Trumpcare & Pre-Existing Conditions

Trumpcare and Pre-Existing Conditions

Over 2 years ago when President Trump announced his campaign for president, at the top of the list was health care reform and his repeated vow to repeal the ACA (Affordable Care Act) which is also known as Obamacare. His intention is to replace it with a plan he thinks will be more beneficial to the American citizens. The specifics of how this would be accomplished or what exactly would change were yet to be defined. Now that the introduction of the AHCA (American Health Care Act) Congress can now give those specifics to Americans with the hope of fulfilling this promised change.

Under the ACA – changes to Pre-Existing Condition Treatment

End of coverage preclusion for people with a pre-existing condition was one of the milestone changes that the Affordable Care Act had brought to the American health care system. Insurance companies could charge people with pre-existing conditions much higher rates than those who were healthier. Insurance companies could also deny anyone based on a pre-existing condition. Repealing the ACA has citizens concerned about the future for those who have a pre-existing condition.

Prior to the American Care Act, decisions regarding pre-existing conditions was primarily based on the judgment of the insurance company.  Allowing the insurance companies to make decisions for themselves as to what they consider was a pre-existing condition. It could include conditions like obesity, arthritis, anxiety, heart disease, or depression as well as many other commonly known conditions. Currently 27 percent of Americans have a pre-existing condition using the standards used prior to the ACA. Allowing insurers to make these decisions left many Americans uninsured. Finding insurance was simply unaffordable for many.

Things changed drastically once the ACA was enacted by President Obama. No longer were insurance companies allowed to deny Americans insurance based on a pre-existing condition. Insurance companies were also not allowed to charge more based on a pre-existing condition.  This allowed those previously denied the ability to have insurance which created a large influx of insurance purchases. The unfortunate side effect of this was the increased number of health insurance claims filed because of the pre-existing condition. The number of healthy people signing up was not high enough to counter act this. This increase in claims is what cause insurance rates to rise for everyone in 2017.

Under the AHCA – Initial Treatment of Pre-Existing Conditions

The AHCA (American Health Care Act) also referred to as Trumpcare or Ryancare (named after Representative Paul Ryan) and Republicare which was initially released to the public March 6th, 2017. The AHCA had offered those with pre-existing conditions the same treatment the ACA offered when first proposed. For those who had pre-existing conditions would not have a rate increase and insurance companies could not deny them coverage. Supporters for the AHCA say the main proponent making this superior to Obamacare’s ACA is it would end the insurance mandate. The passing of the bill would mean Americans citizens would not be required to purchase health insurance or be penalized for choosing not to have health insurance. A surcharge could be added by carriers up to 1 one year for those who have an insurance lapse for 63 days or more to help prevent people from purchasing insurance only when there sick. This charge can be up to 30% or the individual’s premium. There are some opponents of the ACA that feel the AHCA is too similar to the ACA and want all the factors repealed for the ACA.

Under the MacArthur Amendment – Treatment of Pre-Existing Conditions

An amendment to the AHCA was introduced to Congress to appease those who are against Obamacare. The amended changes for the “MacArthur Amendment” were drafted by Representative Tom MacArthur “R-NJ” allowing a waiver to be sought for insurance states from companies allowing them to charge people with pre-existing conditions more for certain situations. In order the conditions to be met, the insured will have had to let their current existing insurance to lapse.  If the state the individual resides in has received a waiver which they applied for from the federal government; then the insurance companies may charge more for pre-existing conditions. Trumpcare already would allow insurance companies to charge more for anyone with a lapse in health insurance of more than 63 days.

In terms of dealing with pre-existing conditions; one commonality between the ACA and AHCA is that neither permits insurance companies to deny coverage based on any pre-existing conditions.  If the bill does pass, the individuals who will be most affected by this bill are those who purchased through the marketplace; have a pre-existing condition and let their health insurance lapse. With that said it is still up to your state and if they have a waiver or no waiver. There is much division in the country regarding the bill and what is best for our countries health care. There are those who feel that the bill has move farther from the goal while others continue to argue that it’s still not far enough.

Passing by only a narrow margin of votes; 217 to 213 on May 4th. The bill has to make its way over to the Senate voting floor. Yet Senators are saying they have additional changes of their own to make before the bill is ready to go to the voting floor. Either way; for or against this bill, America will be flipped on its head if it passes.