House GOP circulates new changes to health bill

House GOP circulates new changes to health bill
© Greg Nash

House Republicans are circulating the text of an amendment to their ObamaCare replacement bill that they believe could bring many conservatives on board. 

According to legislative text of the amendment obtained by The Hill, the measure would allow states to apply for waivers for one of ObamaCare’s core protections for people with pre-existing conditions. 

Conservatives argue the provision drives up premiums for healthy people, but Democrats — and many moderate Republicans — warn it would spark a return to the days when insurance companies could charge sick people exorbitantly high premiums. 

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Specifically, the amendment from Rep. Tom MacArthur (R-N.J.) allows states to apply for a waiver from ObamaCare’s “community rating” requirement, which prevents insurers from charging premiums based on customers' health.

If that were repealed, insurers would be allowed to charge people with pre-existing conditions much higher premiums due to their illnesses, putting coverage out of reach for some. 

The amendment also allows states to apply for a waiver for ObamaCare’s essential health benefits, which mandate that all insurance plans cover certain services, such as mental health and prescription drug benefits. 

States could also apply for a waiver to loosen restrictions on how much more older people can be charged than younger people.  

States would either have to establish a high-risk pool in place for people with pre-existing conditions or participate in the federal pool in order to receive a waiver community rating. But Democrats argue high-risk pools have been underfunded and don’t work. People with pre-existing conditions would also still be protected if they maintained continuous coverage, meaning they had no gaps in coverage. 

The criteria for receiving a waiver appear loose. States must meet just one of a list of possible criteria, including reducing premiums, increasing choice of plans and stabilizing the market. 

Waivers would be approved by default unless the secretary of Health and Human Services rejects requests within 60 days. 

The measure appears to be bringing some conservatives on board, but no moderate Republicans have yet flipped their votes, and many are resistant to supporting what they view as weakening pre-existing condition protections. 

A study from the liberal Center for American Progress released last week found that repealing community rating would lead to sharp premium increases for sick people, such as an increase of roughly $4,000 for those with asthma or as much as $71,000 for those with severe cancer.