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

Critics say pre-existing conditions protections weakened in updated GOP bill
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Critics of the updated ObamaCare repeal measure from Sens. Lindsey GrahamLindsey Olin GrahamGOP strategist: Putin press conference 'made Trump look weak' Release of Carter Page surveillance documents reignites debate Graham: Warrant for Carter Page surveillance was 'a bunch of garbage' MORE (R-S.C.) and Bill CassidyWilliam (Bill) Morgan CassidyGOP senators introduce resolution endorsing ICE Lawmakers pitch dueling plans for paid family leave New push to break deadlock on paid family leave 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 PricePoll: Majority in some GOP districts say Republicans 'more corrupt' than Dems Five GOP lawmakers mulling bid to lead conservative caucus Overnight Health Care: Watchdog finds Tom Price improperly used funds on flights | Ex-Novartis CEO sent drug pricing proposal to Cohen | HHS staffers depart after controversial social media posts MORE.

The new language could make it tougher for Graham and Cassidy to win over holdout Republicans such as Sen. Lisa MurkowskiLisa Ann MurkowskiThis week: GOP mulls vote on ‘abolish ICE’ legislation Dem infighting erupts over Supreme Court pick McConnell: Senate to confirm Kavanaugh by Oct. 1 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 PaulThe Hill's Morning Report — Trump and Congress at odds over Russia GOP leader blocks resolution backing intelligence community on Russia Rand Paul blocks Sanders's Russia resolution, calls it 'crazy hatred' against Trump MORE (R-Ky.) and John McCainJohn Sidney McCainThe Memo: Summit fallout hits White House Graham: Biggest problem is Trump ‘believes meddling equals collusion’ Obama, Bush veterans dismiss Trump-Putin interpreter subpoena MORE (R-Ariz.) have already said they are opposed. Sen. Susan CollinsSusan Margaret CollinsThe Hill's Morning Report — Russia furor grips Washington Overnight Health Care: Novartis pulls back on drug price hikes | House Dems launch Medicare for All caucus | Trump officials pushing ahead on Medicaid work requirements Senate panel to vote next week on banning 'gag clauses' in pharmacy contracts MORE (R-Maine) has said she is leaning against the bill.

Sen. Ted CruzRafael (Ted) Edward CruzDem leaders fend off calls to impeach Trump Cruz: 'I'm glad' Disney fired James Gunn over 'horrible' tweets Washington needs to end hidden inflation tax on our capital gains 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.