Is Endometriosis A Pre-Existing Condition?

There's been a lot of talk about what is and isn’t considered a pre-existing condition under President Donald Trump’s health care plan to repeal and replace the Affordable Care Act. While the legislation isn’t entirely clear in its current state, some health conditions will undoubtedly affect many people’s health care coverage — especially women. Under the American Health Care Act — also referred to as Trumpcare — things like pregnancy, having had a c-section, menstrual irregularities, and hysterectomies could all potentially increase a woman’s insurance premiums. But what about specific chronic health conditions that only affect women? Is endometriosis a pre-existing condition under the AHCA?

Endometriosis is a painful disorder in which tissue that normally lines the inside your uterus grows outside of it and affects about one in 10 girls and women in the United States, according to the Mayo Clinic. Most women diagnosed with endometriosis will experience severe pelvic pain that usually coincides with a woman’s period. According to the Endometriosis Foundation of America, women may suffer from “killer cramps” that interfere with their daily lives, long periods, heavy menstrual flow, and bowel or urinary disorders.

So, in short, endometriosis will likely be a pre-existing condition under the ACHA, even if it's not written specifically as such. Why? Because of the clause that includes the vague term “menstrual irregularities” in the bill, which can include anything from heavy and/or long periods, painful cramping, and spotting between periods — all of which can happen to a woman who has endometriosis.

Also, since many women with endometriosis experience pain during sex, this health condition could also fall under the "sexual deviation or disorder" pre-existing condition category, which is also a frustratingly vague term listed in the AHCA.

What does this mean for the thousands of women who require ongoing treatment or medication to cope with endometriosis? Again, many aspects of Trumpcare are still up in the air as the Senate has yet to pass their version of the bill. But, for someone with health insurance provided by their employer, this pre-existing clause most likely won't affect them. However, as The Wall Street Journal reported, having a pre-existing condition, like endometriosis, could force someone to pay high out-of-pocket costs if her symptoms get really severe.

For those who don't have health insurance through their jobs and obtain individual coverage, if this Obama-era protection is removed from current legislation, then the AHCA could affect as many as 130 million Americans who have a pre-existing health condition, according to the Center for American Progress, a nonprofit for public policy research.

Fortunately, the latest version of the AHCA is far from official and it will undergo many revisions and edits before it gets the green light. Like most other health conditions, dealing with endometriosis every day is painful enough as it is. We don't need to add the burden of higher premiums and expensive health care plans just because someone has a disease or disorder that was completely out of their control.