States could get power to reshape Obama health law

WASHINGTON — The Trump administration Monday took new steps to broaden the availability of health plans that don’t have to cover patients’ pre-existing medical conditions, signaling that the federal government would support state proposals to promote more sales of these skimpier plans.

Administration officials billed the move as a way to give more choices to consumers who are struggling with expensive health insurance.

“Now states will have a clearer sense of how they can take the lead on making available more insurance options,” said Health and Human Services Secretary Alex Azar, who has championed a host of efforts to loosen health insurance regulations established through the Affordable Care Act.

But the latest administration proposal to weaken insurance standards comes as President Donald Trump and Republican congressional candidates are intensifying their bid to convince voters that the GOP backs patient protections in the 2010 law, often called Obamacare.

And with just two weeks until the midterm elections, GOP lawmakers who voted repeatedly last year to roll back the health care law and its protections are insisting they will preserve pre-existing-conditions rules.

The new proposal from the Department of Health and Human Services and the Treasury Department would not explicitly scrap the law’s protections, which bar health plans from denying coverage to people with pre-existing medical conditions.

But the administration plan would dramatically reshape rules established by the 2010 law that were designed to prevent states from weakening these protections.

“Republicans failed at repealing and replacing the ACA last year, but this new guidance gives states the flexibility to do much of it themselves,” said Larry Levitt, senior vice president at the nonprofit Kaiser Family Foundation, which studies health insurance markets.

Under current law, states may apply to the federal government for permission to redesign their insurance markets and keep federal health care aid as long as the redesign does not decrease the number of people with comprehensive health coverage.

The new plan would support state proposals that could shift people out of comprehensive health plans into skimpier plans that don’t cover as many benefits and could deny coverage for pre-existing medical conditions as long as a state’s residents still have access to a more comprehensive plan.

“This guidance focuses on the availability of comprehensive and affordable coverage,” the administration notes in the proposal. “This … ensures that state residents who wish to retain coverage similar to that provided under the [ACA] can continue to do so, while permitting a state plan to also provide access to other options that may be better suited to consumer needs and more attractive to many individuals.”