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Our Take: Senators offer plan to (sort of) protect pre-existing conditions

Aug 27, 2018

Ten Republican senators have introduced legislation that purports to protect the Affordable Care Act (ACA)’s provisions for people with pre-existing conditions. The language offering protections would be effected by amending the Health Insurance Portability and Accountability Act.

“There are strong opinions on both sides when it comes to how we should overhaul our nation’s broken health care system, but the one thing we can all agree on is that we should protect health care for Americans with pre-existing conditions and ensure they have access to good coverage,” said Sen. Thom Tillis, R-N.C., one of the bill’s sponsors.

The other sponsors of the bill are Lamar Alexander, R-Tenn., Chuck Grassley, R-Iowa, Joni Ernst, R-Iowa, Lisa Murkowski, R-Alaska, Bill Cassidy, R-La., Roger Wicker, R-Miss., Lindsey Graham, R-S.C., Dean Heller, R-Nev., and John Barrasso, R-Wyo.

Our TakeThis is the one health care story that you probably didn’t hear much about on Thursday when the bill was introduced to the Senate floor. But you will be hearing a lot about it in the run-up to the midterm elections, so we’re here to inform you before the politicians and pundits take their sides.

The bill is a defensive move by Republicans. As previously reported, 20 GOP-led states filed a lawsuit arguing that the ACA is unconstitutional after Congress repealed the individual mandate penalty last year. Following the repeal, the Justice Department said most of the law should stand, except for protections for those with pre-existing conditions.

Some Democrats have been using the lawsuit to rail against Republicans in their election campaigns—accusing the GOP of failing to protect vulnerable patients.

The bill says that insurers can’t deny coverage or increase premiums because of “health status, medical condition (including both physical and mental illnesses), claims experience, receipt of health care, medical history, genetic information, evidence of insurability (including conditions arising out of acts of domestic violence), disability, [or] any other health status-related factor determined appropriate by the Secretary [of Health and Human Services (HHS)].”

Here’s all you need to know. While the bill does prevent insurers from increasing premiums because of pre-existing conditions, it also allows insurers to exclude coverage of pre-existing conditions.

In other words, insurance companies won’t be allowed to refuse coverage to people who have a history of cancer or those who are pregnant. But they could offer policies that don’t cover cancer treatment or maternity care.

So, under this plan, we would be going back to a time when insurance companies could offer just about anything, and price accordingly, based on age, sex, occupation or just about anything else they think of.

We are just as tired of writing about Obamacare squabbles on the Hill as you probably are reading about them. But getting the facts right on this one is important.

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