The GOP’s New Pre-Existing Conditions Promise Is A Fraud
But it’s what the bill doesn’t say that makes the above mostly meaningless.
Yes, insurance companies wouldn’t be allowed to refuse to offer coverage to someone who, for example, has a history of cancer or is pregnant. But they could sell someone a policy that doesn’t cover cancer treatments or the birth of a child.
Sure, premiums wouldn’t be allowed to vary based on health status or pre-existing conditions. But prices could dramatically vary based on age, gender, occupation and other factors, including hobbies, in ways that are functionally the same as basing them on medical histories. Insurance companies have a lot of experience figuring out that stuff.
There’s no need to speculate about how insurance companies would respond to this, because this is how the system worked for people who bought individual policies before the Affordable Care Act. Insurers don’t make money paying claims; they make money by avoiding claims or refusing the pay them. If they’re allowed to keep the most expensive people and treatments off their books, they will.Before the Affordable Care Act, it already was illegal for health insurance companies to reject customers with pre-existing conditions or charge them more based on their medical histories if they got coverage through a group plan, like from an employer. And insurers and employers are limited in how much they could refuse to pay for treatments related to a pre-existing condition for group policyholders. The Affordable Care Act extended similar protections to people who buy their health insurance directly or via the exchanges the law created.
.. With Obamacare repeal off the legislative agenda ― for now, at least ― why would these senators write legislation to solve a problem that doesn’t exist? Because their party is the middle of unsolving it.
.. The administration, however, doesn’t want to throw out the whole law ― just the parts that protect people with pre-existing conditions.