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Trump Administration Deals Devastating Blow to Pre-existing Conditions Coverage & Other Health Insurance Protections

By October 22, 2018No Comments

This is yet another blatant example of their repeal and sabotage agenda, and proof of their ongoing war on America’s health care,” says Leslie Dach


Washington, DC – In response to a new federal policy issued today that waters down the guardrails that ensure health insurance plans sold in states that are seeking approvals of “1332 waivers” provide the full range of benefits and the cost-sharing protections in the Affordable Care Act, Leslie Dach, chair of Protect Our Care, issued the following statement:

“The hypocrisy of Republicans rolling back protections for pre-existing conditions at a time when their candidates are campaigning as defenders of health care is outrageous. This is yet another blatant example of their repeal and sabotage agenda, and proof of their ongoing war on America’s health care.”



Kaiser Family Foundation’s Larry Levitt Calls The Rule Out Today An “End Run” Around the ACA. Here is what 1332 waivers without appropriate guardrail protections could mean for consumers:

  • Protections for people with pre-existing conditions would be essentially meaningless. The American Cancer Society Cancer Action Network said allowing states to waive essential health benefits “could render those protections meaningless” for people with pre-existing conditions.
  • It would be harder for people with pre-existing conditions to get affordable coverage. As Consumers Union stated, allowing states to waive essential health benefits would be “putting meaningful coverage out of reach for many Americans, especially those with chronic and pre-existing conditions.”
  • You could pay more for the same coverage. 1332 waivers allow states to adjust the amount of premium tax credits and cost-sharing consumers receive to help lower their costs. Without the guardrail to ensure coverage is just as affordable, many consumers could end up paying more for the same care.
  • Insurers would not have to cover essential benefits, like maternity care. Right now, every insurance plan must cover the 10 essential health benefits. Because states could opt out of covering these basic benefits, insurers would likely only offer policies that covered much less than they do now. The Kaiser Family Foundation found that the benefits most likely to no longer be covered would be maternity care, mental health or substance abuse coverage. According to the Brookings Institution, the result would be “that no one in a state’s individual market that waived EHBs would have access to comprehensive coverage. Insurers would likely sell separate policies for benefits not covered in their core plan offerings, but these supplemental policies would be subject to tremendous adverse selection, leading to very high premiums and enrollment almost exclusively by those with pre-existing conditions.” For example, a woman who purchases a separate insurance rider for maternity care would have to pay $17,320 more, according to the Center for American Progress. For states that no longer required substance use disorders or mental health to be covered, coverage for drug dependence treatment could cost an extra $20,450.
  • Insurers could reimpose lifetime and annual limits. Allowing states to opt out of the essential health benefits coverage means that insurance companies could once again put lifetime and annual limits on the amount of care you receive. Moreover, as the Center on Budget and Policy Priorities notes, this would even impact people with coverage from their employer: “The ACA’s prohibition on annual and lifetime limits is tied to the definition of Essential Health Benefits. Thus, repeal of Essential Health Benefit standards could make this protection meaningless, putting almost all Americans with private health insurance coverage — not just those with individual or small-group market coverage — at risk.” The Center for American Progress estimates that 20 million people with health coverage through their employer would face lifetime limits on coverage, and 27 million would face annual limits.