SAN FRANCISCO -- People ages 50 to 64 are most likely to benefit from the new federal health law because they have the highest rates of long-term unemployment among working-age adults and are more likely to have health problems that would make it tough for them to buy individual coverage, according to a report being released Tuesday.
The study, by the Commonwealth Fund, estimated that 18.3 million people in that age group stand to benefit from provisions in the federal health law, including the expanded access to coverage, elimination of lifetime and annual spending caps on policies and, eventually, the end of insurers denying people coverage based on their medical histories.
"For most older adults who are uninsured or underinsured, the early provisions, many of which went into effect this year, will provide transitional relief," said Sara Collins, Commonwealth Fund vice president and the report's lead author.
The study by the liberal-leaning nonprofit think tank found that unemployed workers between the ages of 55 and 64 years old had been jobless for an average of almost 45 weeks, the longest of any working age group. When people lose their jobs, they typically lose health coverage. "A loss of employment benefits can be devastating to people in this age group," Collins said.
California is one of 16 states where the uninsured rate for people in the 50- to 64-year-old age group is higher than the national average of about 15 percent.
The study contends this age group has possibly the most to gain from some of the provisions in the new federal health law, which will probably end up before the U.S. Supreme Court. A federal judge in Virginia on Monday declared that the government cannot require Americans to buy health insurance.
The mandate to have health coverage is an essential component of the law, which in 2014 will prohibit insurers from denying adults coverage due to pre-existing health conditions. Requiring everyone to buy coverage -- young and healthy as well as older and sicker -- helped cut opposition by insurance companies.
Older adults are more likely to have pre-existing conditions that would cause them to be denied coverage, especially in the individual market where insurers can charge higher rates or deny coverage based on an applicant's medical history.
Nearly two-thirds of those ages 50 to 64, or about 35 million people, have a chronic health condition such as heart disease, high blood pressure or diabetes, the Commonwealth Fund reported.
"When you're 50 years old, chances are you have a pre-existing health condition," said California AARP spokesman Mark Beach. "Just being 50 years old may actually be a pre-existing condition for insurance companies."
While most key provisions of the federal law go into effect in 2014, a few went into place this year. The law banned lifetime limits on insurance benefits and started phasing in a ban on annual limits. Policies that are required to comply with the new rules must provide preventive services such as mammograms and colorectal screenings without co-payments.
People with chronic diseases and other pre-existing conditions who are unable to find coverage can apply to a state high-risk pool, which is costly, as well as a new federally funded program, which is more affordable but limited to people who've been uninsured for at least six months.
The federal law also created a program that helps keep early retiree premium costs down.
The California Public Employees Retirement System, the largest public purchaser of health benefits outside the federal government, reported last week that the new program has reduced insurance premiums for more than 115,000 early retirees and their families by more than 3 percent, a savings of about $200 million.
"The new federal health law is a big deal for this pre-retirement population," said Anthony Wright, executive director of California Health Access, a statewide advocacy group. "The big instances of people becoming uninsured are at the beginning of their careers in their 20s and right before their retirement in their 50 and 60s."
The Commonwealth Fund reported that 8.6 million people ages 50 to 64 were uninsured in 2009, a 1.1 million increase from 2008. Of the uninsured, as many as 6.8 million older adults may be eligible under the federal health law for subsidized insurance through Medicaid or the private insurance exchanges scheduled to be available in 2014.
(Contact Victoria Colliver at vcolliver(at)sfchronicle.com.)
(Distributed by Scripps Howard News Service, www.scrippsnews.com.)