GOP Senate Bill Would Cover Pre-Existing Conditions And Drive Down Premiums

Claudine Rigal
Juillet 17, 2017

That means that if you had any of those conditions listed above - asthma, for instance - you still could have the same insurance as someone who had a clean bill of health and someone who is a cancer survivor, pregnant, or obese.

In a document (PDF) posted on its website, the trade group said that allowing health insurance products to be governed by different rules would effectively "fracture and segment insurance markets into separate risk pools and create an un-level playing field that would lead to widespread adverse selection and unstable health insurance markets".

The amendment would allow plans to exist that don't comply with two regulations set up under the Affordable Care Act: community rating and essential health benefits. That has made coverage more robust, but it's also raised premiums for relatively healthy people. By segregating those with preexisting conditions, insurance companies could protect healthier customers from their high medical costs, which would have driven up premiums for everybody.

Before Obamacare, states had significant discretion over their individual health insurance markets and many created high-risk pools for people whom insurers turned away. But that would cause premiums to spike for those looking those who are sick and need more comprehensive policies.

A fixed-indemnity insurance plan is a type of supplemental health plan that gives you a fixed cash benefit payout in case you experience specific illnesses or injuries covered by your policy.

The CBO estimated the original bill would increase the number of uninsured Americans by 22 million by the end of 2026. "If the cost of premiums continues to skyrocket, as they have under the last seven years under Obamacare, than we will have failed".

The proposal "is simply unworkable in any form and would undermine protections for those with pre-existing medical conditions, increase premiums and lead to widespread terminations of coverage for people now enrolled in the individual market", trade associations America's Health Insurance Plans and BlueCross BlueShield Association wrote in a letter to the Senate. Those with preexisting conditions will be on the heavily subsidized exchanges, and those with lower health-care costs would buy non-Obamacare plans outside the exchanges.

This would nearly certainly be an improvement over Obamacare because it would allow room for an actual insurance market, for Americans who are actually insurable. If you force insurance companies to cover things that have already happened, that's not insurance; it's a junky, yet expensive, version of health care as a public utility. In order to secure Lee's and Cruz's votes for the bill, Senate Majority Leader Mitch McConnell may have to include their amendment but find a way to satisfy moderates by minimizing the measure's destabilizing effect on insurance markets. Probably, although there's no way to know for sure until we see such a system in action. But critics say that would depend on how much money is provided. But regardless of the details, Cruz and his Republican colleagues in the Senate have the right idea.

D'autres rapports CampDesrEcrues

Discuter de cet article