Bill aims to protect pre-existing conditions
If Congress or the Supreme Court kills the Affordable Care Act, one of the act’s key provisions — that people with pre-existing conditions have access to health insurance — could be preserved for Florida consumers under a bill advanced by a state Senate committee Tuesday.
How beneficial that access would be without cost controls is not yet known.
On the national level, Republicans have been trying to repeal or gut protections in the ACA, know as Obamacare, since it was enacted by then-President Barack Obama in 2010 without any Republican support.
Under President Donald Trump, the law has been weakened a piece at a time: A requirement that everyone buy insurance or pay a tax penalty has been eliminated beginning in 2020. Trump stopped payment of cost-sharing reductions to health insurers in 2017. And in December, the entire law was ruled unconstitutional by a federal judge in Texas.
The latter ruling is under appeal, but proponents continue to worry whether the law can survive opposition by the GOP, which controls the U.S. Senate and presidency, and the conservative majority on the Supreme Court.
Florida has the largest enrollment of the 39 states that rely on the federal marketplace. During the most recent open enrollment period from Nov. 1 to Dec. 22, more than 1.78 million Floridians registered. That exceeded the 2018 total of 1.76 million and the 2017 total of 1.71 million.
The bill by Sen. Wilton Simpson, a Republican from Spring Hill, was advanced by a 6-1 vote, with support from two of four Republicans and all four Democrats on the committee. Sen. Jeff Brandes, Republican from St. Petersburg, voted against it, and Sen. Joe Gruters, a Republican from Sarasota, was absent.
Committee Chairman Doug Broxson, a Republican whose Senate district is in the western panhandle, called the protection “the right thing for Florida to do.”
“In the event of a catastrophic event in Washington that we would step up and provide some — may not be the best, may not be perfect — but at least we’re saying we’re not going to leave those people vacant with no possibilities of coverage.”
But others on the committee questioned why the bill did not address the cost of premiums for the one policy covering pre-existing conditions.
Simpson said “rules restrictions” could be later.
Sen. Tom Lee, R- Brandon, suggested Simpson “might want to think about it as it goes along to make sure that we’re writing this thing in a way that will ensure that what you’re actually trying to achieve, the companies will have to do.”
The bill still faces additional Senate committees, a full Senate vote, negotiations and addressed with the House if that chamber passes a similar bill, and scrutiny by the governor.
Without cost restrictions, any policy required by the bill would likely become an unaffordable repository for everyone with pre-exisitng conditions, said Karen Pollitz, senior fellow at the Kaiser Family Foundation, which closely monitors health insurance trends across the nation. That’s what happened in the late 1990s, when Congress mandated coverage for pre-existing conditions without cost controls or subsidies, she said.
Jodi Ray, who oversees Florida outreach during open enrollment for the Affordable Care Act, said she didn’t know much about the bill but was concerned that its definition of “pre-existing medical condition” might be too limiting.
The bill defines the term as an existing pregnancy or “a condition that, during the 24-month period immediately preceding the effective date of coverage, manifested itself is such a manner as to cause an ordinary prudent person to seek medical advice, diagnosis, care, or treatment or which for which medical advice, diagnosis,care, or treatment was recommended or received.”
Under the ACA, a preexisting condition is simply “a health problem you had before the date that new health coverage starts,” according to the Department of Health and Human Services’ website.