“A new Republican bill would replace some, but not all, of the ACA’s protections for people with pre-existing conditions. https://t.co/sS6l1AoNQw”
And on the heels of my last post about the ACA potentially getting overturned before 2020, I’ve just learned that there is in fact a GOP alternative to the ACA being floated...and, predictably, it ain’t good.
This bill would continue uphold, as the ACA does, guaranteed issue, meaning that an insurer can’t refuse to sell you insurance because you have a pre-existing condition, and community rating, meaning that an insurer can’t charge you higher premiums due to your pre-existing condition. It would also continue to ban insurers from doing stupid shit like saying “we’ll cover you even though you have a pre-existing condition, but we won’t cover any costs related to that condition” (which a previous version of this bill would have allowed them to do).
However, it would drop many of the ACA’s protections on the cutting room floor, resulting in utterly inadequate protections for those of us who have extensive healthcare needs. It would not ban annual or lifetime caps, so an insurer could stop covering you for a given year after you had spent, say, $100,000 (which could easily happen in one hospitalization), or could stop covering you for the rest of your life after you had spent a million (any cancer patient will hit this).
Most insidiously, it wouldn’t continue to require insurers to cover the 10 essential health benefits that the ACA requires. These are things like maternity care, mental health treatment, and prescription drug coverage.
Without essential health benefits, people with pre-existing conditions are not protected at all. Consider this scenario:
Patient: Hey I’m super sick and would like to buy health insurance, please.
Insurer: Darn it, I have to sell it to you even though I don’t want to.
Patient: Neat. So, what plans do you offer?
Insurer: We have a bronze plan at $400/month and platinum plan at $4000/month.
Patient: Okay....well I definitely can’t afford the platinum plan. What’s the difference between the plans?
Insurer: The bronze plan doesn’t cover prescription drugs.
Patient: Well, that won’t work for me. My health depends on a biologic medication that costs $5000/month. I can’t afford that out of pocket, so I need my medication to be covered.
Insurer: I guess you’ll just have to shop elsewhere then! WHAT A SHAME :)
This insurer has just successfully discriminated against someone with a pre-existing condition while complying with all laws, under this proposed GOP bill.
Call your senator and tell them this bill is not good enough!