The Senate Trumpcare Bill Is as Devastating for People with Pre-Existing Conditions as the House Version

News & Politics

The Senate version of Trumpcare was supposed to fix the problems in the House bill for people with pre-existing conditions by dropping a provision that allows states to waive enforcement of the Affordable Care Act's community ratings provision that bars insurers from charging sick people more for insurance. Remember, the House insisted they were maintaining protections for people with pre-existing conditions, and were just giving states the "flexibility" to decide whether they'd enforce it or not. Now the Senate is compounding the lie that people with pre-existing conditions will be covered by saying they'll drop that provision, when in actuality they're putting in another provision that'll still screw sick people.

What the Senate bill will reportedly do is to allow states to waive the ACA’s essential health benefits (EHB) requirements, and that will still "eviscerate coverage protections" for people with pre-existing conditions, analysis from the Center for American Progress finds. That's because insurers could offer plans that don't give the benefits those sick people need, and shut them out of coverage.

As a result, people with pre-existing conditions in waiver states would face significantly higher costs and find it much harder to find insurance plans that actually covered treatment for even relatively common conditions such as mental health problems or diabetes. The Center for American Progress estimates that in the individual market, 5.3 million enrollees with pre-existing conditions would live in states that waive EHBs and thus see their protections eroded.

In addition, the problem would be particularly acute for older Americans, who would face much higher premiums under the AHCA, as well as for millions of low-income Medicaid enrollees, who would lose comprehensive coverage due to the AHCA’s $834 billion in cuts to that program. […]

Thus, insurers would likely engage in a race to the bottom to avoid attracting the sickest enrollees. This would also affect healthy people, who would see fewer plan options offering comprehensive benefits than prior to the ACA.

Add in the Medicaid cuts and the repeal of the age-rating limits, meaning insurance companies could charge older people significantly more than younger people—5 times more—and you're looking at a bill that's as bad for people in the 50-64 age group as the House bill was. And it's a lot of people. "There are an estimated 5.1 million enrollees ages 55 to 64 covered through the individual market, both on the ACA marketplace and outside it, and estimates show that 84 percent of enrollees in this age group have at least one pre-existing condition that would have resulted in them being denied coverage or being charged more prior to the ACA." CAP estimates that 2.2 million people over 55 would live in the states that chose to waive these requirements, meaning 2.2 million people just in that age bracket who would like be uninsured or completely impoverished trying to maintain insurance.

Senate Republicans are going to try to sell this bill as a kinder, gentler Trumpcare. Don't let them. If you have a Republican senator call them through the Capitol switchboard at 202-224-3121 and let them know you won't be fooled.

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