Trump pushes for health care vote this week
New bill’s effects on consumers largely unknown
WASHINGTON — After two false starts on President Donald Trump’s promise to repeal the health care law, Trump administration officials are pressing the House to vote on a revised version of the Republican repeal bill this week, perhaps as soon as Wednesday, administration officials said.
And Trump insisted that the Republican health legislation would not allow discrimination against people with pre-existing medical conditions, an assertion contradicted by numerous health policy experts and the American Medical Association.
“Pre-existing-conditions are in the bill,” Trump said on CBS’ “Face the Nation” on Sunday. “And I mandate it. I said it has to be.” On Twitter, he vowed a new health care plan was “on its way.”
It will, he added on Twitter, “have much lower premiums & deductibles while at the same time taking care of pre-existing conditions!”
Which bill Trump was referring to is not clear. Since the first version of the American Health Care Act failed to win enough House support on March 24, revisions to win over the conservative House Freedom Caucus have undermined protections for the sick. The conservatives finally endorsed the legislation last week after House leaders revised it to permit states to opt out of several mandates in the health care law.
States could, for example, allow insurers to provide a more limited package of health benefits than the health care law requires. With a waiver, states could also allow insurers to charge higher premiums to people with pre-existing conditions, if states had an alternative mechanism such as a highrisk pool.
But such high-risk pools did not always work well before the health care law banned discriminating against people with preexisting conditions.
Trump appeared to be unfamiliar with details of the amendment that could allow insurers to charge higher premiums based on a person’s “health status.”
Nor did he explain how the Republicans’ new health plan would produce “much lower premiums.” In its analysis of the last version of the repeal bill, the nonpartisan Congressional Budget Office said that average premiums in 2018 and 2019 “would be 15 percent to 20 percent higher under the legislation than under current law.” By 2026, it said, average premiums would be roughly 10 percent lower than under current law.
How the revisions might affect those figures — or the estimated 24 million more Americans who would lack insurance under the original bill after 10 years — may not be known when the House votes on the new version. The GOP will not seek a cost-and-impact estimate from the CBO.