Health care claim passes checkup

Like Democrat Tammy Baldwin against Republican Leah Vukmir in the U.S. Senate race, Tony Evers has been hitting Scott Walker on pre-existing medical conditions in the governor’s race.

Baldwin, the incumbent senator, claimed Vukmir supports letting insurance companies “deny coverage to people with pre-existing conditions.” Our rating was Half True.

Meanwhile, Evers, the Democratic nominee for governor, has made similar attacks on Walker, the two-term incumbent, ahead of the Nov. 6 election.

One attack comes in a video posted Oct. 10 in which Evers claims Walker supports “a health care plan that would gut protections for pre-existing conditions.”

Let’s see what plan Evers is referring to.

Repealing Obamacare

As we noted in the Baldwin fact check, at issue here is the Affordable Care Act (Obamacare) and its prohibition on insurers denying coverage to people with pre-existing conditions. Under the federal law, if you don’t have health insurance from an employer or the government, you have guaranteed access to insurance in the individual market, regardless of your health, and you can’t be charged higher rates for a pre-existing condition.

That blanket protection is something that is threatened by Republican efforts to repeal the law, and Walker supports repeal. For example, he backed the socalled Graham-Cassidy repeal bill, saying: “I think it’s awesome. … It’s a winner all the way around.”

News reports said that under the bill, states could have allowed for waivers to

let insurers charge sick patients higher premiums and stop covering certain benefits required under the Affordable Care Act; and that states could obtain waivers to permit insurers to charge different premiums based on health status, age or other factors.

PolitiFact National, noting that Democrats across the country are attacking Republicans over pre-existing conditions, has reported that Republican proposals are not as air tight as Obamacare when it comes to pre-existing conditions. Graham-Cassidy would have allowed insurers to sell bare-bones plans with low premiums that would be attractive to healthy people, while plans that provide the coverage that sicker people need would be very expensive, our colleagues reported.

So, repeal of Obamacare — and its protections for pre-existing conditions — is one plan Walker supports. But there’s another.

Walker also backed a lawsuit brought by Wisconsin and 19 other states that a New York Times news story said could eviscerate major parts of the Affordable Care Act and allow insurers to again deny people coverage because of their medical condition or history.

So, Walker supports two plans, or initiatives, that would result in eliminating blanket protections for people with preexisting conditions.

To be clear, Walker hasn’t said people with pre-existing conditions shouldn’t be covered. But he hasn’t spelled out an alternative that would provide protections that Obamacare does.

Walker’s response

Walker has repeatedly promised to cover people with pre-existing conditions and has pledged to pass legislation to guarantee them coverage.

For example, he called for such a law in his 2018 “state of the state” speech in January. And in September, he said he would call a special session of the Legislature to adopt that measure if the Affordable Care Act were blocked.

The prospects for such a bill passing, however, are unclear.

Moreover, Walker has provided few details on what he has in mind, raising questions about how people with preexisting conditions would be covered.

The Milwaukee Journal Sentinel examined what would happen to people in Wisconsin with pre-existing conditions if Obamacare were overturned.

In short, the fates of some them are uncertain. The Affordable Care Act requires insurers to cover specific health benefits, including prescription drugs for almost every medical condition. So, without a similar requirement in state law, insurers could sidestep any requirement that they cover pre-existing health conditions. They could do this by not including some services or costly drugs in a health plan’s benefits.

It’s also worth noting that before Obamacare, Wisconsin’s high-risk pool was held up as something as a model on pre-existing conditions, at least for the people it covered.

But it worked only for people who could afford the insurance in the first place — and many people with pre-existing conditions could not afford coverage from the high-risk pool, as it covered fewer than 25,000 people. An estimated 852,000 people in Wisconsin have a health condition that would have led to being denied coverage in the market for health insurance sold directly to individuals and families before the Affordable Care Act.

Our rating

Evers says Walker supports “a health care plan that would gut protections for pre-existing conditions.”

Walker has supported two efforts that would result in elimination of blanket protections for pre-existing conditions: Legislation to repeal the Affordable Care Act and a lawsuit that would block it. The law provides a variety of protections to people with pre-existing medical conditions — including prohibiting insurers from denying coverage to those people and prohibiting them from charging those people higher rates. So, getting rid of Obamacare would eliminate those protections.

Walker has pledged that if Obamacare is repealed, he would seek legislation to guarantee coverage to people with pre-existing conditions. But it’s not clear how that legislation would compare to Obamacare and not clear if it could pass the Legislature.

For a statement that is accurate but needs clarification, our rating is Mostly True.