Insurers: GOP should keep pre-existing condition protections

Insurers: GOP should keep pre-existing condition protections
© Greg Nash

Health insurers are calling on Senate Republicans to maintain ObamaCare’s protections for people with pre-existing conditions as they draft their replacement bill. 

The Affordable Care Act forced health insurers to adjust to a remade individual market that now prevented them from denying people coverage or charging them more based on pre-existing conditions. Those rules are known as guaranteed issue, and community rating. 

The main health insurance insurance trade group, America’s Health Insurance Plans (AHIP), wrote to Senate Republicans on Thursday saying that insurers do not want to go back to the pre-ObamaCare rules, but instead maintain the protections. 

“We believe that core insurance market reforms that guarantee access to affordable coverage for those with pre-existing conditions should be retained, including guaranteed issue, community rating, and barring pre-existing condition exclusions,” AHIP CEO Marilyn Tavenner wrote in the letter to Senate Finance Committee Chairman Orrin HatchOrrin Grant HatchPhRMA CEO 'hopeful' Trump officials will back down on drug pricing move Live coverage: Trump AG pick grilled on Mueller probe at confirmation hearing Trump praises RNC chairwoman after she criticizes her uncle Mitt Romney MORE (R-Utah). 


The House bill, in contrast, would allow states to waive the community rating protection, meaning insurers could charge sick people more, pricing many out of coverage.  

The call came as part of a broader letter outlining insurers’ priorities. 

Many parts of the healthcare industry, such as doctor and hospital groups, have outright opposed the House GOP replacement bill, warning of coverage losses and other damage. Insurers have not opposed the House bill, but they are expressing concerns to the Senate. 

Insurers called for the tax credits to be made more generous “to make coverage affordable.”

A top priority for insurers is also getting funding for key ObamaCare payments known as cost-sharing reductions. Insurers want Congress to guarantee funding for the payments. With uncertainty from President Trump threatening to cancel them, insurers warn they have to hike premiums by 15 to 20 percent. 

AHIP also warns that a new cap on Medicaid payments in the House bill “could result in unnecessary disruptions in the coverage and care beneficiaries depend on.”

One area of the Republican effort so far that insurers do embrace is loosening restrictions to allow insurers to charge older people higher premiums than they currently can now relative to younger people.