Tillis Bill Could Get a Vote as Early as Tonight, Fails to Meaningfully Protecting People with Pre-Existing Conditions

In a blatant attempt to cover his abysmal health care record, Senator Thom Tillis (R-NC) released bill text for the “The Protect Act.” Despite its name, this bill does not fully protect people with pre-existing conditions. 

The Affordable Care Act (ACA), a law that Senator Tillis has repeatedly voted to repeal, already provides comprehensive protections for people with pre-existing conditions. However, the ACA is currently in danger of being overturned in the courts in a lawsuit brought by the Trump administration and its Republican allies in the states. If successful, the lawsuit would rip coverage away from more than 23 million and eliminate protections for 135 million people with pre-existing conditions. Republicans have made clear they want to put insurance companies back in charge and return to the days when insurers could charge more and limit care all while their profits soar. 

Any Bill That Meaningfully Protects People With Pre-Existing Conditions Must Include Four Key Provisions: 

  • GUARANTEED ISSUE: Rule that forbids insurance companies from denying coverage to people with pre-existing conditions. 
  • COMMUNITY RATING: Rule that prevents insurers from charging people with pre-existing conditions more. 
  • ESSENTIAL HEALTH BENEFITS: Requirements that insurance companies cover essential health benefits, such as prescription drugs, mental health and substance abuse treatment, and maternity care.
  • LIFETIME & ANNUAL CAPS: Ban on insurance companies having lifetime caps on coverage.

PEOPLE WITH PRE-EXISTING CONDITIONS WOULD NOT BE PROTECTED UNDER THOM TILLIS’ BILL: 

What Tillis’ Bill Looks Like In Practice:

If Tillis’ bill replaced the Affordable Care Act, 135 million Americans with pre-existing conditions would be put at risk. 

For example, without the ban on annual and lifetime limits, a patient with cancer – whose costs for treatment average about $150,000 – could quickly reach their plan’s coverage limit and face the devastating choice of continuing treatment or facing financial ruin. Moreover, while Tillis’s bill claims to prohibit insurance companies from excluding coverage of treatments based on a person’s pre-existing condition, insurers could deny coverage of certain treatments across the board. So insurance companies could still refuse to cover this person’s chemotherapy drugs because they would no longer need to cover essential health benefits. This is all assuming that the patient wasn’t already paying higher premiums for being a woman or over the age of 50.