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 GrahamFBI’s top lawyer believed Hillary Clinton should face charges, but was talked out of it Overnight Defense: Graham clashed with Pentagon chief over Syria | Talk grows that Trump will fire Coats | Coast Guard officer accused of domestic terrorism plot Graham cursed at acting DOD chief, declaring himself his 'adversary' MORE (R-S.C.) and Bill CassidyWilliam (Bill) Morgan CassidyCongress must step up to protect Medicare home health care Ivanka Trump to meet with GOP senators to discuss paid family leave legislation Bipartisan senators ask industry for information on surprise medical bills 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 PriceIs a presidential appointment worth the risk? Former Ryan aide moves to K street Grassley to test GOP on lowering drug prices MORE.

The new language could make it tougher for Graham and Cassidy to win over holdout Republicans such as Sen. Lisa MurkowskiLisa Ann MurkowskiGOP Sen. Collins says she'll back resolution to block Trump's emergency declaration The Hill's 12:30 Report: Trump escalates fight with NY Times The 10 GOP senators who may break with Trump on emergency 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 12:30 Report: Trump escalates fight with NY Times The 10 GOP senators who may break with Trump on emergency On unilateral executive action, Mitch McConnell was right — in 2014 MORE (R-Ky.) and John McCainJohn Sidney McCainMellman: Where are good faith and integrity? GOP senator says Republicans didn't control Senate when they held majority Pence met with silence after mentioning Trump in Munich speech MORE (R-Ariz.) have already said they are opposed. Sen. Susan CollinsSusan Margaret CollinsTexas GOP rep opposes Trump’s use of national emergency to get border wall GOP Sen. Collins says she'll back resolution to block Trump's emergency declaration Talk grows that Trump will fire Dan Coats MORE (R-Maine) has said she is leaning against the bill.

Sen. Ted CruzRafael (Ted) Edward CruzO’Rourke not ruling out being vice presidential candidate CNN ripped for hiring former Republican operative as political editor: 'WTF?!?!' The Hill's Morning Report - Can Bernie recapture 2016 magic? 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.