President Donald Trump has made some huge promises for healthcare overhaul, but his new guarantee for people with preexisting conditions may not reflect the reality of the GOP’s current legislation.
Trump has promised that the plan to repeal and replace the Affordable Care Act will bring down premiums, bring down deductibles, bring down the cost of the government, and eventually cover “everybody.” Most health policy experts agree hitting all four of these marks is next to impossible.
Now, with the White House and congressional leaders apparently readying an effort to bring the American Health Care Act to the House floor, Trump is making another promise that is contradicted by the actual legislation.
In an interview with CBS’ “Face the Nation” on Sunday, Trump guaranteed protections for patients with preexisting conditions as he has done since the campaign.
“Preexisting conditions are in the bill,” Trump said. “And I just watched another network than yours, and they were saying, ‘Preexisting is not covered.’ Preexisting conditions are in the bill. And I mandate it. I said, ‘Has to be.'”
Trump reiterated those comments during an interview with Bloomberg on Monday, saying the AHCA has to cover preexisting conditions just as well as Obamacare — or better.
“I want it to be good for sick people. It’s not in its final form right now,” Trump said. “It will be every bit as good on preexisting conditions as Obamacare.”
But those guarantees run in opposition to recent adjustments to the AHCA.
An amendment added to the bill, authored by moderate Republican Rep. Tom MacArthur, would allow states to waive certain protections of Obamacare, including aspects of the ACA’s community-rating provisions that mandated all people in an area be charged the same price by insurers if they are the same age.
If a state is given a waiver for those protections, experts agree insurers could be able to price plans for people with illnesses above those for healthy people and, in the worst case, make it unaffordable for those with preexisting conditions to access insurance.
Trump, in speaking with CBS, did reference the addition of “pools are going to take care of the preexisting” as a way to offset the issue.
The new version of the AHCA does allow for the implementation of an “invisible high risk pool,” which functions as a way to subsidise insurers covering people with preexisting conditions to keep costs down for others.
That could bring down costs for those without preexisting conditions, but unless the plan is adequately funded by the government it would likely leave people with preexisting conditions with higher costs or unable to enroll. According to experts at the Kaiser Family Foundation, a nonpartisan health policy think tank, the current iteration of the AHCA’s pools do not provide enough funds to keep down costs.
Trump’s comments come as House Republicans are attempting to wrangle enough votes to pass the AHCA at some point this week. Both administration and congressional officials have pushed for a vote in the coming days, and reports suggest a vote could come as soon as Wednesday.
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