Over the weekend, President Trump was interviewed by John Dickerson on Face the Nation (or as he so cleverly refers to it: “deface the nation”). Before abruptly kicking Dickerson out of the Oval Office to avoid being questioned about the validity of his wiretapping claims, the president said that the new GOP healthcare bill “guarantees” coverage for those with pre-existing conditions.
There is language in the new MacAuthur Amendment to the bill that describes protections:
“Nothing in this Act shall be construed as permitting health insurance issuers to limit access to health coverage for individuals with preexisting conditions.”
Notice how the language dances around the issue; it tries to convince the reader that the rest of the bill doesn’t exist by presenting an unsupported, overarching narrative. Potentially limiting access to health insurance for those with pre-existing conditions, and many others is exactly what the bill will do. The most significant change to the original draft of the American Health Care Act (the aforementioned MacArthur Amendment) involves three sets of waivers that will be made available to states. To be granted a waiver a state would have to meet only one of the following requirements:
“(i) Reducing average premiums for health insurance coverage in the State.
(ii) Increasing enrollment in health insurance coverage in the State.
(iii) Stabilizing the market for health insurance coverage in the State.
(iv) Stabilizing premiums for individuals with pre-existing conditions.
(v) Increasing the choice of health plans in the State.”
Now, according to Trump, Ryan and co., every health insurance market is the country is currently unstable. So it stands to reason that it wouldn’t be too difficult to propose a plan that staunch Obamacare opponent, and current Health and Human Services Secretary Tom Price would approve on this basis.
If a waiver is approved, states would be allowed to generate their own protections and coverage by creating their own sets of essential health benefits and their own community ratings. This would dismantle the federal essential health benefits and pre-existing condition protections in those areas—there is no other way to spin this.
While the MacArthur Amendment does not explicitly remove pre-existing condition protections or essential health benefits coverage, it provides a way out of both of them, which is essentially the same thing.
Many GOP lawmakers claim that individuals with pre-existing conditions will be able to receive affordable coverage through high-risk pools that will be set up in states that receive waivers. However, the data does not support this conclusion; in many instances premiums have gone through the roof for individuals in high-risk pools. In prior scenarios, before the implementation of the Affordable Care Act, high-risk pools occasionally helped mitigate costs slightly for certain individuals, but the results are nothing like the protections that are currently offered under the Affordable Care Act. High risk pools are incredibly expensive and inefficient—they are not in any way equivalent to concrete protections.
Additionally, under the proposed bill, reentering the insurance market will come with an additional 30% surcharge penalty to help offset the removal of the individual mandate. The proposed, new system is way more of a crap shoot; it puts power back into the hands of insurance companies, which is never a good thing.
The Center for American Progress analyzed the new bill and found that premiums would rise exponentially for those with pre-existing conditions living in states that received a waiver:
A $142,650 premium surcharge for someone with metastatic cancer; $5,600 for diabetes, $5,510 for autistic disorder, $18,720 for congestive heart failure, $4,320 for Asthma, $17,320 for pregnancy with minor complications. Increases like these would make health insurance completely unaffordable for millions of Americans with pre-existing conditions.
A Politico/Morning Consult poll released this morning found that only 38% of voters support states being allowed to opt out of pre-existing condition protections. The GOP knows these protections are popular, but they also know that there is zero possibility of the ultra-conservative Freedom Caucus voting for a bill that keeps the protections intact—and the bill will not get through the house without the Freedom Caucus.
So, Tom MacArthur (R-NJ) artfully constructed an amendment that says one thing and does the other.
As per the president’s comments, either he has not read the bill, or he’s lying.
This bill in no way, shape, form, format or fantasy “guarantees” protections for individuals with pre-existing conditions.
It does the opposite.
UPDATE: The recently announced addition of $8 billion in funds to help reduce the burden on those with pre-existing conditions is not nearly enough to limit the surcharges for reentering the market. And it’s not anywhere near enough to ensure high-risk pools don’t price out individuals with pre-existing conditions. In other words, it doesn’t change anything, it’s just optics.
Previously published on The Overgrown.