FACT CHECK: Flake on Coverage for Pre-Existing Conditions

On the Senate floor yesterday, Senator Flake claimed that he wanted to “make sure that those with pre-existing conditions have access to affordable care.” The problem? Flake has supported every iteration of the Republican health care agenda that would gut coverage for pre-existing conditions.

Take a look at how the various versions of the Republican health care bill, all of which were endorsed by Flake, failed to protect coverage for pre-existing conditions:

TPM: TIMELINE: How Republicans Broke Their Promise on Preexisting Conditions

By Tierney Sneed

September 26, 2017

  • March 6: Ryan introduces the long-awaited House repeal bill, the American Health Care Act, which he says in a statement protects ‘patients with preexisting conditions.’ The bill does maintain ACA’s various insurer regulations, including guaranteed issue (which bans insurers from denying coverage based on preexisting conditions) and community ratings (which prohibits insurers for raising jacking up premiums based one’s health status). The tweaks it makes to other aspects of Obamacare, however, mean thatconsumers facing expensive conditions are likely to pay more out of pocket than under current law.”

  • March 22: The House Freedom Caucus get a major concession when Republican leaders signal that they’re willing to gut Obamacare’s Essential Health Benefits. Though technically, the ACA’s preexisting conditions will remain, nixing EHBs would mean that insurers could sell plans that don’t offer the 10 specific coverage areas mandated by Obamacare, including maternity and additional services. Eliminating EHBs also would raise out-of-pocket costs by bringing back lifetime and annual caps, and experts suggest those repercussions could apply to those on employer plans as well.”

  • April: …By late April, a House moderate and a Freedom Caucus leader say they’ve struck a deal that would allow states to waive out of certain ACA insurer mandates, including EHBs as well as community ratings, meaning the insurers would be able to charge more based on health status. Despite many health experts pointing out that allowing states to waive community ratings could cause sick people to be priced out of affording insurance, House Republicans still claim they’re protecting preexisting conditions.”

  • May 3: To address concerns that sick people will be unable to afford health insurance under the revised GOP plan, Rep. Fred Upton (R-MI) sponsors an amendment providing more funding for high-risk pools and other programs. The amendment is vaguely written with an arbitrary amount of funding well short of what it would cost to fund a national high risk pool. Nonetheless, it’s enough to pass the bill narrowly out of the House the next day.”

  • May 4: The House bill passes, and the Senate GOP immediately begins distancing itself from it by arguing that they’re starting from scratch and that their bill will do better on preexisting conditions.”

  • May 9: Sen. Bill Cassidy (R-LA) appears on Jimmy Kimmel Live! to talk about what he has dubbed the ‘Jimmy Kimmel test,’ after Kimmel’s account of his young son’s heart condition goes viral. That test includes taking ‘care of preexisting conditions,’ Cassidy says.”

  • June 22, 2017: McConnell formally introduces the Better Care Reconciliation Act. On its face, the state waivers that roiled the House negotiations appear to have been abandoned. However, the bill aggressively expands the ACA’s existing waiver structure, so that states can use that avenue to opt out of a bevy of ACA insurer mandates. Community ratings remain intact and not available for a waiver, but health experts argue that nonetheless the waiver provision is loose enough for sick people to face higher premiums. Senate conservatives revolt against the bill.”

  • June 30: The American Academy of Actuaries say that BCRA ‘could erode preexisting condition protections.’”

  • Early July: To win back conservatives’ support, Sen. Ted Cruz (R-TX) proposes his ‘Consumer Freedom Option’ which would allow insurers to sell unregulated plans if they also offer ACA-complaint options. Other Republicans warn the idea may be an end-run around preexisting conditions protections.”

  • July 14: …Insurers pen a letter to congressional leaders claiming just the opposite — that the Senate bill, coupled with the Cruz proposal, would “undermine protections for those with preexisting medical conditions.’”

  • July 25: A revised repeal bill with the Cruz amendment and more funding for moderates fails spectacularly in a floor vote that was largely symbolic, because the legislation needed 60 votes to pass. A vote to keep repeal alive with a ‘skinny repeal’ also fails later that week.”

  • September 13: Cassidy and Sen. Lindsey Graham (R-SC) formally unveil their last-ditch repeal bill. The bill allows states to waive out of preexisting condition protections, and requires only that a waiver-seeking state show how it ‘intends to maintain access to adequate and affordable health insurance coverage for individuals with preexisting conditions.’”

  • September 24: A revised version of the Cassidy-Graham bill is rolled out. States no longer have to apply for waivers to rewrite ACA regulations, but some of the insurer mandates — including community ratings — must stay intact. However, another provision allows states to permit multiple risk pools— a system where sick people would still likely see their premiums increase.”

  • September 25: The CBO releases a preliminary report that makes clear the vulnerabilities those with preexisting conditions face under the Graham-Cassidy bill. Either they’ll live in a state that keeps the regs that protect them, with a possible death spiral prompting insurers to leave the marketplace. Or states will modify those regs, at the risk of making coverage more expensive for those with preexisting conditions.”

See Senator Flake's floor speach here.

Read the full article here.