TRUMPCARE: A CONGRESSMAN SPEAKS OUT

Rep. Justin Amash is a Republican congressman from Michigan and a self-described libertarian. I clipboarded this straight from his Facebook page, so these words are either his or his minion’s:

The bill does not change the ACA’s federal requirements on guaranteed issue (prohibition on policy denial), essential health benefits (minimum coverage), or community rating (prohibition on pricing based on health status). In short, Obamacare’s pre-existing conditions provisions are retained.

The latest version of the AHCA does allow any state to seek a waiver from certain insurance mandates, but such waivers are limited in scope. Guaranteed issue cannot be waived. Nobody can be treated differently based on gender. And any person who has continuous coverage—no lapse for more than 62 days—cannot be charged more regardless of health status.

Consider what this means: Even in a state that waives as much as possible, a person with a pre-existing condition cannot be prevented from purchasing insurance at the same rate as a healthy person.

Bear in mind two things, please. First, these are aspects of Trumpcare that the Congressman doesn’t like. Second, he’s confused; one look at the Trumpcare website will prove that Obamacare’s pre-existing conditions provisions are not retained.

REPUBLICAN MISDIRECTION ON TRUMPCARE

The Right is engaging in fascinating and skilled misdirection to imply that, look, under Trumpcare the coverage for pre-existing conditions won’t be that different from what it already is [under Obamacare] or was under private insurers. This is Avik Roy in Forbes, via Redstate:

[P]rior to Obamacare, the vast majority of Americans with health insurance were already in plans that were required to offer them coverage regardless of pre-existing conditions. Employer-based plans were required to offer coverage to everyone regardless of pre-existing conditions. So were Medicare, Medicaid, and other government programs like the VA. Employer- and government-based plans, prior to Obamacare, represented 90 percent of Americans with health insurance.

Amazingly, that’s an entire paragraph without (so far as I can tell) a single lie in it. But would you like to drive through the hole it nonetheless contains? The pre-existing condition coverage provided by the VA is probably safe, because of the stink that would follow any attempt to delete it. I’ve got my fingers crossed that the same is true for Medicare. But if Trumpcare says that employer-based plans are no longer obligated to cover pre-existing conditions, a lot of them no longer will. And as for Medicaid… Any number of Republicans have been looking for an excuse to get rid of Medicaid for decades. The facts are cut in stone: a majority of poor people do not vote Republican, and Republican legislators do not want to provide medical care to those people. Roy’s implication is that, when Obamacare is replaced by the AHCA, the insurance environment will go back to what it was before Obamacare. Other statements by Republican legislators make it clear that that is ridiculous.

I still can’t find a verified deniable conditions list. Stay tuned.

TRUMPCARE: CONTINUING UPDATE

Larry Levitt, Senior VP of the Kaiser Family Foundation, has said that “27% of adults have pre-existing conditions that insurers wouldn’t cover pre-[Obamacare] at all. The premiums for these people [under Trumpcare] will be astronomical.” Other estimates of the proportion of adults that will NOT be covered by the AHCA (Trumpcare 2.0) range up to 50%. The AHCA partly copes with this problem by establishing a “risk pool” of uncertain amount – some sources say $8 billion, some say $15 billion – but many pre-existing conditions are not eligible for it, and insurers would have to certify individual eligibility for the risk pool, creating a massive burden of administrative overhead whose cost would of course be passed on to consumers. Trumpcare official propaganda states that the AHCA does cover pre-existing conditions. “Yes, it does,” for some people, under restricted circumstances, and until it runs out of money. For people with pre-existing conditions, the situation will be what it was before the establishment of Obamacare, at best. The Center for American Progress estimates that, for some cancer patients who are eligible for Trumpcare, premiums will be over $140,000 per year.

Meanwhile, my own research displays the worst disadvantages of social media. The young woman who posted the “List of Deniable Conditions” on Facebook informs me that she originally got that list from a tweet, but the tweet has now been taken down, and neither she nor I can find that list anywhere else…so far. Most of what I have found suggests that the official propaganda for Trumpcare is grossly misleading. Our only hope at the moment is that a bill banning coverage for pregnancy, cancer therapy, hemophilia, and heart disease – to pick just four examples out of dozens – will never make it past the Senate. If the AHCA becomes law, the wallets of the wealthy will become dramatically healthier as they fatten off its carefully obscured tax breaks. For most of the rest of us, the American “Health” “Care” act is a Federally guaranteed lose-lose proposition.

eta, I can’t let this go by:

A divided Republican Party now faces the possibility of healthcare reform grinding to a halt in light of the issue over pre-existing conditions. President Trump, for his part, seems unsure about what’s in his own bill, which only adds to the confusion. Optimistic members of Congress have suggested that they could push the AHCA to a House vote by next week, but there doesn’t appear to be widespread support even for the revised version. For people with medical problems, the debate over healthcare reform continues to play fast and loose with their care.

Now, is this from HuffPo? Think Progress? TPM? No, this is from the official Trumpcare site itself. Tell me that anybody knows what’s going to happen next.