President Donald Trump and Republicans on Capitol Hill are trying to assure Americans their latest effort to repeal and replace the Affordable Care Act (ACA) covers people with pre-existing conditions.
Both the president and Senator Lindsey Graham (R-S.C.), who with Senator Bill Cassidy (R-Louisiana) is co-sponsoring the health care bill known as the “Graham-Cassidy plan,” took to Twitter to defend the legislation, expected to be up for a vote on the Senate floor next week. “I would not sign Graham-Cassidy if it did not include coverage of pre-existing conditions. It does! A great bill,” Trump wrote Wednesday night. “Repeal & Replace.”
Graham quoted the president’s tweet later Wednesday, adding that any claims his bill doesn’t cover those with pre-existing conditions should be called “#FakeNews on steroids!”
Unlike former President Barack Obama’s landmark health care law, however, the new Republican bill would not guarantee coverage for people living with pre-existing conditions. Instead, the Graham-Cassidy plan would disproportionately harm sick people and Americans living with a variety of medical factors, who could see their insurance costs soar if the legislation were to pass.
The bill would allow states to opt to waive Obamacare rules requiring basic health benefits, essentially cutting protections for sick people in an effort to keep premiums from rising. The waivers allow states to charge more for health insurance offered to people with pre-existing conditions—including cancer, heart disease, Alzheimer’s (or dementia), cerebral palsy and even pregnancy, among other medical factors that could have resulted in denied coverage prior to Obamacare—while continuing to receive federal block grant funding.
Experts say the bill could raise health care costs for those with pre-existing conditions to a point where insurance would be virtually unaffordable for millions of people.
The Graham-Cassidy plan would allow states to more easily gut protections for sick people than the previous Senate bill, the Better Care Reconciliation Act, as well as the House’s failed effort, the American Health Care Act. The earlier Senate bill would have let states request a reduction from the federal government in what was considered “essential health benefits,” while the House bill would have allowed states to charge more for people living with certain pre-existing conditions when searching for insurance.
The new bill—seen by House Majority Leader Paul Ryan as “our best, last chance” to repeal Obamacare—has received criticism from the even health care industry, which said it would damage existing benefits and do little to reduce insurance premiums that continue to tick upward for millions of Americans.
“The Graham-Cassidy plan would take health insurance coverage away from millions of people, eliminate critical public health funding, devastate the Medicaid program, increase out-of-pocket costs and weaken or eliminate protections for people living with pre-existing conditions,” Georges Benjamin, executive director of the American Public Health Association, said in a statement.
Meanwhile, Democrats are warning that if a sudden vote on the legislation is held before the nonpartisan Congressional Budget Office (CBO) can issue a full report on it, there could be serious implications for years to come.
“Thus far, every version of Republicans’ effort to repeal and replace the ACA has meant higher health costs, millions of hard-working Americans pushed off coverage, and key protections gutted with devastating consequences for those with pre-existing conditions,” House Minority Leader Nancy Pelosi wrote in a letter Monday to CBO Director Keith Hall. “A comprehensive CBO analysis is essential before Republicans force a hasty, dangerous vote on what is an extreme and destructive repeal bill.”
So, while those with pre-existing conditions wouldn’t have their insurance suddenly ripped away, the Graham-Cassidy plan could make it increasingly difficult for sick Americans to afford any insurance at all. Until the CBO is able to fully assess the latest Republican-led attempt to overhaul the nation’s health care system, the bill’s total impact will remain unknown.
The key section lies in the bill’s rules for state waivers from many regulations in the Affordable Care Act (starting at page 8 in the bill.) If a state says it “intends to maintain access to adequate and affordable health insurance coverage for individuals with pre-existing conditions,” then it can allow insurance companies to charge sick people more than healthy ones.