Senate Republicans are proposing new legislation that would force health insurers to cover all individuals regardless of health status — a move designed to blunt the fallout over a Texas lawsuit that aims to kill Obamacare.
The bill sponsored by 10 Republicans would require insurers selling plans in either the group or individual markets to guarantee coverage, while prohibiting them from discriminating or charging more based on a range of health factors including enrollees' medical histories or disabilities.
That language would extend many of the same protections that Obamacare currently guarantees for people with pre-existing conditions, the bill's sponsors argue in a statement shared with POLITICO — ensuring access to coverage even if a judge ultimately invalidates the health law. It does so not through the Affordable Care Act but by amending the Health Insurance Portability and Accountability Act, the main medical privacy law known as HIPAA.
"There are strong opinions on both sides when it comes to how we should overhaul our nation's broken health care system, but the one thing we can all agree on is that we should protect health care for Americans with pre-existing conditions," said GOP Sen. Thom Tillis of North Carolina, one of the bill's co-sponsors.
Democrats have pilloried Republicans in recent weeks over the Obamacare lawsuit brought by 20 attorneys general hailing from red states, accusing the GOP of failing to protect vulnerable patients.
The suit, scheduled for oral arguments Sept. 5, maintains that Obamacare is invalid now that Republicans voted to zero out the law's individual mandate as part of last year's tax reform. The executive branch normally defends federal laws in court but the Trump administration in a rare move endorsed part of that argument, contending that Obamacare's pre-existing condition protections should be eliminated.
That's put Republicans in Congress and on the campaign trail in a tough spot, forced to straddle two positions — criticizing Obamacare while at the same time supporting the pre-existing condition provisions that enjoy overwhelming popularity across partisan lines. Vulnerable Democrats like Sens. Heidi Heitkamp of North Dakota and Claire McCaskill of Missouri have made the patient protections a key plank of their platforms.
"If all you do is say, you know what, we're just going to vote to repeal this and good luck to the rest of the country, then we're leaving patients and we're leaving the state on its own," Heitkamp said Wednesday.
This new bill is designed to eliminate that risk, Senate Republicans backing the legislation say. It would also push back on Democrats' contention that Republicans don't support pre-existing condition protections, while allowing the GOP to resume its calls for repealing Obamacare.
But the proposal also is likely to prompt an uproar within the health insurance industry, where insurers count on receiving hefty government subsidies through Obamacare as a tradeoff for guaranteeing coverage.
The GOP bill by itself wouldn't provide that same financial support — and it also would not include Obamacare's various other provisions designed to keep cheaper, healthier individuals in the market in order to help insurers offset their sicker patients, who cost more to cover.
Insurers that discriminate against enrollees would be suspended for 180 days under the legislation, according to language shared with POLITICO. Health plans that demonstrate they're not financially stable enough to accept all applicants could be excepted from the coverage requirements, however.
In addition to Tillis, the bill is co-sponsored by Sens. Lamar Alexander of Tennessee, Chuck Grassley of Iowa, Bill Cassidy of Louisiana, Joni Ernst of Iowa, Lindsey Graham of South Carolina, John Barrasso of Wyoming, Dean Heller of Nevada, Lisa Murkowski of Alaska and Roger Wicker of Mississippi.
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