Later On

A blog written for those whose interests more or less match mine.

In the health care debate over pre-existing conditions, who’s lying?

leave a comment »

Tony Pugh reports for McClatchy:

Someone must be lying about health care coverage for pre-existing medical conditions.

Republicans, including President Donald Trump, are trying to drown out the chorus of doctor, patient and hospital groups that say people with chronic medical conditions could be priced out of coverage under the Republican health plan that narrowly passed the House of Representatives on Thursday.

Trump, House Speaker Paul Ryan, R-Wis., and the 216 House Republicans who voted for the bill say it protects these folks. They includes House Majority Leader Kevin McCarthy, R-Calif.

“Let me state it one more time: We will replace (Obamacare) with a system that protects pre-existing conditions,” McCarthy said on the House floor before Thursday’s vote.

So who’s telling the truth? It all depends on what you call a lie.

People with pre-existing conditions who could be priced out of coverage under the GOP legislation could ultimately get insurance through high-risk pools for the medically uninsurable. But such coverage pools have a long history of high costs, poor funding and limited benefits.

“Virtually every health care analyst that you talk to will tell you that these things just don’t work very well,” Andy Slavitt, former acting administrator of the Centers for Medicare and Medicaid Services, said during an online discussion this week with Rep. John Yarmuth, D-Ky.

Slavitt, who served under President Barack Obama, said Republicans were using the risk pools to falsely claim they were protecting coverage for people with pre-existing conditions.

“As long as we can throw someone with a pre-existing condition into a high-risk pool, we can say that they’re covered,” Slavitt said. “Even if we can charge them tens of thousands of dollars more. Even if we can give them something that doesn’t give them access to care. And even if we don’t fund it well enough. And that’s what I call a ‘high-five and a wink.’

“ ‘Hey, we got this deal done. Hey, we can say we didn’t take away pre-existing conditions,’ ” Slavitt said of congressional Republicans, “ ‘but we’re going to give the (insurers) the opportunity to charge people whatever they want.’ ”

In an editorial in Friday’s Washington Post, House Republican Conference Chair Cathy McMorris Rodgers, R-Wash, said high-risk pools and other programs to reimburse medical costs for sick plan members “have been successful in the past.” She defended the GOP health care proposal.

“Our plan establishes a program to provide federal resources for states to create high-risk pools, reduce out-of-pocket costs or promote better access to services,” McMorris Rodgers wrote.

Under the 2010 Affordable Care Act, individual health coverage must be offered to people with pre-existing conditions, which can be anything from asthma, acne and obesity to cancer, heart disease and AIDS.

Insurers couldn’t charge these folks more for coverage either, because the health law’s “community rating” provision bars insurers from varying premium rates based on health status or medical history under a process known as medical underwriting, which was discontinued under Obamacare.

Instead, the ACA requires everyone in the statewide coverage pool to pay the same rates, spreading the higher cost of sicker enrollees among all plan members. That was considered a crucial piece of the overhaul of the nation’s health care system that came to be known as Obamacare.

The GOP’s 2017 health care bill allows . . .

Continue reading.

Written by LeisureGuy

5 May 2017 at 6:39 pm

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s