President Donald Trump has made some huge promises for healthcare
overhaul, but his new guarantee for people with preexisting
conditions may not reflect the reality of the GOP’s current
Trump has promised that the plan to repeal and replace the
Affordable Care Act will bring down premiums,
bring down deductibles, bring down the cost of the
government, and eventually cover “everybody.” Most health policy
experts agree hitting all four of these marks is next to
Now, with the White House and congressional leaders apparently
readying an effort to bring the American Health Care
Act to the House floor, Trump is making another promise that is
contradicted by the actual legislation.
interview with CBS’ “Face the Nation” on Sunday, Trump
guaranteed protections for patients with preexisting
conditions as he has done since the campaign.
“Preexisting conditions are in the bill,”
Trump said. “And I just watched another network than yours,
and they were saying, ‘Preexisting is not covered.’ Preexisting
conditions are in the bill. And I mandate it. I said, ‘Has to
Trump reiterated those comments during
an interview with Bloomberg on Monday, saying the AHCA has to
cover preexisting conditions just as well as Obamacare — or
“I want it to be good for sick people. It’s not in its
final form right now,”
Trump said. “It will be every bit as good on preexisting
conditions as Obamacare.”
But those guarantees run in opposition to recent
adjustments to the AHCA.
An amendment added to the bill, authored by moderate Republican
Rep. Tom MacArthur, would allow
states to waive certain protections of Obamacare, including
aspects of the ACA’s community-rating provisions that mandated
all people in an area be charged the same price by insurers
if they are the same age.
If a state is given a waiver for those protections, experts
could be able to price plans for people with
illnesses above those for healthy people and, in the
make it unaffordable for those with preexisting conditions to
Trump, in speaking with CBS, did reference the addition of
“pools are going to take care of the preexisting” as a way to
offset the issue.
The new version of the AHCA does allow for the implementation of
an “invisible high risk pool,” which functions as a way to
subsidize insurers covering people with preexisting conditions to
keep costs down for others.
That could bring down costs for those without preexisting
conditions, but unless the plan is adequately funded by the
government it would likely
leave people with preexisting conditions with higher costs or
unable to enroll. According to experts at the Kaiser Family
Foundation, a nonpartisan health policy think tank, the current
iteration of the AHCA’s pools
do not provide enough funds to keep down costs.
In response to Trump’s comments to Bloomberg, a spokesperson for
Paul Ryan told NBC that the AHCA does take care of people with
“The Republican plan protects people with preexisting
conditions,” said AshLee Strong, the spokesperson for Ryan.
“States can’t opt out without a high risk pool to take care of
them. And waivers never apply to someone who has been
continuously covered. We believe there is more than one way to
address this problem.”
Trump’s comments come as House Republicans are attempting to
wrangle enough votes to pass the AHCA at some point this week.
Both administration and congressional officials have
pushed for a vote in the coming days, and reports
suggest a vote could come as soon as Wednesday.