Because health care is so important, there are two parts to the newsletter today, Chapter 1 and Chapter 2 - Preexisting Conditions. Both are below.
Health Insurance: Chapter 1
Last week, the House passed the American Health Care Act (AHCA) to repeal Obamacare and start a health care reform process to return power to the states, drive down costs, and offer options to American families.
Let’s review the current state of health insurance.
Across the country, costs have sky rocketed and choices have decreased.
In Iowa, 94 out of 99 counties will be left with literally zero insurance options on the Obamacare exchanges, when insurers pull out as they have announced. It’s the same situation for 16 counties in Tennessee.
In Arizona, the Obama Administration reported premiums increased 145% in Phoenix and 116% across the state in 2017.
Don’t think it can happen here? Recently, Aetna announced they are pulling out of Virginia individual markets. Aetna said they “could still lose more than $200 million in its individual market products this year. That's on top of the nearly $700 million it's lost in the three years after the exchanges opened in 2014.”
CareFirst Blue Cross Blue Shield requested a 35% increase in Virginia customer rates.
More than 40% of Healthcare.gov (Obamacare) counties have only one insurer option.
In the words of Majority Leader McCarthy, you know what doesn’t cover preexisting conditions? A health care system that doesn’t have coverage. No options means no coverage.
Democrats blame Republicans. But there is no way Donald Trump and the Republicans are responsible for these results.
In Bristol in 2008, Obama claimed typical families would save $2,500 a year in health care. Now, Nancy Pelosi and others who claimed or defended that promise, along with “If you like your plan, you can keep your plan,” are whipping up hysteria over hypothetical, alarming stories about the Republican health care plan.
The Democrats’ claims weren’t true then and they aren’t true now.
I’ve heard stories from Ninth District residents who struggle to pay increased premiums and are still faced with deductibles they can’t afford, forcing them to sell off assets.
Democrats’ claim the disabled won’t receive care and preexisting conditions won’t be covered.
That is just not true.
The idea that a rape victim, asthmatic, or child born with a severe health issue will be uninsured is blatantly false.
Democrats’ claims are so outrageous, even the Washington Post fact check gave 4/4 Pinocchios to one of the Democrats accusations. That’s a whopper.
Democrats also claim Republicans didn’t allow time to read the bill. We didn’t put a 2,000 page bill on the floor like Obamacare. I pointed out on the House floor, our base bill was 130 pages, available to read since March. The MacArthur Amendment was around 8 pages, the McSally Bill was less than 1 ¼ page, and the Upton amendment, offered the day before the vote, was only 2 pages. As I said, they could have read the text during the time it was being debated. But it appeared to me, the Democrats were more interested in scaring the American public than understanding the bill.
According to the Center for Medicare and Medicaid Services, an average of 10.4 million consumers paid premiums and had an active policy through the Obamacare marketplaces for the first half of 2016.
However, 19 million Americans either paid the IRS penalty or claimed an exemption.
That means more people rejected insurance under Obamacare than people who gained insurance.
Heritage Foundation reported, the average deductible for a family on a bronze plan is $12,393 and the average nationwide premium increase for individuals is 99 percent and 140 percent for families from 2013-2017. While I haven’t heard of deductibles that high here, I have spoken with a number of families with a $10,000 deductible.
In 2016, there were almost 30 million Americans still uninsured.
Is anyone really going to try and argue the costs and chaos of Obamacare were worth it for the increased premiums and deductibles, lack of choice, and significantly less expansion of coverage than forecasted?
Massive, one size fits all programs from Washington most often prove to be ineffective, wasteful, and expensive. Health insurance included.
The health insurance system won’t be fixed overnight.
Even if the Senate passed some form of the AHCA tomorrow, the benefits will not be seen next year. Insurers are already setting their rates for 2018 under Obamacare, and most likely will set 2019 rates before reforms can be enacted.
But the AHCA is the first step in getting Washington out of your health care, providing more choices, and lowering costs.
Health Insurance: Chapter 2
There are many falsehoods being spread about the American Health Care Act (AHCA).
You’ve probably heard Democrats and talking heads on the news warning that those with any preexisting conditions will no longer be able to get health insurance.
As Speaker Ryan put it, "Let's remember what is happening right now. Obamacare is collapsing. Obamacare isn't working. What good is Obamacare for anybody, let alone for a person with preexisting conditions if you don't have a health insurance plan that you can even get. So this is a rescue mission to make sure that we can achieve the goals we all want, which is getting the cost of coverage down and making sure that everyone has access to affordable health care, especially and including people with preexisting conditions.”
Furthermore, the AHCA prohibits denying coverage on the basis of a preexisting condition.
Democrats on the floor last week kept saying tens of thousands would lose their coverage because of preexisting conditions.
That’s just not true. It’s false.
Their theory is derived from the idea that if a state, in the future, requests a waiver (see below) from the Department of Health and Human Services, nobody in that state with a preexisting condition will get insurance.
Let me walk you through how it works and why the Democrats are just plain wrong.
It’s not a quick sound bite.
The waiver provisions, as included in the MacArthur amendment, would affect 7% of Americans who currently get health insurance from the individual market.1 Also, it would hopefully encourage some of the 8% who have currently chosen to be uninsured, to come back into the insurance market. It’s important to address health insurance needs of all Americans, but these percentages illustrate the scope of this scenario.
Out of those 7% +, the waiver changes would only affect an individual who lives in a state that receives a waiver AND
has allowed their health insurance to lapse more than 63 days.
The bill stipulates that if you have had no coverage for 64 days and then purchase health insurance, in a waiver state, with a preexisting condition, you can be charged more. Being on Medicaid counts as being insured.
Further, if you read the bill, one or more of the following criteria must be met for the Department of Health and Human Services to accept the states’ application for a waiver.
(i) Reducing average premiums for health insurance coverage in the State.
(ii) Increasing enrollment in health insurance coverage in the State.
(iii) Stabilizing the market for health insurance coverage in the State.
(iv) Stabilizing premiums for individuals with preexisting conditions.
(v) Increasing the choice of health plans in the State.
(Note, particularly iv)
Keep in mind, even with the waivers, a person can buy insurance. The question is, would their rates go up exorbitantly?
So for the Democrats’ dramatic claims to be true, we have to assume
1. You are uninsured for more than 63 days
2. You wish to enter the individual health insurance market
3. Your state asks for a waiver
4. Your state gets the waiver
5. Your state crafts a plan that meets the criteria above and still leaves people out
6. We did nothing to stop the rates from rising exorbitantly
But wait… we did something to help those with preexisting conditions who are also currently uninsured. Because there was a concern that some people could fall into that category, the Upton-Long amendment was adopted.
That amendment provides $8 billion in funding to help pay down the cost of insurance for a person with a preexisting condition, in a state with an accepted waiver, and placed into a health care risk sharing plan. So the cost charged to a person with a preexisting condition cannot be exorbitant.
But wait… there is even more.
The increased premiums, whether paid by the government, individual, or a combination of the two, only applies for one year under the AHCA.
If you have questions, concerns, or comments, feel free to contact my office. You can call my Abingdon office at 276-525-1405 or my Christiansburg office at 540-381-5671. To reach my office via email, please visit my website at www.morgangriffith.house.gov