Tuesday, November 6, 2018

Republicans Mislead on Pre-existing Conditions


By Edwin Amenta and Drew Halfmann

The GOP celebrates the House vote to Repeal the ACA
In 2017, Republicans almost succeeded in destroying the Affordable Care Act and its protections for people with pre-existing conditions.

But they’d rather you forget all about that. Facing tough re-election, they now are posing as protectors rather destroyers of such protections.

A good example is Orange County Congresswoman Mimi Walters. She voted for the Republican health care bill even though she had pledged many times to preserve protections for pre-existing conditions. She even took joyful selfies at President Trump’s party celebrating the bill. But in a recent Twitter video, she makes her promise again. She shows a photo of a baby covered in wires, her constituent Callan. He was born with a severe congenital heart defect and survived four open heart surgeries. Walters then stares into the camera and vows to protect his access to health care. This pledge is hardly credible. She vowed to protect people with pre-existing conditions before and then went back on her word when it counted.

So why are pre-existing condition protections so important? Because before the ACA was signed into law, insurance companies could avoid patients who might use a lot of costly medical services by refusing to sell them policies or by charging them exorbitant, often unaffordable, rates. And insurance companies defined these conditions broadly to include even common maladies like allergies, acne, or being prescribed an anti-depressant.

That meant a lot of Americans simply didn’t have access to health insurance.

The ACA ended those shady practices. It required insurers to sell insurance to everyone and prohibited them from charging discriminatory rates. The House GOP tried to roll back these protections while dishonestly claiming to preserve them.  

Sure, the Republican health legislation required insurers to sell to everyone, but waivers in the bill meant that they could charge patients according to their health status. Callan’s parents could buy him insurance, but at what cost? Non-partisan analyses found that they and hundreds of thousands like them would not have been able to afford it.

Protecting high-income people with pre-existing conditions is not the same as protecting people with pre-existing conditions.

Under the failed Republican legislation, the Congressional Budget Office estimated that some 23 million people would have lost insurance coverage, all so corporations and the wealthy could get tax cuts. Meanwhile, Republicans leaders now claim that we must cut Medicare to pay for the budget deficits created by their most recent tax cuts (also for corporations and the wealthy).

Republicans continue to tout their support for pre-existing condition protections. Recently, some even sponsored a bill on the matter. But this, too, was dishonest. The bill is merely intended to give vulnerable Republicans cover for their unpopular health care vote. The sponsors know that the GOP leadership will bury the bill and will turn to cutting health care benefits if they retain power. 

Despite their misleading claims, the Republican position on health care is clear. You can have it if you can afford it.  

Edwin Amenta is Professor of Sociology at the University of California, Irvine, where he writes and teaches about social policy. He is the author of  When Movements Matter: The Townsend Plan and the Rise of Social Security. He can be contacted at ea3@uci.edu.

Drew Halfmann is Associate Professor of Sociology at the University of California, Davis, where he writes and teaches about health policy. He is the author of Doctors and Demonstrators: How Political Institutions Shape Abortion Policy in the United States, Britain and Canada.  He can be contacted at dhalfmann@ucdavis.edu.

Monday, July 24, 2017

To defend the ACA, please contact your friends in NV, WV, AK, OH and AZ!

Please contact your friends in Nevada, West Virginia, Alaska, Ohio, and Arizona and ask them to call or write their Senator's health staffer. You can find your friends in those states by typing “friends in [Nevada]” in the Facebook search bar. 
You can tell your friends:
It’s do-or-die time for repeal of the Affordable Care Act. Voting starts tomorrow.
If repeal of the Affordable Care Act passes, 22 million Americans will lose their health insurance and most of us will face higher premiums and/or deductibles (especially if we are old or sick, or will someday get old or sick). 
Please call the health staffers of the following undecided Republican Senators and tell them that you oppose repeal of the ACA. If you have a personal story, that would be great too.
Contact Info
Murkowski (AK), (202) 224-6665, Morgan Griffin, Morgan_Griffin@murkowski.senate.gov
Capito (WV), (202) 224-6472, Dana Richter, dana_richter@capito.senate.gov
Portman (OH), (202) 224-3353, Sarah Schmidt, sarah_schmidt@portman.senate.gov
Heller, (NV), (202) 224-6244, Rachel Green, rachel_green@heller.senate.gov

McCain (AZ), 202-224-2235, David Bennet, david_bennett@mccain.senate.gov
Flake (AZ), 202-224-4521, Helen Heiden, helen_heiden@flake.senate.gov

Friday, April 28, 2017

Loss of protections for people with pre-existing conditions would disproportionately hurt states won by Trump


Before the ACA, insurance companies either denied coverage to people with pre-existing conditions or charged them more than other people for their coverage (this was only true in the individual market, not the employer-provided market). As a result, millions of Americans were unable to find affordable coverage. The ACA outlawed this practice, but the new Republican health care proposal will allow it again in most states. 

Insurers will still be required to cover everyone who can afford coverage, but they will be able to charge any price and decide which treatments to cover. (The new proposal eliminates the ACA's requirement that insurers provide ten "essential health benefits"). This will effectively end protections for people with pre-existing conditions. The Republicans claim that states will be free to choose whether they allow this, but because the the proposal will no longer require healthy people to buy insurance, most states will be forced to reinstate the practice in order to avoid unaffordable increases in insurance premiums for most of their residents. 

Kaiser Family Foundation conducted an analysis in 2016 of the percentage of people in each state who have excludable pre-existing conditions under the pre-ACA rules. I've taken that analysis and broken it down by which candidate won the presidential election in each state. As the table shows, the new rules will disproportionately effect Trump states. Of the 17 states with an above-average percentage of people with excludable conditions, 15 voted for Trump. 

Yesterday, Trump reportedly decided to keep NAFTA because his agriculture and commerce secretaries  brought him a map showing that its elimination would disproportionately hurt Trump country.  How I wish the President read this blog and also that I was better at making maps. 

By the way, GOP cuts and changes to ACA subsidies would also disproportionately hurt voters in Trump counties (mainly rural)

Percent of Non-Elderly Population with Excludable Pre-existing Conditions under pre-ACA insurance Rules* by 2016 Presidential Winner
West Virginia
36%
Trump
Mississippi
34%
Trump
Kentucky
33%
Trump
Alabama
33%
Trump
Arkansas
32%
Trump
Tennessee
32%
Trump
Oklahoma
31%
Trump
Kansas
30%
Trump
Louisiana
30%
Trump
Missouri
30%
Trump
Indiana
30%
Trump
Georgia
29%
Trump
Delaware
29%
Clinton
Maine**
29%
Clinton
South Carolina
28%
Trump
Michigan
28%
Trump
Ohio
28%
Trump
United States
27%



*Gary ClaxtonCynthia Cox, Anthony Damico, Larry Levitt, and Karen Pollitz. 2016. “Pre-existing Conditions and Medical Underwriting in the Individual Insurance Market Prior to the ACA,” Kaiser Family Foundation Issue Brief, Dec 12. <http://kff.org/health-reform/issue-brief/pre-existing-conditions-and-medical-underwriting-in-the-individual-insurance-market-prior-to-the-aca/>


**Clinton received 3 electoral votes in Maine and Trump received 1.