On Sunday, President Donald Trump suggested a new version of the healthcare bill, being put together by the GOP, would include required coverage for pre-existing conditions, a statement that deviates from the recent proposal created by House Republicans that would have allowed states to opt out of the requirement.
As reported by Business Insider, the first iteration of the healthcare bill intended to repeal and replace the Affordable Care Act included the provision for mandatory coverage of pre-existing conditions. That particular bill was pulled from the House floor before the vote based on a lack of clear support.
During an interview on “Face the Nation,” Trump told John Dickerson, “Pre-existing conditions are in the bill. And I mandate it. I said, ‘Has to be.’”
Trump’s original healthcare bill was not favored by members of the House Freedom Caucus, an ultraconservative group that believed it did not do enough to repeal Obamacare in its entirety. To gather support from the Freedom Caucus, New Jersey Rep Tom MacArthur, the leader of the Tuesday Group, presented an amendment designed to give states the ability to opt out of two provisions included in Obamacare, including the requirement to cover pre-existing conditions.
If the amendment was put in place, states choosing to waive the requirement would position insurance companies to charge higher premiums to those with known conditions. It would require states to provide funding for those individuals in an attempt to “stabilize premiums” as a qualification for the waiver.
Speaking during the interview, Trump’s suggested the amendment would be changed to ensure coverage for individuals with pre-existing conditions regardless of their state of residence. Speaking directly about the amendment proposed by MacArthur, Dickerson said, “In one of the fixes that was discussed, pre-existing [coverage] was optional for the states.”
“Sure, in one of the fixes,” said Trump. “And they’re changing it.”
Dickerson then asked if it would be a permanent change, to which Trump replied, “Of course.”
Trump did go on to discuss the use of pools to classify individuals, such as the “invisible high-risk pools” created by the AHCA. However, he continued to assert the “pools are going to take care of the pre-existing.”
The concept was borrowed from the state of Maine, where individuals deemed higher risk are placed in separate “high-risk” pools which are then subsidized by the state to increase affordability.
Critics of the use of pools fear the approach isolates the sickest members of the population and would lead to skyrocketing premiums.
Often, the success of such programs is based largely on whether the government is prepared to offer adequate subsidies to manage the costs. Additionally, the likely source of funds for the subsidies could lead to higher taxes.
Dickerson continued to press Trump, repeatedly asking him to guarantee coverage for pre-existing conditions would be guaranteed for those living in any state. He said, “So I’m not hearing you, Mr. President, say there’s a guarantee of pre-existing conditions.”
Trump replied, “We actually have – we actually have a clause that guarantees. We have a specific clause that guarantees.”
The inclusion of pre-existing conditions coverage would increase the likelihood of finding support for more moderate Republicans that have recently expressed concerns regarding the current proposal.
Pennsylvania Rep Charlie Dent said, regarding a lack of coverage of a requirement to provide coverage for pre-existing conditions, “It could affect people with pre-existing conditions, and it’ll make different insurance probably much more expensive for them, and in some cases perhaps inaccessible.”