Our Pledge To You

News

Cold-hearted Obamacare replacement is bad medicine

Laurel Smith, 56, of Medford, N.J., attends a protest outside the office of Rep. Tom MacArthur of R-NJ., in Marlton, N.J., last week. She says she's concerned that repeal of the Affordable Care Act could affect health insurance coverage for her son, 26-year-old son, Jamieson Smith, who has a rare sickness called mitochondrial disease. (AP Photo/Mike Catalini)

Let’s read the prescription label on a new American health insurance program, a replacement for Obamacare, that Republican leaders say will be voted on Thursday in the U.S. House.

Here’s one warning on the label: “Provides reduced protection for pre-existing conditions.”

EDITORIAL

That’s surprising. Just on Monday, President Donald Trump said the Republican health care bill would protect people with pre-existing medical conditions.

But this bill makes it possible for insurance companies to charge a person with a pre-existing illness a premium so high that the insurance is unaffordable if the person’s coverage has lapsed, just as insurers did in the days before the Affordable Care Act.

A pot of money would be set aside so states could set up “high-risk” pools for sick people who couldn’t afford insurance otherwise, but it would not be enough. For Illinois, the shortfall would be $575 million a year, according to the Center on American Progress. Can you imagine Illinois — a state that can’t pay its bills for public universities or social services — coming up with that kind of money, year after year?

The change that persuaded Reps. Fred Upton, R-Mich., and Billy Long, R-Mo., to support the bill would add $1.6 billion a year for the high-risk pools. That won’t go far.

On Monday night, talk show host Jimmy Kimmel choked up as he revealed his newborn son had a congenital heart condition. Not long ago, as Kimmel pointed out, his son might have been instantly categorized as someone who could never get health insurance because of a pre-existing condition.

More than a quarter of American adults under age 65 have a pre-existing medical condition.

Maybe Trump didn’t read this part of the label.

Let’s keep reading. The label’s fine print also warns: “Reduces funding for Medicaid.”

The bill would cut $880 billion for Medicaid. States could make up the difference, of course — the same states that would have to come up with hundreds of millions of dollars for high-risk pools. More likely, though, lots of people now getting Medicaid would lose their health insurance.

Also on the label: “Removes ‘essential benefits.’ ”

Before the ACA, people who thought they were covered for serious illnesses learned too late that their insurance policies had huge gaps. It wasn’t their fault. Even medical professionals struggled to figure out how much protection complicated policies provided. The requirement of coverage for 10 essential benefits put a stop to that.

The bill also would eliminate fines for people who don’t buy insurance. It would axe federal subsidies for people who can’t afford the premiums. Also, states could allow sick and older people to be charged higher premiums. All that will lead to more people dropping out of the health insurance system.

And we see this: “This part of the label intentionally left blank.”

If lawmakers vote now, they will be doing so without a Congressional Budget Office score that tells them how much this bill will cost and how many people will lose their insurance. When sizing up the GOP’s previous Obamacare replacement plan, the CBO said 24 million people would lose their insurance.

But Speaker Paul Ryan says he is confident he has the votes.

If this bad bill does pass in the House, a good deal of arm-twisting could get it through the Senate, and Trump, so eager to claim a win, would gleefully sign it. He might not understand it, but he would sign it.

And there’s not a label big enough to spell out all the health care disasters sure to follow.

Send letters to letters@suntimes.com.