patient Protection and Affordable Care Act. That's according to a series of analyses conducted by advocacy group Families USA.

The reports, issued by the group for all 50 states and the District of Columbia, outline the number of non-elderly adults with pre-existing conditions who will have access to medical insurance in 2014.

At that time, the health reform law will prohibit insurers from denying coverage to adults because of a pre-existing condition. In addition, health insurance companies will not be allowed to issue new policies with benefit-exclusion periods or charge higher premiums because of a health condition. Currently, these protections are already extended to children younger than age 19.

Overall, Families USA estimates roughly 56.35 million Americans will benefit from these provisions. The following are some of the states with the largest number of residents who are expected to be eligible for coverage in 2014:

  • California: 6.9 million
  • Texas: 4.9 million
  • Florida: 3.8 million
  • Illinois: 2.9 million
  • Pennsylvania: 2.7 million
  • Ohio: 2.7 million

Aetna to acquire Coventry Health Care

In other health insurance news, insurer Aetna has entered into an agreement to purchase Coventry Health Care in a transaction valued at $7.3 billion.

"Integrating Coventry into Aetna will complement our strategy to expand our core insurance business," said Mark T. Bertolini, Aetna's chairman, CEO and president, in a written statement. "Coventry has distinct capabilities and a local market focus that will accelerate our efforts to bring simpler, more affordable products to consumer insurance exchanges in 2014 and beyond."

According to Aetna, the acquisition will help Aetna grow in several ways:

  • Add individual Medicare Advantage and Medicare Part D business to the company's existing group Medicare Advantage health insurance plans
  • Expand Aetna's Medicaid coverage area
  • Improve Aetna's position in the commercial health insurance market
  • Increase Aetna membership by more than 5 million people, including nearly 4 million in medical insurance and 1.5 million in Medicare Part D

According to data from the National Association of Insurance Commissioners, Aetna is the nation's fourth largest health insurance company in terms of market share. The insurer currently provides health care benefits to approximately 36.7 million individuals.

The acquisition of Coventry is expected to be completed in mid-2013.