Wave Goodbye to Your Pre-existing Condition Protections Under New Trumpcare Bill

by Joan McCarter –

Remember when Republicans were going to keep all of the protections in the Affordable Care Act for people with pre-existing health conditions, even while they were going to repeal it? Slowly, surely, that promise faded away through every iteration of Trumpcare and Zombie Trumpcare that emerged. With the latest one Mitch McConnell and Senate Republicans are trying to jam through, they’re not even pretending anymore. This bill would “give states broad waiver authority to eliminate the ACA’s core protections for people with pre-existing health conditions.”

These waivers would come on top of the proposal’s elimination of the ACA’s marketplace subsidies and Medicaid expansion, its radical restructuring of the rest of the Medicaid program, and its large cuts to total federal funding for health insurance coverage.

Specifically, a little-noticed provision of the block grant funding states would receive under the plan would let them obtain waivers of ACA pre-existing conditions protections and benefit standards for any insurance plan subsidized by block grant funding. For example, a state that used a small portion of its block grant funding to provide even tiny subsidies to all individual market plans could then waive these protections for its entire individual market. Likewise, states that used block grant funding to offer or subsidize coverage for low-income people could offer plans with large gaps in benefits. States seeking waivers would have to explain how they “intend” to maintain access to coverage for people with pre-existing conditions, but they wouldn’t have to prove that their waivers would actually do so.

States would be allowed to waive the prohibition against insurance companies charging people higher premiums based on their health status in Obamacare. They technically still have to offer plans to people with health issues (which can be as minor as acne, or as serious as cancer as we’ve seen from previous behavior), but they can charge those people much higher premiums—basically as much as they want to discourage any potentially sick people from being covered by their own plans.

JAM THE PHONE LINES. Call your senator at (202) 224-3121 and tell them to just stop playing with our lives.  (After you call, please tell us how it went.)

The other way the legislation undermines the ACA’s protections for pre-existing conditions is to allow states to let insurers offer coverage that doesn’t include the essential health benefits in the law. That means insurers could exclude things like mental health coverage, or maternity care, or substance abuse treatment from plans. In case you think that wouldn’t happen, an analysis from the Kaiser Family Foundationshows that “75 percent of individual market plans excluded maternity coverage, 45 percent excluded substance use treatment, and 38 percent excluded mental health care” before the ACA. You bet they’d do it again, if allowed.

Which is just fine with Republicans. They probably had their fingers crossed behind their backs when they made that promise, anyway.


Reprinted with permission from Daily Kos