April 22, 2019/Press

The Protect Act Offers “Political Cover” For Vulnerable Senator Tillis But Little for People with Preexisting Conditions

Raleigh – Senator Thom Tillis, worried that North Carolinians will remember his long record pushing policies that would gut preexisting conditions, introduced The Protect Act to solve an issue the Trump Administration created. Since then, national editorial boards have panned the bill as a “false promise” while analysts described how it “would do little to protect people with pre-existing conditions.”

Now, a new report summarizes the bill’s many problems, laying bare how it’s “political cover” for vulnerable senators like Tillis that leaves patients with “significantly less protection” than under the ACA. Of note, the bill does not “specify what benefits must be provided,” does not “prohibit insurers from charging women more than men,” and would not “ban annual or lifetime limits on benefits,” which are “of most concern to people with serious illnesses.” Taken all together and it’s clear: Senator Tillis’ bill is more about protecting his reelection chances than protecting people with preexisting conditions.

New York Times: Republicans Offer Health Care Bills to Protect Patients (and Themselves)
By Robert Pear
April 20, 2019 

WASHINGTON — President Trump and Republicans in Congress say they are committed to protecting people with pre-existing medical conditions. But patients with cancer, diabetes and H.I.V., for example, would have significantly less protection under Republican proposals than under the Affordable Care Act.

The proposals may provide some political cover for Republicans on an issue likely to figure prominently in the 2020 elections. But a close inspection of the Republican bills shows that their protections are undercut by a combination of imprecise language, explicit exceptions and “rules of construction” that explain how the legislation is to be interpreted.


The Republican proposals would provide some protections for people with pre-existing conditions. But they are not as comprehensive as the protections in the Affordable Care Act, which result from several interrelated provisions.

The bills do not specify what benefits must be provided. They do not prohibit insurers from charging women more than men, as insurers often did before the Affordable Care Act. And they would not ban annual or lifetime limits on benefits. Such limits are of most concern to people with serious illnesses.


But other provisions of the two bills “could be read as undermining those protections against discriminatory premiums,” said Edward G. Grossman, who drafted health care bills for Republicans and Democrats as a lawyer for more than 40 years in the House Office of the Legislative Counsel.

Thus, for example, the Republican bills say that an insurer cannot charge one person more than another “on the basis of any health status-related factor.”

But the bills then appear to qualify this guarantee, saying that it shall not be construed to restrict the amount that an employer or an individual may be charged for coverage. Republicans said their purpose here was to make clear that the federal government could not tell health insurance plans what to charge.

The American Heart Association and 32 other patient groups expressed concern about an earlier version of the Senate bill. The proposed safeguards “fall far short of the patient protections” provided under current law, they said in a letter to Senate leaders.


The protections for people with pre-existing conditions are among the most popular provisions of the 2010 health law. Democrats rode the issue to victory in many House races last fall, and they give every indication that they intend to emphasize it again in 2020.

“Republicans are terrified that Democrats will use the issue of pre-existing conditions as a cudgel to beat up Republicans,” said Michael F. Cannon, the director of health policy studies at the libertarian Cato Institute. “That’s what they did in 2018, and it worked.”

Health care dominated television commercials run by Democratic candidates for Congress in the fall. They argued that Republicans, in trying to repeal the Affordable Care Act, had repeatedly voted to take away the protections for people with pre-existing conditions.

The political risks for Republican lawmakers increased in December after a federal judge in Texas invalidated the entire health law, including the protections for pre-existing conditions. The Trump administration said it would not defend the law in court, but would instead support the judge’s ruling on appeal.


“The Republican bill does not include critical A.C.A. consumer protections, including community rating, essential health benefits requirements and annual or lifetime prohibitions,” said Representative Frank Pallone Jr., Democrat of New Jersey and the chairman of the Energy and Commerce Committee.

Under the bill, Mr. Pallone said, “you could theoretically buy insurance if you have a pre-existing condition, but it is very deceptive because the bill will still allow insurers to set premiums based on health status.”


Sarah Lueck, a health policy analyst at the liberal-leaning Center on Budget and Policy Priorities, saw another potential problem in the Senate bill. Even if a person with cancer could buy insurance without being charged a higher premium, she said, “his or her benefits could run out because the insurer imposes an annual or lifetime limit.”


Read the full article online here.