The Atlanta Journal-Constitution
White House presses for vote on health bill
Trump: Pre-existing medical conditions must be covered.
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 as well as the American Medical Association. “Pre-existing conditions are in the bill,” the president said on CBS’ “Face the Nation” on Sunday. “And I mandate it. I said has to be.”
On Twitter, he promised that 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 or a reinsurance program to provide or subsidize coverage for people with serious illnesses.
But such high-risk pools did not always work well before the health care law’s outright ban on discriminating against people with pre-existing conditions took effect.
Trump appeared to be unfamiliar with details of the amendment that would allow states to obtain a waiver permitting 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, 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. Rep. Chris Collins, R-N.Y., a top Trump ally, said Republicans were not planning to seek a new cost-and-impact estimate from the Congressional Budget Office.
White House officials expressed confidence on Monday that they were nearing success, at least in the House. “Do we have the votes for health care? I think we do,” Gary Cohn, director of the White House National Economic Council, said in an interview with “CBS This Morning.” “We’re going to get health care down to the floor of the House,” he added. “We’re convinced we’ve got the votes and we’re going to keep moving on with our agenda.”