Critics say pre-existing conditions protections weakened in updated GOP bill

Critics say pre-existing conditions protections weakened in updated GOP bill
© Getty Images

Critics of the updated ObamaCare repeal measure from Sens. Lindsey GrahamLindsey Olin GrahamCongress punts fight over Dreamers to March Pence tours Rio Grande between US and Mexico GOP looks for Plan B after failure of immigration measures MORE (R-S.C.) and Bill CassidyWilliam (Bill) Morgan CassidyTo lower prescription drug prices, fix existing drug discount programs Kimmel writer tweets amount NRA has given lawmakers in response to shooting prayers Overnight Regulation: Trump unveils budget | Sharp cuts proposed for EPA, HHS | Trump aims to speed environmental reviews | Officials propose repealing most of methane leak rule MORE (R-La.) say it goes further than their earlier bill in gutting protections for people with pre-existing conditions.

The two lawmakers say they changed their legislation in a bid to win over holdout senators by giving the states more money and more freedom.

As a result, the new bill would “explicitly allow states to permit insurers to vary premiums” based on pre-existing conditions, so long as insurers don’t discriminate on the basis of sex or genetics, said Timothy Jost, emeritus professor at the Washington and Lee University School of Law.

“Insurers might have to sell coverage to people with preexisting conditions, but it could be very expensive,” Jost, a critic of the bill, wrote in a blog post.

Like the earlier bill, the updated measure would allow states to waive ObamaCare’s essential health benefits, which require insurance plans to cover a range of services like mental health or prescription drugs.

But now, states don’t need to apply to the Trump administration for a waiver. They just have to submit an application explaining how they would provide “adequate and affordable coverage” to people with pre-existing conditions.

There is no clear definition in the bill of what “adequate and affordable” care means. Without such language, the waivers would essentially be a judgment call for Health and Human Services Secretary Tom PriceThomas (Tom) Edmunds PriceGreen group calls on Pruitt to pay back first-class flight costs Top Dems seeks answers from HHS on ethics lapses GOP lawmaker calls for Shulkin to resign MORE.

The new language could make it tougher for Graham and Cassidy to win over holdout Republicans such as Sen. Lisa MurkowskiLisa Ann MurkowskiThe siren of Baton Rouge Interior plan to use drilling funds for new projects met with skepticism The 14 GOP senators who voted against Trump’s immigration framework MORE (Alaska), who has said she won’t support a bill that doesn’t protect people with pre-existing conditions.

Republicans can only afford to lose two votes, and Sens. Rand PaulRandal (Rand) Howard PaulDem wins Kentucky state House seat in district Trump won by 49 points GOP's tax reform bait-and-switch will widen inequality Pentagon budget euphoria could be short-lived MORE (R-Ky.) and John McCainJohn Sidney McCainLawmakers worry about rise of fake video technology Democrats put Dreamers and their party in danger by playing hardball Trump set a good defense budget, but here is how to make it better MORE (R-Ariz.) have already said they are opposed. Sen. Susan CollinsSusan Margaret CollinsOvernight Tech: Judge blocks AT&T request for DOJ communications | Facebook VP apologizes for tweets about Mueller probe | Tech wants Treasury to fight EU tax proposal Overnight Regulation: Trump to take steps to ban bump stocks | Trump eases rules on insurance sold outside of ObamaCare | FCC to officially rescind net neutrality Thursday | Obama EPA chief: Reg rollback won't stand FCC to officially rescind net neutrality rules on Thursday MORE (R-Maine) has said she is leaning against the bill.

Sen. Ted CruzRafael (Ted) Edward CruzOvernight Health Care: Trump eases rules on insurance outside ObamaCare | HHS office on religious rights gets 300 complaints in a month | GOP chair eyes opioid bill vote by Memorial Day HHS official put on leave amid probe into social media posts Trump, Pence to address CPAC this week MORE (R-Texas) also said he doesn’t support the bill, but has been optimistic he can get to “yes.” Cruz has pressed for legislation to lower premium costs.

The bill’s supporters insist it would protect people with pre-existing health conditions.

“The ObamaCare legislation required coverage of pre-existing conditions. This legislation does not change that,” White House Legislative Affairs Director Marc Short said Sunday on CBS's “Face The Nation.”

But the bill in inconsistent in how it treats pre-existing conditions, and critics argue a rush to move forward on the bill has led to confusion

“The language in the revised Graham-Cassidy bill is convoluted and contradictory,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation.

For example, one section lists all the ObamaCare rules that states can allow insurers to overturn. The prohibition on charging more based on health status isn’t one of them.

Another section says states can waive everything except the prohibition on charging people more based on sex or genetics. This implies that insurers can charge more for people with pre-existing conditions.

“However you read Graham-Cassidy, then, it allows insurers to screw sick people. It’s just not clear exactly how they can screw them,” Nicholas Bagley, a law professor at the University of Michigan, wrote in a blog post.