CBO predicts some with pre-existing conditions will lose coverage under GOP plan

Republicans pledged their healthcare bill would protect those with pre-existing conditions. The Congressional Budget Office (CBO) disagrees. 

In its analysis Wednesday, the CBO warned that a new provision in the GOP healthcare bill would lead to people with pre-existing conditions being charged much more for coverage. This directly contrasts a promise from House Republicans that those with pre-existing conditions would still be able to afford health insurance. 

At issue is an amendment from Rep. Tom MacArthur (R-N.J.), added to the bill to get conservative hard-liners on board. The provision lets states waive two ObamaCare regulations: community rating, which banned insurers from charging sick people more for coverage, and essential health benefits, which mandates a list of services insurers must cover. 

{mosads}About one-sixth of the population live in states that would obtain these waivers. And for those residents, premiums would “vary significantly according to health status” and “less healthy people would face extremely high premiums.” 

“People who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all — despite the additional funding that would be available under (the AHCA) to help reduce premiums,” the CBO concluded. 

Insurers could only charge people more based on their health status if they have a lapse in coverage longer than 63 days and purchase insurance on the individual market.  

MacArthur defended his amendment after the score came out Wednesday, saying it would protect people with pre-existing conditions. 

“I don’t agree with them that waivers will destabilize [the market]. I think waivers will cover people with preexisting conditions because they’ll have to create risk pools,” MacArthur told reporters Wednesday.

“I respect the CBO’s role, but just because a group of auditors down the block have created a model that has a lot of ifs, ands and maybes, looking out 10 years, doesn’t make that the gospel. That is somebody’s opinion at CBO. I have a different opinion.”

Other lawmakers believe states won’t apply for the waivers. At least one GOP governor, Wisconsin Gov. Scott Walker, has already expressed interest in applying.

“I still don’t think states are going to take that waiver,” House Energy and Commerce Chairman Greg Walden (R-Ore.) told reporters shortly after the CBO released its analysis, “and they would have to clearly make their case that it would result in better coverage and more people covered.”