President Trump American Health Care Act
Photo: Getty Images

In the latest version of the American Health Care Act that passed the House today, Republicans sought to loosen current requirements that insurers offer premiums at the same price, regardless of applicants' pre-existing health conditions. Those restrictions are one of the hallmarks of Obamacare.

 

The AHCA, a.k.a. Trumpcare, would allow states to opt out of that requirement. States could seek a waiver from the Department of Health and Human Services allowing insurers to charge higher rates to people with pre-existing conditions who allowed their coverage to lapse. They would be placed in "high-risk pools" set up with federal subsidies to help defray the cost of premiums.

 

Theoretically. In a letter urging the House to reject the bill, no less than the American Medical Association said that high-risk pools "could effectively make coverage completely unaffordable to people with pre-existing conditions."

 

(People who live in states that do not seek those waivers, and people who do not buy individual insurance — i.e. are covered through an employer — would not be affected.)

 

So what is a pre-existing condition anyway?

The AHCA does not say. But before Obamacare, there was literally nothing holding insurance companies back. Many people with pre-existing conditions found their premiums unaffordable — or could not get an insurance policy at all. That could again be the case if the AHCA becomes law. The Washington Post reports: "In the past, some insurers had identified domestic violence, sexual assault, Caesarean section and postpartum depression as grounds for either denying coverage or charging higher premiums. 'When you can’t predict the future,' Alina Salganicoff, vice president and director of women’s health policy at the Kaiser Family Foundation, said Thursday, 'one looks back to see what the prior experience has been.'"

Today, Ohio Sen. Sherrod Brown tweeted out dozens of pre-existing conditions he said could result in higher premiums under the Republican bill, including acid reflux, acne, depression and high cholesterol.

Last weekend, Donald Trump said the AHCA "guaranteed" coverage to those with pre-existing conditions, but CNN pointed out that it was unclear whether he knew what he was talking about. House speaker Paul Ryan said the AHCA "protects people with pre-existing conditions." The "New York Times" found those assertions "misleading" because the AHCA does not protect them from higher costs.

Today, CNN listed the 11 states with highest percentage of residents who have pre-existing conditions. All of them voted for Donald Trump.