Alice Ollstein contributed reporting.
House Republicans promised that their hastily passed Obamacare repeal legislation wouldn’t weaken pre-existing conditions protections — even as it let states permit insurers to charge sick people more and whittle down benefits — but the Congressional Budget Office reported Wednesday that under the GOP plan sick people would face substantially higher premiums and in some cases be priced entirely out of the market.
Faced with the new independent analysis, some Republicans admitted that they’d like to see some tweaks to their ideas as the Obamacare repeal effort proceeds in the Senate. But many dug on in on waiver provision that passed the House and claimed the CBO was not getting the full picture.
“There’s about four different layers that exist to cover pre-existing conditions, beyond which one isn’t even spoken about, which is one of the most important, and that’s just the personal responsibility we have in our lives that’s not even mentioned in there,” Rep. Brian Mast (R-FL) told reporters.
Rep. Peter King (R-NY) took issue with the CBO’s estimate for how many people will live in states taking the waivers under the GOP plan.
“I don’t know how CBO would know that,” King said. “This is going to be a political decision made in the states, I don’t know how the CBO becomes a political expert.”
Not everyone was dismissive of the CBO’s findings, and pointed out that the Senate is working on its own repeal bill that, if passed, will have to be reconciled with the House version.
“Obviously, the Senate is going to work on whatever waiver might or might not be proposed and you’re going to come back to conference,” Rep. Mark Sanford (R-SC) said. “I think there’s gong to be a couple more bites at the apple in terms of further refining the bill based on that CBO report.”
Less than a month ago, top Republicans were promising that their bill, the American Health Care Act, was not a violation of of their vows to protect people with pre-existing conditions. Majority Whip Steve Scalise (R-LA) swore that “everyone” with a pre-existing conditions would keep their coverage. House Speaker Paul Ryan (R-WI) touted “VERIFIED” talking points claiming people with pre-existing conditions were “protected.”
The provision that set off alarm bells among patient advocates was an amendment spearheaded by New Jersey moderate Rep. Tom MacArthur (R) that offered waivers to states to opt out of some of the Affordable Care Act’s insurer mandates, including its rule barring insurers from charging people more for premiums based on their health status.
The CBO said in the report released Wednesday that about half of Americans live in states that would not take waivers and one-third live in states that would seek only “moderate” changes to Obamacare’s insurer mandates, specifically its provision requiring insurers to offer 10 broad coverage areas. But one-in-six Americans would live in states that took a more aggressive approach to the waivers and would seek to allow insurers to charge more based on one’s health status. There, the CBO predicted variations in premiums so wide that it did not provide an average estimate for them, while warning of increased instability in the individual market.
“Over time, it would become more difficult for less healthy people (including people with preexisting medical conditions) in those states to purchase insurance because their premiums would continue to increase rapidly,” the CBO said.
Furthermore, the CBO said that the $8 billion in funding for states that was added after the MacArthur amendment, to appease spooked moderates, “would not be sufficient to substantially reduce the large increases in premiums for high-cost enrollees.”
In reaction to the CBO score, MacArthur employed the well-honed technique of brushing off the expertise of the non-partisan research agency, telling TPM he “fundamentally” disagreed with the “biased” report.
“They won’t opine on how much premiums will come down if a state takes both waivers” MacArthur said, noting that CBO gave premium reduction estimates for states that took no waivers and for states that sought a partial waiver on Essential Health Benefits.
“Suddenly, they can’t come up with an estimate if a state takes two waivers? They just acknowledge that it will go down way more. That to me is disingenuous. There is a number,” he said.
House Freedom Caucus Chair Mark Meadows (R-NC), who worked on the amendment with MacArthur, was reportedly caught off guard Wednesday night when reporters pointed him to the CBO report’s section on pre-existing conditions.
By Thursday he was more defensive, telling reporters that he found it “disappointing” that it was “long on rhetoric but short on support for where that rhetoric came from.”
He said that he intended on having a follow-up meeting with the CBO.
“I’m not saying it’s incorrect, but I don’t have enough information to say whether it’s correct or not,” Meadows added.