Despite GOP Claims, Trumpcare II Does Not Protect Pre-Existing Conditions


As early as today, the House Republican leadership will force its members to vote on an updated version of Trumpcare. In an usual move, leadership has deliberately scheduled the vote before the Congressional Budget Office has completed scoring the new bill.

In March, the CBO scoring of Trumpcare I, also known as the American Health Care Act, found that 24 million people would likely lose insurance coverage were the bill to pass. This was one of the prime factors that made Trumpcare I very unpopular. Polling found that just 17 percent of voters liked it. Not surprisingly, leadership killed the bill.

But now it’s back, and by most accounts Trumpcare II is even worse than the first. It’s possible, even likely, that the CBO will find that the new bill will cause even more people to lose coverage.

Another controversial aspect of the bill is its failure to ensure that people with pre-existing conditions will not be penalized. Pre-existing conditions include cancer, heart failure and diabetes as well as autism, depression and pregnancy. Yes, pregnancy.

Republicans insist that the new iteration protects people with these conditions. This is, to put politely, an “alternative fact.”

As you can see in the chart above, premiums for people without coverage who are seeking coverage would rise by over $142,000 for patients with metastatic cancer, over $72,000 for those with other severe cancers, over $26,000 for those with rheumatoid arthritis, over $17,000 for women who are pregnant and over $5,000 for people born with autism.

No less an authority than Consumer Reports has assessed that Republican claims that the bill protects pre-existing coverage are false:

President Donald Trump insists that the GOP’s American Health Care Act makes good on that pledge, and House Speaker Paul Ryan says on his website that “under no circumstance can people be denied coverage because of a pre-existing condition.”

But a recent amendment to the AHCA, authored by House Republican Tom MacArthur (shown above), from New Jersey, provides a loophole. It allows states to let insurers charge higher premiums to sicker people if their coverage has lapsed, and if the state has set up a so-called “high-risk pool,” or special health insurance programs for sicker patients.

In a bid to garner more votes from moderate Republicans concerned about going back on their pledge to cover sick people, House Republicans said Wednesday they are discussing adding more funding for those high-risk pools.

But critics say that even with that extra cash those risk pools will be underfunded. And they point out that people with pre-existing conditions are especially likely to have gaps in insurance, because if they become too sick to work they may lose coverage through their employer, says Sara Collins, vice president of health care coverage and access at the Commonwealth Fund, a nonpartisan foundation that supports independent research on health and social issues.

And while those people may technically still have access to insurance, in practice it may be out of their reach. “If you can charge sick people whatever you want, that’s effectively denying people coverage,” says Linda Blumberg, a senior fellow in the Health Policy Center at the Urban Institute, a nonpartisan health policy research group.

This move is also reckless for Republicans in general and Donald Trump specifically because the people who’ll be most vulnerable live in red states and purples that voted for Trump in 2016:


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