Critics wrong; GOP bill improves care for pre-existing conditions

One of the great ironies of the recent national debate and media coverage regarding the future of health care in America is that the defenders of the status quo consistently cite their concern for those with pre-existing medical conditions as a reason to keep the Affordable Care Act — even as the law collapses before our eyes.

As is the case in the recent op-ed by Douglas McSwain and Douglas Scutchfield who ignore the threat to access to care posed by Obamacare’s skyrocketing costs and increasingly limited choices to those with pre-existing conditions.

To actually protect care for those with pre-existing conditions we have to keep protections in place while lowering costs and expanding choices. The American Health Care Act, as passed by the House, does just that.

A new report from the Department of Health and Human Services this week confirms that health insurance premiums have increased by an average of 75 percent in Kentucky since Obamacare took effect in 2013. At the same time, choices in coverage have dwindled. In the last year alone, the number of insurers on the Kentucky exchange have decreased from seven to three. And in roughly half of Kentucky counties there is only one option for coverage — which is not a choice at all.

Unaffordable premiums and fewer choices have forced many Kentuckians to choose plans with extremely high deductibles, meaning they may not be able to afford to get the care they need even if they do have insurance. Many more have chosen Medicaid, a government-run plan intended to be a last resort, not a default public-option for care. While better than nothing, Medicaid often means waiting lines and is not accepted by many specialists, which hurts those with pre-existing conditions the most.

I refuse to accept this status quo as success, and so do the vast majority of Kentuckians who have overwhelmingly elected leaders at the federal, state and local levels promising to repeal Obamacare and replace it with reforms that will actually improve quality and access to care. My vote for the American Health Care Act was delivering on that promise.

Our bill maintains the guarantee that no insurance company in any state can deny coverage based on a pre-existing condition. There is no waiver for this promise. Period. Any suggestion otherwise is simply wrong.

We also guarantee that those with pre-existing conditions cannot face higher costs based on their health history as long as they maintain continuous coverage. The bill includes $138 billion to assist in providing coverage and lowering costs for patients, including $8 billion specifically targeted to reduce premiums and out-of-pocket costs for the small percentage of people who have a pre-existing condition, chose not to maintain health insurance, and are now purchasing insurance on the individual market.

The critics suggest our plan will simply repeat the old model of subsidized high-risk pools for very sick people that inevitably go bankrupt. They are wrong. Our plan is modeled after an innovative, successful and sustainable “invisible reinsurance” program in Maine that delivers care and keeps costs down for people with pre-existing conditions.

As Doug Holtz-Eakin, a former director of the Congressional Budget Office stated, “The combination of tailoring insurance to a state’s needs, appropriate federal oversight, and the commitment of over $130 billion is a three-part guarantee of meeting the needs of those with pre-existing conditions.” In other words, the rug will not be pulled out from under anyone.

In fact, the American Health Care Act will give all Americans better options for their health and budget, while providing multiple layers of protections for those previous and ongoing health concerns. I take this promise seriously because, like all Americans, members of my family have suffered from serious health conditions, including my sister who has coped with Juvenile Rheumatoid Arthritis her entire life.

I would never vote for legislation if it would hurt people like my sister or anyone with a medical challenge. As the American Health Care Act works through the legislative process, I will keep my promises and those with pre-existing conditions will always be my top priority.

This story was originally published May 26, 2017 at 1:27 PM with the headline "Critics wrong; GOP bill improves care for pre-existing conditions."