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Preexisting condition


Senators Ted Cruz and Mike Lee, unhappy that the Senate's repeal of the Affordable Care Act isn't quite cruel enough, are quietly pushing a nifty new proposal that would make everyone happy by gutting the ACA even more than the current bill while pretending to partly preserve Obamacare, at least on paper. Their brainchild is called the "Consumer Freedom Act," and would essentially require that every state's exchange for individual healthcare plans carry two types of plans: one that includes all of the ACA's essential health benefits and protections for patients with preexisting conditions, and another tier of plans exempt from those requirements, with very low rates and no real coverage, and also no subsidies. Everyone would be happy that way!

Needless to say, rightwingers who want to strangle the ACA once and for all are over the moon with this beautiful example of consumer choice:

“We’re very proud to see these folks leading the way toward real repeal,” said Ken Cuccinelli, president of the Senate Conservatives Fund.

Besides, it would be very popular with House Republicans, who also want to gut the ACA's protections for preexisting conditions, since it's only fair that people pay more when they make poor life choices, like getting old, getting sick, or being born with expensive medical conditions. Lee is very enthusiastic about how the proposal would fulfill Republicans' promise to kill off Obamacare, since it kept getting them elected:

We campaigned on repealing Obamacare for eight years. At a bare minimum we should allow those Americans who want to opt out of Obamacare to do so[.]

It's nice to see Mike Lee is suddenly an advocate for choice. At least some choices.

Except of course that's not how "insurance" works -- in practice, while lots of young, healthy people might sign up for the minimal plans, that would also leave the real insurance only appealing to older people with preexisting conditions, leading to an imbalanced risk pool and exactly the sort of "death spiral" Republicans have been falsely claiming Obamacare faces. It's even possible there are enough Republicans in the Senate who know how insurance markets work that Cruz and Lee's brilliant idea could get more laughs than votes:

“What that will do is allow insurers to offer cheap policy to young invincibles. And on the exchange you’re going to get all the sick people,” said Douglas Holtz-Eakin, a former Congressional Budget Office director and president of the American Action Forum. “That’s a recipe for a meltdown. You’ve split the risk pool into two exchanges.”

And, he added: “I think it would end up being bad politics.”

Bad politics? Hmmm, in that case, sign up the wingnuts! It has "freedom" in the name, so it's gotta be good. Politico says that before the Senate bugged out for the 4th of July recess, Cruz and Lee met with Majority Leader Mitch McConnell's staff to pitch the idea; while "Republican insiders" predict the prospect of eliminating the ACA's protections would likely lose more votes among "moderates" than it gains among hardliners, the thing still has enough support that it will be sent to the Congressional Budget Office for a score, just to see what might happen to premiums, deductibles, and the number of uninsured people. Axios reports that Republicans are asking for CBO scores of two versions of the current draft bill, one with Cruz and Lee's amendment and one without.

The White House may be receptive to the Cruz/Lee proposal, too. On "Fox News Sunday," White House legislative affairs director Marc Short said, "We hope it's part of the process of bringing everybody together," although at this point, the Trumplings would support any proposal that could get 50 votes in the Senate regardless of how it affected people with preexisting conditions or the insurance markets. To get White House buy-in, perhaps Cruz and Lee could add a provision stripping health insurance coverage from all employees of CNN -- then Trump might at least notice it.

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[Politico / Axios / https://www.axios.com/wh-official-endorses-cruz-lee-health-care-efforts-2451992308.html]

Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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