A stethoscope sits on an examination table in an exam room at a Community Clinic Inc. health center in Takoma Park, Maryland, April 8, 2015. 
Photo by Andrew Harrer/Bloomberg/Getty

Republican bill on pre-existing conditions is not what it appears to be

Oral arguments will begin next week in a federal lawsuit called Texas v. United States, which you’re going to want to keep an eye on. The Republican lawsuit, brought by 20 states, argues that the recent repeal of the individual mandate in the Affordable Care Act means that the entire law should be deemed unconstitutional, including current protections for Americans with pre-existing conditions.

Donald Trump and his administration endorsed the litigation and announced in June that they would not defend “Obamacare” in the courts.

There are all sorts of things wrong with the endeavor, but among the implications is a potential political nightmare for the Republican Party: as the midterm elections draw closer, and polls show health care as one of the nation’s top campaign issues, GOP officials are fighting to gut the health security of millions of American families – on purpose and for reasons that don’t seem to make any sense.

And with this in mind, several Senate Republicans came up with an idea intended to give the appearance of helping Americans who may suffer if their own party’s litigation succeeds. Bloomberg Politics reported the other day:

Ten Senate Republicans have introduced legislation that would reinstate Obamacare rules that prohibit insurers from turning away people with pre-existing conditions if a new lawsuit that seeks to invalidate the health-care law succeeds. […]

The “Ensuring Coverage for Patients with Pre-Existing Conditions Act” was announced Friday by Senators Thom Tillis of North Carolina, Lamar Alexander of Tennessee, Chuck Grassley of Iowa, Dean Heller of Nevada, Bill Cassidy of Louisiana, Lisa Murkowski of Alaska, Joni Ernst of Iowa, Lindsey Graham or South Carolina, John Barrasso of Wyoming, and Roger Wicker of Mississippi.

So, for health care advocates, this is a step in the right direction, right? Wrong.

Jeff Young did a nice job explaining why the new GOP bill is a fraud.

Yes, insurance companies wouldn’t be allowed to refuse to offer coverage to someone who, for example, has a history of cancer or is pregnant. But they could sell someone a policy that doesn’t cover cancer treatments or the birth of a child.

Sure, premiums wouldn’t be allowed to vary based on health status or pre-existing conditions. But prices could dramatically vary based on age, gender, occupation and other factors, including hobbies, in ways that are functionally the same as basing them on medical histories. Insurance companies have a lot of experience figuring out that stuff.

There’s no need to speculate about how insurance companies would respond to this, because this is how the system worked for people who bought individual policies before the Affordable Care Act.

Larry Levitt, the senior vice president for health reform at the nonpartisan Kaiser Family Foundation, added in comments to Bloomberg Politics that this new GOP gambit is filled with loopholes intended to hurt those with pre-existing conditions.

“An insurer would have to give you insurance if you have a pre-existing condition, but it could exclude any services associated with your pre-existing condition,” Levitt said. “This would make protections for people with pre-existing conditions a bit of a mirage.”

It’s unclear whether there’s any meaningful appetite among Republican leaders to take up such a bill – there really aren’t many legislative days remaining between now and Election Day – which means it’s entirely possible that the proposal is for show. GOP lawmakers who want to be able to claim to support health care protections can point to this bill as some kind of proof of progressive intentions. It’s more about creating political cover than creating meaningful protections.

Anyone who believes the sponsors’ claims will be making a mistake.

Affordable Care Act, Health Care, Health Care Policy and Obamacare

Republican bill on pre-existing conditions is not what it appears to be