The U.S. House of Representatives passed by a 217-213 margin on Thursday a revised version of the American Health Care Act -- a bill that rolls back federal protections for those with pre-existing conditions and sets the stage for loss of coverage for some 24 million Americans. If signed into law, this could mean health care cost increases for an estimated 130 million Americans.
In the pre-Obamacare era, insurers were able to deny coverage outright to people with pre-existing conditions. The Affordable Care Act banned individual states from allowing insurers to charge people with pre-existing conditions at a higher cost.
Under the American Health Care Act, states can opt to allow individual insurers the discretion of deciding what does and not count as a pre-existing condition. While people with those pre-existing condition can't be denied coverage, they can potentially be charged more. These states would also receive $138 billion over a 10-year period to help subsidize.
The Atlantic's Olga Khazan explains the thinking behind this policy structure:
"The idea behind this provision is that it would make health insurance cheaper for people who are relatively healthy, while sick people would be in their own, subsidized risk pool. As they debated on the House floor Thursday, Republican members consistently assured their audience that their bill would still protect preexisting conditions."
Varying policy perspectives abound, but the greatest fear for opponents of the legislation is that the $138 billion fund to set up a "high-risk pool" simply won't be enough.
While individual insurers have the right to choose what is defined as a "pre-existing condition," these are the conditions that were previously listed as deniable in the market, before the ACA was passed:
- Alcohol abuse
- Drug abuse with recent treatment
- Mental disorders (severe, e.g. bipolar, eating disorder)
- Alzheimer's/dementiaMultiple sclerosis
- Arthritis (rheumatoid), fibromyalgia, other inflammatory joint disease
- Muscular dystrophy
- Cancer within some period of time (e.g. 10 years, often other than basal skin cancer)
- Obesity, severe
- Cerebral palsy
- Organ transplant
- Congestive heart failure
- Coronary artery/heart disease, bypass surgery
- Crohn's disease/ ulcerative colitis
- Parkinson's disease
- Chronic obstructive pulmonary disease (COPD)/emphysema
- Pending surgery or hospitalization
- Diabetes mellitusPneumocystic pneumonia
- Pregnancy or expectant parent
- Sleep apnea
- Hepatitis (Hep C)
- Kidney disease, renal failure
RELATED: A look at the American Health Care Act