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Republican U.S. senators (from left) Bill Cassidy of Louisiana, Dean Heller of Nevada, Lindsey Graham of South Carolina and Ron Johnson of Wisconsin are co-sponsoring the latest GOP alternative to Obamacare. (Andrew Harnik/Associated Press)

Republican U.S. senators (from left) Bill Cassidy of Louisiana, Dean Heller of Nevada, Lindsey Graham of South Carolina and Ron Johnson of Wisconsin are co-sponsoring the latest GOP alternative to Obamacare. (Andrew Harnik/Associated Press)

Republican U.Due south. senators (from left) Bill Cassidy of Louisiana, Dean Heller of Nevada, Lindsey Graham of South Carolina and Ron Johnson of Wisconsin are co-sponsoring the latest GOP alternative to Obamacare. (Andrew Harnik/Associated Press)

Graham-Cassidy, the GOP alternative to Obamacare, weakens protections for pre-existing atmospheric condition

How the latest GOP culling to Obamacare would treat pre-existing conditions is a question repeatedly put to U.South. Sen. Ron Johnson, the Wisconsin Republican who is one of the lead co-sponsors of the neb.

On Sept. 20, 2022 -- 10 days before a deadline to pass the measure with a simple bulk -- there was this exchange between Johnson and Chuck Todd, host of MSNBC'southward "MTP Daily" talk show:

Todd: "And then, you contend that this bill will protect those folks with pre-existing conditions -- period."

Johnson: "Every flake as well as Obamacare did. And it's besides going to protect the individuals that can't afford Obamacare right at present."

The protections are a major point of contention. The Affordable Care Act makes it illegal for insurers to deny coverage to people who have pre-existing wellness conditions, such as asthma, diabetes or cancer, or accuse them higher rates.

Just under the Johnson-sponsored plan, waivers that would give states new flexibility erode protections for pre-existing atmospheric condition.

"The but manner people (with pre-existing conditions) are protected is if every state in the nation looks at this and says, 'We're not going to do that,'" said Karen Pollitz, a health reform and private insurance expert at the nonprofit Kaiser Family Foundation. "This lets states accept abroad your protections."

The beak

The neb, introduced a week before Johnson's interview, is known every bit the Graham-Cassidy-Heller-Johnson bill (or its shorter moniker, Graham-Cassidy). That's for the GOP senators co-sponsoring the measure: Lindsey Graham of South Carolina, Neb Cassidy of Louisiana, Dean Heller of Nevada and Johnson.

Under Senate rules, the nib could be canonical with 51 votes (50 senators plus a tie-breaking vote by Vice President Mike Pence) if information technology is adopted by Sept. thirty, 2017. After that, Republicans, who concur 52 seats, would need threescore votes, which seems an impossibility.

(On Sept. 22, 2017, with viii days left before the deadline, Arizona's John McCain said he would join two other Senate Republicans who accept indicated they would not vote for the bill, potentially dooming its chances.)

The neb and pre-existing conditions got heavy attention after tardily-night Goggle box host Jimmy Kimmel, whose infant son was born with a built heart disease, attacked it on his show the night before Johnson'south interview.

(Johnson has also noted in defending the bill that his adult girl was born with a pre-existing condition.)

How information technology treats pre-existing conditions

The bill keeps the Affordable Care Act prohibition on insurers denying coverage to people with pre-existing conditions.

But states could obtain waivers that would enable them to opt out of other ACA provisions that protect those people.

The upshot: States could allow insurance companies to charge people with pre-existing conditions more than they charge healthy people; and the insurers could offering policies that offer less than the "essential benefits" that are now mandated.

PolitiFact National rated Mostly Fake a claim past President Donald Trump that the neb includes "coverage of pre-existing conditions," finding that:

  • If a country merely says it "intends to maintain access to acceptable and affordable health insurance coverage for individuals with pre-existing weather," so it can allow insurance companies to charge sick people more than healthy ones. The federal government could withhold money granted to a state nether a waiver if the state doesn't exercise as it promised, but the words "adequate" and "affordable" are open to interpretation.

  • Policies would not have to provide the same level of coverage at present mandated under Obamacare.

  • Estimates say about 34 states would see internet funding cuts under the bill. It costs coin to encompass people with known health conditions, and virtually states would accept less of it.

Johnson'due south claim goes further than Trump's, saying the neb's pre-existing protections are as good as Obamacare'southward.

But in reviewing the GOP neb, the political news website Axios arrived at like findings:

  • The funding cuts "could pressure states to waive protections for sick people every bit a way to keep premium increases in bank check. Older, sicker people in every state could stop up paying more equally states effort to brand upwards for a funding shortfall."

  • States could become a waiver to let insurers charge ill people more than healthy people.

  • A waiver would exempt insurers from the current requirement to provide "essential wellness benefits," including prescription drugs -- and so, people who need expensive drugs might have to pay out of pocket.

And Pollitz told u.s.a. that states could also allow insurance companies to:

  • Charge lower premiums to people while they're healthy, just and then raise the rates at renewal time if, for example, they get cancer.

  • Charge higher premiums based on a person'south location or occupation, practices that are outlawed under Obamacare.

Information from the nib'southward sponsors say it would protect people with pre-existing weather condition, but doesn't provide details.

Patrick McIlheran, a Johnson spokesman, told us the bill gives states the flexibility to attempt "new approaches to keeping insurance for those with pre-existing weather condition affordable."

Earlier we close, it'south worth noting:

Writing about the bill in the conservative National Review, Michael Tanner, a senior fellow at the libertarian Cato Establish, made i reference to pre-existing conditions, saying:

On the positive side, supporters of the legislation correctly point out that it would give the states far more flexibility with the funds they receive, and would allow them to waive many of Obamacare's more than onerous regulations, including the mandate to buy coverage, mandated benefits and pre-existing-condition coverage requirements. Those are the regulations most responsible for driving up premiums and destabilizing insurance markets.

Our rating

Johnson said the GOP health bill he is co-sponsoring volition protect people with pre-existing atmospheric condition "as also every bit Obamacare did."

The beak would keep the Affordable Care Act's prohibition on denying coverage to people with pre-existing health weather. But states could obtain waivers that would allow insurers -- unlike under Obamacare -- to charge people with pre-existing conditions premiums and provide them lesser benefits.

We rate Johnson'southward statement False.

MSNBC, Ron Johnson interview (10:00), Sept. twenty, 2017

E-mail, Ron Johnson spokesman Patrick McIlheran, Sept. 22, 2017

PBS Newshour, "What's in the new GOP health care neb, in one (simple) chart," Sept. 19, 2017

PolitiFact National, "Trump's misleading merits on pre-existing protections in Graham-Cassidy," Sept. 21, 2017

Sen. Lindsey Graham, "Graham-Cassidy-Heller-Johnson Background and Endorsements," Sept. 15, 2017

PolitiFact National, "Fact-checking Jimmy Kimmel'due south reaction to the Graham-Cassidy bill," Sept. 20, 2017

Interview, Kaiser Family Foundation health reform and private insurance senior swain Karen Pollitz, Sept. 21, 2017

Washington Mail, "How many with preexisting conditions would be priced out of coverage under Cassidy-Graham?" Sept. 21, 2017

CNN/Money, "Trump says GOP'southward health bill protects pre-existing conditions. Here's the truth," Sept. 21, 2017

National Review, "The Graham-Cassidy Conundrum," Sept. 21, 2017

Fortune, "How the Graham-Cassidy Obamacare Repeal Bill Fails the 'Jimmy Kimmel Exam' for Pre-Existing Conditions," Sept. 19, 2017

Associated Press, "Winners and losers in GOP's terminal-ditch wellness overhaul," Sept. 19, 2017

USA Today, "What would the Graham-Cassidy health care neb mean for you?" Sept. 21, 2017

National Review, "Graham-Cassidy Is a Likewise-Mild Comeback on Obamacare," Sept. 20, 2017

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