Pre-Existing Conditions At Center Of New Republican Health Care Debates

WASHINGTON, DC — Republicans on Capitol Hill are working on putting forward a new proposal on health care, and early reports suggest that protections for people with pre-existing conditions may be significantly weakened under the plan.

Under Obamacare, insurers are not able to deny coverage to people because they have pre-existing medical conditions or charge them higher premiums than healthy people. This is one of the most popular provisions of the law, and President Trump, as well as other Republicans, have promised to keep this part of the bill they otherwise despise.

There are two main parts of Obamacare that protect people with pre-existing conditions, known as the "essential health benefits" and "community rating" provisions.

According to Axios, both of these provisions are under threat in current GOP negotiations. The idea would be to let states opt out of these provisions at their own discretion.

In plain English, these rules mean that all insurers have to include a certain set of 10 health benefits, such as mental health care and maternity coverage, and all members of certain insurance pools have to pay the same rate, regardless of their current health status.

If you repeal "community ratings," sick people could get charged incredibly high amounts for their necessary coverage.

Josh Barro, writing for Business Insider, argues that repealing "essential health benefits" while keeping the community ratings would create perverse incentives for insurers.

"People who want coverage for expensive benefits, such as substance-abuse treatment, might wait until they need the coverage to buy it," wrote Barro.

He continued: "Insurers, unable to block specific customers, would have to price insurance on the assumption that any buyer is buying a specific benefit because he or she intends to use it. Ultimately, the pricing for many benefits would become so unattractive that insurers would stop selling coverage for them altogether."

Writing an opinion column for Fox News, Lanhee Chen advocated eliminating the "essential health benefits" provision.

"Conservatives have long argued that the essential health benefits requirement in Obamacare most represents the law’s aggregation of power in the federal government," Chen wrote. "This provision gives Washington the authority to determine precisely what benefits every health insurance plan sold on ObamaCare’s exchanges must cover. It’s also at least partially responsible for the rapidly increasing premiums for plans sold on the law’s marketplaces."

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