These 15 States Rank Highest Among America's 12.5 Million Patients at Risk if Pre-Existing Condition Laws Change

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An estimated 54 million Americans ages 19 to 64 have a pre-existing condition that qualifies as a “potentially declinable” illness or disorder, according to a report by the nonprofit Kaiser Family Foundation (KFF). With recent changes to the tax code, increased premium costs, cases of health insurance fraud and legal challenges to the Affordable Care Act (ACA), the US health care industry could return to a system where would-be policyholders pay higher rates for pre-existing conditions. Some people could be denied coverage completely. MoneyGeek crunched the numbers on the KFF report and concluded that 12.5 million Americans with potentially declinable health conditions could be impacted by a policy change. These people with pre-existing conditions are either uninsured or obtain coverage through the ACA Marketplace.

These are the states with the most people at risk of losing coverage if regulations around pre-existing conditions are changed.


  • 15. South Dakota
    South Dakota

    • 36,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 7.20%Percentage of total state population with pre-existing conditions
    • 123,000Residents with declinable pre-existing conditions

  • 14. Nebraska
    Nebraska

    • 75,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 6.80%Percentage of total state population with pre-existing conditions
    • 295,000Residents with declinable pre-existing conditions

  • 13. Idaho
    Idaho

    • 83,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 8.40%Percentage of total state population with pre-existing conditions
    • 259,000Residents with declinable pre-existing conditions

  • 12. Arkansas
    Arkansas

    • 138,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 8.00%Percentage of total state population with pre-existing conditions
    • 597,000Residents with declinable pre-existing conditions

  • 11. Mississippi
    Mississippi

    • 162,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 9.50%Percentage of total state population with pre-existing conditions
    • 593,000Residents with declinable pre-existing conditions

  • 10. Louisiana
    Louisiana

    • 201,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 7.40%Percentage of total state population with pre-existing conditions
    • 932,000Residents with declinable pre-existing conditions

  • 9. Oklahoma
    Oklahoma

    • 214,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 9.50%Percentage of total state population with pre-existing conditions
    • 718,000Residents with declinable pre-existing conditions

  • 8. South Carolina
    South Carolina

    • 240,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 8.20%Percentage of total state population with pre-existing conditions
    • 914,000Residents with declinable pre-existing conditions

  • 7. Alabama
    Alabama

    • 249,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 8.80%Percentage of total state population with pre-existing conditions
    • 957,000Residents with declinable pre-existing conditions

  • 6. Missouri
    Missouri

    • 261,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 7.30%Percentage of total state population with pre-existing conditions
    • 1,079,000Residents with declinable pre-existing conditions

  • 5. Tennessee
    Tennessee

    • 326,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 8.20%Percentage of total state population with pre-existing conditions
    • 1,302,000Residents with declinable pre-existing conditions

  • 4. North Carolina
    North Carolina

    • 478,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 7.90%Percentage of total state population with pre-existing conditions
    • 1,762,000Residents with declinable pre-existing conditions

  • 3. Georgia
    Georgia

    • 508,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 8.10%Percentage of total state population with pre-existing conditions
    • 1,805,000Residents with declinable pre-existing conditions

  • 2. Florida
    Florida

    • 1,209,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 9.90%Percentage of total state population with pre-existing conditions
    • 3,526,000Residents with declinable pre-existing conditions

  • 1. Texas
    Texas

    • 1,566,000At-risk residents (pre-existing conditions directly insured or uninsured)
    • 9.30%Percentage of total state population with pre-existing conditions
    • 4,794,000Residents with declinable pre-existing conditions

About the Author


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Jeff Ostrowski is a writer for MoneyGeek. A veteran business journalist, he also writes about money for the Palm Beach Post in Florida. Ostrowski is proud to say he knows how to use a financial calculator to amortize a mortgage.


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