In praising the Affordable Care Act, President Joe Biden misleadingly warned of the consequences if Republicans ever repealed the law, saying that would mean “100 million Americans with preexisting conditions can once again be denied health care coverage by their insurance companies.” But those Americans could only be denied coverage on the individual market.

Employer-based plans, the largest source of insurance in the U.S., couldn’t deny an insurance plan to employees before the ACA. They could decline coverage for some preexisting conditions for a limited period, if a new employee had a lapse in coverage. 

As a candidate, Biden made a similar claim during the 2020 campaign. As we explained then, the 100 million figure is an estimate for the number of Americans with preexisting conditions, such as cardiovascular diseases, obesity or diabetes, not including those with Medicare or Medicaid coverage. (The Kaiser Family Foundation put the figure at 53.8 million people who could be denied if seeking coverage on the individual market, as we also wrote before.)