Collins points to an underappreciated flaw in the GOP health plan

Ebony Scott
July 17, 2017

But, tellingly, Republicans nearly never speak explicitly about getting rid of pre-existing condition protections.

GOP leaders might want to think that over, added Holtz-Eakin.

The provision - a version of the Consumer Freedom Option pushed by Texas Senator Ted Cruz - would give insurers more flexibility in the plans they offer in the individual market.

On the other hand, the new bill doesn't include quite as many tax cuts for the wealthy.

What's particularly puzzling about the Cruz-Lee plan though, is that it is likely to actually worsen the biggest problem the GOP has had when it comes to rallying support for its ACA replacement proposals: the number of people with insurance coverage.

The provision would let insurers sell low-priced policies with skimpy coverage, as long as they also sell policies that meet a stringent list of services they're required to provide under Obama's law, like mental health counseling and prescription drugs. They could offer skimpier policies that don't offer maternity, mental health and prescription drugs. "People who need (comprehensive) benefits go to those policies, which become more expensive".

One would be the current Obamacare plans that are sold on government-run marketplaces, which would cost more than other plans, but would tend to disproportionately attract sicker customers who needed the guaranteed benefits.

Indeed, the same bias is evident in CNN's previous reporting on the health care bills, heavily favoring the ACA over Republican amendments. Two major lobbying groups said Friday that it would make coverage unaffordable for those who are sick.

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But critics including the insurance industry say it would split the sick and the healthy, leading to unsustainably high premiums for people with medical problems and pre-existing conditions, who may get priced out of the market unless taxpayers bail them out.

The Affordable Care Act (Obamacare) is like vehicle insurance in which riskier drivers are subsidized by safer motorists - and that's why it has to be repealed and replaced, Sen.

Cruz, who is attempting to morph from the most hated man in the Senate into a conservative dealmaker, is very pleased with this development. (It also bulks up the market stabilization fund that was already in the legislation by an additional $70 billion, which should help keep a lid on premiums.) Beyond that, the market probably won't divide entirely into two tiers.

On Thursday, when the latest draft of the BCRA was released, it appeared to many as though the addition of the modified Cruz-Lee amendment would be enough to sway both Cruz and Lee, but Lee quickly announced that he wasn't almost as sold as Cruz.

But to reduce federal health care costs, the Republican bill reduces the subsidies, requiring individuals to pay a higher share of their income for premiums as well as higher deductibles.

AHIP's cautious opposition was not enough to sink the House-passed version of the bill to repeal and replace the ACA, but the group's skepticism may hold more weight with senators, who are awaiting the Congressional Budget Office's cost estimate of the market impact of Cruz's amendment.

These changes have concerned moderate Republican lawmakers and governors, as well as health care providers and consumer advocates. In 2009, during the Great Recession, Consumer Reports noted that an estimated 14,000 people a day were losing employer-based health insurance.

For the most part, Garthwaite said, the revisions of the bill appeared to target individual senators, such as the Cruz amendment.

Other reports by GizPress

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