Generous Republicans Will Let You Buy Health Insurance As Long As You Don't Need Healthcare
Next: Car insurance that only covers your boat.
As you may recall, there's this incredibly dumb lawsuit moving forward against the Affordable Care Act and its protections for patients with pre-existing conditions. Texas and a bunch of red states are suing with the claim that since the Big Fat Tax Cuts for Rich Fuckwads did away with the individual mandate, the whole law is therefore unconstitutional, since that mandate was a key part of the 2012 decision upholding Obamacare in the first place. It's generally considered a laughably weak argument, but with Neil Gorsuch on the Supreme Court, it really could lead to the ACA being tossed out altogether. But don't worry, America! The Republicans have a plan to protect YOU, just in case! Except it's a really, really shitty plan, as you'd expect.
The US Senate bill , humorously titled the "Ensuring Coverage for Patients with Pre-Existing Conditions Act," seems right nice at a glance. It would forbid insurers from refusing to sell anyone an insurance policy because of a pre-existing condition, or to charge higher rates because of a pre-existing condition. There's just one eensy-teensy problem: It would allow insurers to deny coverage for any treatment related to a pre-existing condition. So hooray! If you have ever had cancer, you wouldn't be able to buy insurance that covers cancer. But if you get hit by a bus on the way to rob a bank to pay for chemo out of pocket, you might be covered, assuming you had no previous bus-related problems.
The bill, introduced by Republican Thom Tillis of North Carolina, is pretty much the opposite of its name, putting it in the fine Republican tradition of the Healthy Forests Initiative and the Leopards Won't Eat Your Face Act of 2017. Larry Levitt, the nonpartisan Kaiser Family Foundation's senior vice president for health reform, explained:
If the goal is to protect people with pre-existing conditions, the bill is a bit of a mirage [...]
You don't have to be real creative to imagine how this might work. These pre-existing condition exclusions were typical before the ACA.
True fact! We remember when we bought health insurance in grad school. When we answered the question about any previous medical treatment, we dutifully mentioned that three years before, we'd been treated for very minor eczema on one hand, which earned us a full coverage exclusion for any skin disease ever. It certainly motivated us to use sunscreen, but that's exactly the good old days of insurance that covers very little that the Trumpers hope we'll just love, because maybe premiums will be lower. (They won't.)
Mind you, a spokesperson for Tillis, Adam Webb, promised that nothing could be further from the truth than the pernicious charge that the bill has big pro-insurer loopholes, or that this is a pathetic attempt to have band-aids on hand in case the entire ACA is thrown out a 30th-floor window:
"This legislation protects Americans with pre-existing conditions so that they cannot be denied coverage or charged more based on health status — two of the central protections contested in Texas vs. United States," Webb wrote in an email. "In the event that the Affordable Care Act is struck down in its entirety, Congress would put forward a more comprehensive response."
We like the part where he doesn't at all deny that insurance companies would be free to deny all coverage for pre-existing conditions, which seems a tad important.
Ever the killjoy, Levitt pointed out that, nah, even the premium protections in Obamacare wouldn't be preserved by this bill. While the ACA only allows insurers to charge more on the basis of tobacco use or age (the latter increase is strictly limited), the GOP plan would allow rate hikes for age, gender, occupation or high-risk activities. But no, not for health status, so that's something.
Most Republicans seem less than enthusiastic about the red state lawsuit against the ACA anyway, particularly since polls show voters list healthcare as a top issue in the midterms. Sen. Lamar Alexander of Tennessee isn't a fan, and has called the Texas case " as far-fetched as any I've ever heard ."
Tough timing for Republicans, though: The oral arguments in the Texas case will be heard in September , putting the possible judicial murder of healthcare coverage for tens of millions in the public eye just as people start paying attention to midterms.
[ McClatchy/ "Ensuring Coverage for 5 Patients with Pre-Existing Conditions Act" / Image byKelsey Stefanson, open permission for reuse]
ah non expansion red state. i am so sorry. just a quick follow up: i believe there are some folks who qualify for medicaid in non expansion states: those between 100-138% of the FPL (in IL where i am that's like 1000-1387/month). also, we've always been told to apply for medicaid even if you're pretty sure you'll get rejected.
this all makes me so angry.
Thank you very much for the offer. We've looked into it. He doesn't qualify for Obamacare because he doesn't make enough, and he doesn't qualify for Medicaid in Texas because he makes too much, so he's one of those stuck in a gap. On the upside, his condition is chronic, so absent flare-ups we should be able to handle it for a while until, hopefully, some health care solution for folks in his shoes comes through.