Senate Majority Leader Mitch McConnell is proposing to keep in place the Affordable
Care Act’s protection against higher health-insurance premiums for people with
pre-existing conditions when they buy individual coverage, said a Republican aide
familiar with the recommendation.
The idea was discussed in a closed-door Senate GOP meeting Tuesday, said the aide,
who spoke on condition of anonymity. Republicans in the chamber are working to craft a
more modest health-care bill than a House measure that nonpartisan analysts said
would cause premiums to skyrocket for many older, poorer and sicker Americans and
result in 23 million fewer people with coverage over a decade.
The House bill, passed May 4 on a narrow 217-213 vote, would let states allow insurers
to charge higher premiums to people with pre-existing conditions and a gap in coverage
as long as the state provides help — such as a high-risk pool — for people priced out of
commercial insurance. The House measure is H.R. 1628.
The ACA’s protection for those with pre-existing conditions has broad public support and
was one of the few ideas with bipartisan backing when the Affordable Care Act was
moving through Congress in 2009 and 2010.
Senator John Cornyn of Texas, the No. 2 Republican leader, said addressing the needs
of people who already have serious or chronic health conditions is a key priority in
negotiations for a Senate bill.
“We’re going to take care of people with pre-existing conditions,” he told reporters
Wednesday, adding that the specific approach hasn’t been finalized.
One Republican considered a pivotal vote in the Senate debate, Bill Cassidy of
Louisiana, said he found the ideas put forward by leadership Tuesday to be “very
cognizant of pre-existing conditions,” and that he was reassured that Republicans might
produce a broad bill he could support.
“I’m very encouraged,” Cassidy said. “Of course, it’s not everything I want, but that’s life.”
Senate Republicans are struggling for consensus as they seek to keep the party’s
campaign promise to repeal and replace the ACA. There is no Democratic support for
the effort, and Republicans — who hold a narrow 52-48 majority — seek to use expedited
procedures to pass a health plan with as few as 50 votes, plus a tie-breaker from Vice
President Mike Pence. That would bypass the usual 60-vote threshold and keep
Democrats from blocking the measure.
McConnell told reporters Tuesday that Republicans are nearing introduction of their
health plan, but he gave no details and some members, including Finance Committee
Chairman Orrin Hatch of Utah, said they’re not expecting action on a bill anytime soon.
“We’re getting closer to having a proposal that we’ll be bringing up in the near future,”
McConnell of Kentucky told reporters after the closed-door Senate GOP luncheon.
“We’ve had seven years to talk about health care,” he said. “We believe we can do better
than the status quo.”
Addressing the needs of those with pre-existing conditions could help McConnell attract
votes of moderate Republicans including Cassidy, Lisa Murkowski of Alaska and Susan
Collins of Maine.
REINSURANCE POOL
Senator John Hoeven, a North Dakota Republican who is part of a working group helping
draft a measure, said there is discussion about creating a federal reinsurance pool for
people with chronic illnesses. That could provide coverage for people with pre-existing
conditions, while at the same time helping lower premiums for those who remain in the
regular insurance market.
“People won’t be worried that they’re going to lose affordable coverage if they have a
pre-existing condition,” Hoeven said.
About half a dozen Senate Republicans have expressed doubt that the chamber will act
on a health bill in 2017. Senator Lindsey Graham of South Carolina said Tuesday that
he’s concerned there won’t be enough support in the GOP.
“We need to bring this to an end and move to taxes,” Graham told reporters.
