Hypocrisy to spare on health care

The Hamilton Spectator - - OPINION -

This ap­peared in the Wash­ing­ton Post:

What a be­trayal: Repub­li­cans prom­ise to main­tain ac­cess to health in­sur­ance for peo­ple with pre-ex­ist­ing med­i­cal con­di­tions, and then press a bill through the House that would elim­i­nate those guar­an­tees.

Care­lessly, the bill would threaten the in­tegrity of even em­ployer-based health-care plans in ev­ery state, ap­par­ently by ac­ci­dent. Reck­lessly, its drafters in­tro­duced just one day be­fore the vote new leg­isla­tive lan­guage that an in­de­pen­dent ex­pert called “in­co­her­ent, ar­bi­trary, and tech­ni­cally com­plex.” Trag­i­cally, the re­peal-and-re­place ef­fort is caus­ing so much un­cer­tainty that, even if this bill dies in the Se­nate, it may un­ravel the ex­ist­ing health-care sys­tem.

There can be no doubt that this leg­is­la­tion would erode pro­tec­tions for peo­ple with pre-ex­ist­ing con­di­tions. States seek­ing to weaken reg­u­la­tions pro­tect­ing vul­ner­a­ble peo­ple would face few le­gal bar­ri­ers. The Brook­ings In­sti­tu­tion’s Matthew Fiedler warns that once these states got fed­eral waivers al­low­ing in­sur­ance com­pa­nies to hike pre­mi­ums on sick peo­ple, many of those with pre-ex­ist­ing con­di­tions would be priced out of any com­pre­hen­sive in­di­vid­ual in­sur­ance mar­ket plan, whether or not they kept cov­er­age con­tin­u­ously to that point. There would be few re­quire­ments on states to of­fer a real back­stop — no man­dates on who or what a high-risk pool must cover, or even that a high-risk pool be cre­ated.

Mean­while, the bill’s sloppy draft­ing means that em­ployer-based health-care plans might be per­mit­ted to im­pose an­nual spend­ing lim­its and life­time cov­er­age lim­its — even if most states at­tempted to keep strong mar­ket pro­tec­tions in place.

And do not for­get that much of the bill is un­changed from March, when the CBO found that it would re­sult in 24 mil­lion fewer peo­ple with health in­sur­ance.

This process be­gan with Repub­li­cans seek­ing to solve a prob­lem that ex­ists only in their imag­i­na­tion, the sup­posed cat­a­strophic fail­ure of Oba­macare. Their so­lu­tion has in­volved half-baked leg­isla­tive lan­guage and mag­i­cal think­ing at ev­ery step.

It is be­yond sad that this is what passes for a “win” for Pres­i­dent Don­ald Trump and the Repub­li­can ma­jor­ity in Congress.

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