The Republicans’ revision of their repeal-and-replace plan for Obamacare is facing its next hurdle — its new waiver program may go against promises to protect those with pre-existing conditions.
The revised bill contains an amendment by Rep. Tom MacArthur (R-N.J.) that would enable states to apply for waivers from an ObamaCare Title I protection called community rating, which prevented insurers from charging higher premiums to people with pre-existing conditions.
Although the waivers were demanded by members of the Freedom Caucus to secure their “yes” votes on the revised legislation, some moderate Republicans, such as Rep. Patrick McHenry (R-N.C.), say the waivers are a “bridge too far.”
McHenry and many of his colleagues oppose the bill because they worry that the possibility of some states returning to insurers charging sick people higher rates will test Republicans’ vows to their constituents.
McHenry stated, “If you look at the key provisions of Title I, it affects a cross-section of our conference based off of their experience and the stories they know from their constituents and their understanding of policy.”
On the House Republicans’ website, it pledges that people should “never” be charged more for pre-existing conditions. When asked about this pledge, Rep. Leonard Lance (R-N.J.), who also opposes the bill, said, “I do not think that the current configuration of the law is consistent with that and that’s why I’m voting as I’m voting.”
Representative Dan Donovan (R-N.Y.), a moderate and another “no” vote, said, “It would cost people more than it’s costing them now, people who are already sick, and that’s not going to help those people.”
Those who support the new legislation point out that people would be protected from higher-premiums if they maintain “continuous coverage.” In addition, states can only receive waivers out of the community rating if they set up a high-risk pool to help provide coverage for ill people. The revised bill allocates $130 billion dollars for programs like this pool.
“The MacArthur Amendment preserves important protections for individuals with pre-existing conditions while also giving states flexibility to design insurance programs that work for their unique populations. The $130 billion dollars in funding for states to build risk-sharing programs will ensure that both our promises of protecting patients and lowering premiums are kept,” said an Energy and Commerce aide.
Still, many like Larry Levitt, a health policy expert at the Kaiser Family Foundation, say although the $130 billion for programs like high-risk pools would help, “none would provide guaranteed access to people with pre-existing conditions.”
Levitt added that the revived Republican bill “effectively eliminates guaranteed access to insurance for people with pre-existing conditions.”
Institutions like the American Medical Association also have expressed concern, stating that allowing the waivers would make pre-existing condition protections “illusory.”
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