Under the ACA, insurance companies must sell polices to people with chronic diseases and charge the same premiums paid by healthy people. But patients with pre-existing conditions in fact are being denied coverage when their insurance plans don’t cover medically-recommended treatments or when they place significant obstacles in the way. Many plans impose “utilization management” rules restricting access to drugs. Dr. Blinderman suggests a “preauthorized trial period” for all medications. Following this trial period, physicians could be asked to justify continuation of the therapy. Doing this would relieve patient suffering due to delays or disruptions in the amelioration of symptoms, reducing health-care costs in the process.

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