From:
National Review
Obamacare’s
Illusion of Preexisting Condition Protections
By SEEMA VERMA
October 19, 2020 4:04 PM
SEEMA VERMA is
administrator of the Centers for Medicare and Medicaid Services (CMS).
Prohibitive costs placed coverage outside the
reach of everyday Americans, including countless with preexisting conditions.
President Trump’s recent executive order laying out his
“America-First Healthcare Plan” makes clear his continued commitment to the
long-standing, bipartisan consensus that we should protect people with
preexisting conditions. Unfortunately, the previous administration’s attempt to
make good on that consensus — Obamacare — has failed to deliver on its
promises.
Contrary to the prevailing media narrative, federal health
insurance enrollment protections for preexisting conditions long predate Obamacare.
Bipartisan legislation passed nearly 25 years ago protects people with
preexisting conditions and prior health coverage from having to wait for their
condition to be covered when they move to a new job. These protections apply to
the 180 million Americans with job-based coverage, who represent roughly 90
percent of everyone with private health coverage.
Obamacare attempted to deliver additional protections for people
with preexisting countless with preexisting conditions.
After premiums doubled and even tripled in some states once
Obamacare regulations took effect, individual-market coverage became
unaffordable and unusable for millions of middle-class and self-employed
Americans earning too much to qualify for subsidies. A 60-year-old couple
living in Hannibal, Missouri, who earn $70,000 a year faces a $37,000 annual
premium for the lowest-cost silver plan — over half their income — and that’s
before a staggering $12,000 deductible. For them, there are no protections if
they have a preexisting condition. Sadly, Obamacare has failed to protect them.
It’s time the national debate over Obamacare finally confronts
this reality. One can support maintaining formal preexisting protections in the
individual market — as President Trump has done repeatedly, and has done again
in his recent executive order — while honestly confronting the law’s poor track
record in making those protections meaningful for real people.
The data bear this out. From 2016 to
2018, 2.5 million unsubsidized enrollees left the individual market. Census
data in turn show that the number of uninsured with incomes greater than 400
percent of the federal poverty line — the cutoff point to qualify for federal
tax credits — increased by 1.1 million in 2018.
In short, Obamacare created a new class of uninsured — none of
whom, of course, have the slightest protection against their preexisting
conditions.
The pandemic has underscored just how unaffordable and
unattractive Obamacare remains to most Americans. Over the last six months,
millions have lost their jobs and with them their health-care coverage. Each
and every one of these individuals who held job-based coverage is eligible for
enrollment, and many states opened enrollment to anyone who is still
uninsured. Still, relatively few have opted for Obamacare thus far.
Americans
were promised Obamacare would protect them against discrimination on the basis
of preexisting conditions. But when the price of unsubsidized coverage would
bankrupt the average middle-class family, the promise of protection rings
hollow.
By
contrast, no one has done more to protect real people with real preexisting
conditions than President Trump. He has not abided by the old, worn-out
playbook of simply increasing taxes and spending more taxpayer dollars. Rather,
he has addressed the underlying factors that limit access to care and make
health care unaffordable in the first place. Under his watch, premiums have
gone down for three consecutive years across HealthCare.gov, Medicare
Advantage, and Part D health plans, while options have expanded for Americans
who rely on these plans.
Moreover,
his policies are driving toward a new age of transparency and interoperability
where patients have the information they need — including the price of care and
their medical records — to make the best health-care decisions with their
doctor or to shop for new health-insurance coverage. This information will move
us toward a system that increases provider competition and rewards lower-cost
care. And that just scratches the surface.
The
president’s antagonists are free to oppose his health-care agenda, marked by
almost four years of increased patient control, fewer government mandates, and
robust competition — an agenda that has delivered results. They are even free
to defend the dubious legacy of Obamacare. But they should do so on the basis
of fact, not fiction.
