Skip to main content

U.S. must keep its promise on health care

By Nancy Brown, Larry Hausner and John Seffrin, Special to CNN
updated 8:06 AM EDT, Tue March 27, 2012
At a clinic last week in Miami, a doctor tends to a patient who said her pre-existing condition made it impossible to find insurance.
At a clinic last week in Miami, a doctor tends to a patient who said her pre-existing condition made it impossible to find insurance.
  • Writers: Health coverage easy to get if you're healthy, not so if you're already sick
  • They say cancer, diabetes, heart disease patients very vulnerable to insurance cutoffs
  • They say mandate is essential to providing patient protections; keeps costs down
  • Writers: Supreme Court should affirm Americans' access to affordable, adequate care

Editor's note: Nancy Brown is CEO of the American Heart Association, Larry Hausner is CEO of the American Diabetes Association, and John R. Seffrin is CEO of the American Cancer Society and American Cancer Society Cancer Action Network.

(CNN) -- Health coverage is easy to get if you're healthy. The problem is when you're sick or have a history of illness.

For decades, people with life-threatening chronic diseases such as cancer, diabetes, heart disease or stroke faced numerous barriers to getting the care they needed. Insurers could deny coverage to anyone with a pre-existing condition, terminate coverage when the cost of a patient's care exceeded arbitrary dollar limits, or raise premiums to unaffordable levels in response to a diagnosis. As a result, patients had to skip or cut short their treatment because of costs, or go deeply into debt to pay for needed care.

The patient protections enacted into law in 2010 are changing that, enabling more Americans to afford lifesaving care. These protections provide patients with the best chance to beat their illness. When fully implemented in 2014, they will require insurers to cover people with pre-existing conditions, eliminate dollar limits on the coverage a patient can receive and ban the practice of inflating premiums for people with health concerns.

The law makes these protections possible by requiring that most Americans buy health insurance. By ensuring that coverage extends both to healthy people, who are less expensive to insure, and to those who are sick, who cost more, the law helps to keep costs down for those who need care the most. Unfortunately, the "individual responsibility" requirement has been attacked as unconstitutional, posing a grave threat to the law's critical patient protections. Federal appeals courts are divided on the issue, and the U.S. Supreme Court hears arguments on the matter this week.

Opinion: Health reform could survive loss of individual mandate

Our organizations, which represent tens of millions of people across the country with life-threatening chronic diseases, together submitted a friend-of-the-court brief asserting that the individual responsibility provision is essential to preserving the protections that patients desperately need and deserve.

We already know what a health care system without such a requirement looks like: Many healthy Americans opt not to buy health coverage until they are ill, and costs skyrocket as insurance pools fill with people in urgent need of treatment and care. People with pre-existing conditions are charged exorbitant rates for health coverage, putting critical care out of reach for many American families. As a result, many people with a chronic illness must resort to emergency room care, which lowers their chances of surviving their illness and drives up costs system-wide.

Opinion: Why health care reform law is unconstitutional

Many of those who want the individual responsibility requirement struck down also express support for the patient protections that the provision makes possible. Several states have tried such an approach by enacting insurance protections for patients with pre-existing conditions without compelling healthy people to enter the insurance market as well. These states are now among the most expensive in the country in which to buy insurance, and two of them, Kentucky and New Hampshire, ended up repealing those protections because of increasingly unaffordable premiums.

Half of all non-elderly Americans are living with a pre-existing medical condition. They need the protection from discrimination by insurers that the Affordable Care Act provides. Our hope is that the Supreme Court will enable all Americans to benefit from the promise of access to guaranteed, affordable and adequate insurance. It is a promise our nation must keep.

Follow us on Twitter: @CNNOpinion

Join us at Facebook/CNNOpinion

The opinions expressed in this commentary are solely those of Nancy Brown, Larry Hausner and John Seffrin.

Part of complete coverage on
updated 8:21 AM EDT, Mon September 1, 2014
Carlos Moreno says atheists, a sizable fraction of Americans, deserve representation in Congress.
updated 12:25 PM EDT, Sun August 31, 2014
Julian Zelizer says Democrats and unions have a long history of mutual support that's on the decline. But in a time of income inequality they need each other more than ever
updated 12:23 AM EDT, Sun August 31, 2014
William McRaven
Peter Bergen says Admiral William McRaven leaves the military with a legacy of strategic thinking about special operations
updated 12:11 PM EDT, Fri August 29, 2014
Leon Aron says the U.S. and Europe can help get Russia out of Ukraine by helping Ukraine win its just war, sharing defense technologies and intelligence
updated 1:24 PM EDT, Fri August 29, 2014
Timothy Stanley the report on widespread child abuse in a British town reveals an institutional betrayal by police, social services and politicians. Negligent officials must face justice
updated 9:06 PM EDT, Fri August 29, 2014
Peter Bergen and David Sterman say a new video of an American suicide bomber shows how Turkey's militant networks are key to jihadists' movement into Syria and Iraq. Turkey must stem the flow
updated 11:54 AM EDT, Mon September 1, 2014
Whitney Barkley says many for-profit colleges deceive students, charge exorbitant tuitions and make false promises
updated 10:34 AM EDT, Fri August 29, 2014
Mark O'Mara says the time has come to decide whether we really want police empowered to shoot those they believe are 'fleeing felons'
updated 10:32 AM EDT, Thu August 28, 2014
Bill Frelick says a tool of rights workers is 'naming and shaming,' ensuring accountability for human rights crimes in conflicts. But what if wrongdoers know no shame?
updated 10:43 PM EDT, Thu August 28, 2014
Jay Parini says, no, a little girl shouldn't fire an Uzi, but none of should have easy access to guns: The Second Amendment was not written to give us such a 'right,' no matter what the NRA says
updated 1:22 PM EDT, Sat August 30, 2014
Terra Ziporyn Snider says many adolescents suffer chronic sleep deprivation, which can indeed lead to safety problems. Would starting school an hour later be so wrong?
updated 9:30 AM EDT, Fri August 29, 2014
Peggy Drexler says after all the celebrity divorces, it's tempting to ask the question. But there are still considerable benefits to getting hitched
updated 2:49 PM EDT, Fri August 29, 2014
The death of Douglas McAuthur McCain, the first American killed fighting for ISIS, highlights the pull of Syria's war for Western jihadists, writes Peter Bergen.
updated 6:42 PM EDT, Tue August 26, 2014
Former ambassador to Syria Robert Ford says the West should be helping moderates in the Syrian armed opposition end the al-Assad regime and form a government to focus on driving ISIS out
updated 9:21 AM EDT, Wed August 27, 2014
Ruben Navarrette says a great country does not deport thousands of vulnerable, unaccompanied minors who fled in fear for their lives
updated 9:19 AM EDT, Wed August 27, 2014
Robert McIntyre says Congress is the culprit for letting Burger King pay lower taxes after merging with Tim Hortons.
updated 7:35 PM EDT, Tue August 26, 2014
Wesley Clark says the U.S. can offer support to its Islamic friends in the region most threatened by ISIS, but it can't fight their war
updated 4:53 PM EDT, Tue August 26, 2014
America's painful struggle with racism has often brought great satisfaction to the country's rivals, critics, and foes. The killing of Michael Brown and its tumultuous aftermath has been a bonanza.
updated 3:19 PM EDT, Tue August 26, 2014
Rick Martin says the death of Robin Williams brought back memories of his own battle facing down depression as a young man
updated 11:58 AM EDT, Tue August 26, 2014
David Perry asks: What's the best way for police officers to handle people with psychiatric disabilities?
updated 3:50 PM EDT, Mon August 25, 2014
Julian Zelizer says it's not crazy to think Mitt Romney would be able to end up at the top of the GOP ticket in 2016
updated 4:52 PM EDT, Mon August 25, 2014
Roxanne Jones and her girlfriends would cheer from the sidelines for the boys playing Little League. But they really wanted to play. Now Mo'ne Davis shows the world that girls really can throw.
updated 5:04 PM EDT, Mon August 25, 2014
Kimberly Norwood is a black mom who lives in an affluent neighborhood not far from Ferguson, but she has the same fears for her children as people in that troubled town do
updated 5:45 PM EDT, Fri August 22, 2014
It apparently has worked for France, say Peter Bergen and Emily Schneider, but carries uncomfortable risks. When it comes to kidnappings, nations face grim options.