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 GrahamSunday shows preview: Trump sells U.N. reorganizing and Kavanaugh allegations dominate Kim, Moon toss ball to Trump in ‘last, best chance’ for Korean peace GOP senator: Kavanaugh accuser 'moving the goalposts' MORE (R-S.C.) and Bill CassidyWilliam (Bill) Morgan CassidyOvernight Health Care: Opioids package nears finish line | Measure to help drug companies draws ire | Maryland ObamaCare rates to drop Overnight Health Care: HHS diverts funds to pay for detaining migrant children | Health officials defend transfers | Lawmakers consider easing drug company costs in opioids deal Overnight Health Care: Senators target surprise medical bills | Group looks to allow Medicaid funds for substance abuse programs | FDA launches anti-vaping campaign for teens 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 PriceWhite House officials discussing potential replacements for FEMA chief: report Overnight Health Care: CBO finds bill delaying parts of ObamaCare costs B | Drug CEO defends 400 percent price hike | HHS declares health emergency ahead of hurricane HHS should look into Azar's close ties to the drug industry MORE.

The new language could make it tougher for Graham and Cassidy to win over holdout Republicans such as Sen. Lisa MurkowskiLisa Ann MurkowskiKavanaugh accuser agrees to testify next week Murkowski says she’ll wait until Ford testifies before making decision on Kavanaugh Alaska gov, lieutenant gov come out against Kavanaugh 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 PaulConservatives left frustrated as Congress passes big spending bills Senate approves 4B spending bill Some employees' personal data revealed in State Department email breach: report MORE (R-Ky.) and John McCainJohn Sidney McCainTrump hits McCain on ObamaCare vote GOP, White House start playing midterm blame game Arizona race becomes Senate GOP’s ‘firewall’ MORE (R-Ariz.) have already said they are opposed. Sen. Susan CollinsSusan Margaret CollinsKavanaugh accuser agrees to testify next week The Memo: Could Kavanaugh furor spark another ‘year of the woman’? Kavanaugh fight roils an already ugly political climate MORE (R-Maine) has said she is leaning against the bill.

Sen. Ted CruzRafael (Ted) Edward CruzViral video shows O’Rourke air-drumming to the Who’s ‘Baba O’Riley’ after Cruz debate Five takeaways from Cruz, O'Rourke's fiery first debate NY Times, McCabe give Trump perfect cover to fire Rosenstein, Sessions 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.