Scalise says GOP bill protects people with pre-existing illnesses; UNO economist weighs in

Whip Steve Scalise says GOP bill protects people with pre-existing illnesses; UNO economist weighs in

NEW ORLEANS, LA (WVUE) - Republican House Majority Whip Steve Scalise said Tuesday that the GOP's proposal for replacing former President Obama's signature law, the Affordable Care Act, would not abandon Americans with ongoing medical conditions.

"Our bill protects people with pre-existing conditions, and it actually provides multiple layers of protection for people with pre-existing conditions in ways that Obamacare doesn't do," said Scalise, R-Metairie.

President Donald Trump has said that the law is on life support and will collapse under its own weight.

"Republicans are complaining that Obamacare is broken because the premiums are going up. The premiums are going up for one reason and that's the pre-existing conditions," said Dr. Walter Lane, a University of New Orleans health care economist.

Under the GOP's proposal, states would be allowed to get permission from the federal government for insurance companies to charge people with pre-existing illnesses higher premiums. Having continuous health coverage is a big part of the equation.

"Even if that state requests a waiver and gets a waiver, a continuous coverage is still the law of the land and can't be waived for people with pre-existing conditions. On top of that, in the state's waiver they actually have to lay out how they're going to protect people with pre-existing conditions, and they have to show that they have a high risk pool to protect people with pre-existing conditionss, so all of those layers are in place to protect people with pre-existing conditions in our bill which focuses on reducing costs while protecting people with pre-existing conditions," said Scalise.

"They're saying if you get insurance while you're healthy, you keep continuous coverage, then if you get a condition then we can't raise the premium, but if you drop coverage then you could still get insurance, but we could put you into high-risk pools in which you might pay higher premiums, at least for the first use," Dr. Lane said.

Under the ACA, insurance companies cannot discriminate against people with existing illnesses and there is a mandate that most Americans have coverage or face a tax penalty.

Dr. Lane thinks the GOP's "continuous coverage" idea might serve as a better carrot to people reluctant to obey the present law and buy coverage.

"This idea of, well, if you get sick you have to buy in at a higher price, the sick people price, then that threat is to try to get them in. Will that work or not is unclear. The individual mandate didn't work very well, obviously that's why we're having some problems," said Lane.

And Dr. Lane said before the Affordable Care Act, people who developed serious medical conditions and then tried to shop for insurance for just out of luck.

"No, no. These people just got sick and they died," he said.

A spokesman for Blue Cross Blue Shield of Louisiana, which dominates the individual market in the state, issued a statement:

"It is premature to comment on shifting proposals that may or may not be enacted and signed into law. We will stay engaged with our Congressional representatives and others as the healthcare debate progresses so that we can best advocate for our customers. What's important now and in the future that we all act to improve the individual marketplace so people can maintain coverage and get the care they need at a price they afford."

Jeff Drozda, of the Louisiana Association of Health Plans, said they did not have a comment at this time.

Dr. Lane said bringing down premiums is tied to enlarging the pool of insured people with more that are healthy.

"The people that came in with pre-existing conditions were sicker than they thought they were, and they were getting much more expensive healthcare than we thought they were. That's exactly the problem that's breaking the market, it's that issue and I don't see that the Republicans have a solution to that."

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