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As Congress considers changes to the Affordable Care Act (ACA), a key issue will be ensuring that people with preexisting health conditions have access to affordable health insurance

coverage. The ACA bans insurance companies from denying coverage, charging higher premiums, and imposing coverage limits or exclusions to people with preexisting health conditions. The

protections are especially important for older adults because they are more likely than younger adults to have health problems. This _Insight on the Issues_ examines the impact that

eliminating or weakening the ACA’s protections for people with preexisting conditions would have on older adults ages 50-64.  Building on a recent report by Kaiser Family Foundation, this

analysis finds that 40 percent of older adults ages 50-64 – or about 25 million people in this age group – could be denied health coverage because of a preexisting condition if they sought

to buy an individual plan.  The analysis also found wide state-by-state variation in the prevalence of preexisting conditions among older adults. At the high end, in some states, at least

half of those between ages 50 and 64 have a declinable preexisting condition.