So, Republicans are poised to resurrect their failed Trumpcare legislation this week, wanting very much to score a meaningful victory before Trump’s first 100 days are up. Trump, for his part, apparently was advised by someone — presumably either his daughter or son-in-law, the only people he listens to — to manage expectations by now calling the “first 100 days” standard ridiculous, notwithstanding his own repeated references to it on the campaign trail.
So, let’s talk about something that’s not ridiculous. This new plan to “repeal and replace” Obamacare would cause premiums to soar for those with preexisting conditions, and would likely price them out of the insurance market, leaving them with no coverage.
Sounds great. Where do I sign up?
States can request waivers
The new plan restores the ACA’s requirement that insurers cover Essential Health Benefits (EHBs) — such as doctor’s and emergency room visits and maternity care — but would allow states to seek waivers from them. Of even greater concern, it would also allow waivers of the ACA’s prohibition on charging higher premiums to people with preexisting conditions.
Trumpcare is the same but different
While Trumpcare would retain the prohibition against refusing to cover people with preexisting conditions, it could price people out of the market, because insurance companies would be free to charge as much as they want. If a person has diabetes, it could mean that the policy available to them is prohibitively expensive. Or for a cancer patient, it could mean their insurance won’t cover the cost of cancer medications or treatments. In both of these scenarios, the result is the same: These patients will go without insurance because it is either prohibitively expensive or it does not provide coverage for the type of treatment they need.
The result is that healthy people — those fortunate enough not to get cancer, for example, or arthritis or suffer from depression or any other chronic condition — would be the only ones who can afford insurance. Insurance will be un-affordable — or worthless — for those who really need it.
Just go to the emergency room
Rep. Mark Meadows, the same person who suggested that emergency room care is available to everyone, and therefore, there is no such thing as anyone not being covered, pointed to high-risk pools as the solution for those who are already sick. However, those high-risk pools that existed prior to the ACA often had long waiting periods or limited benefits. Nevertheless, Mr. Meadows seemed quite proud of the fact that waivers under Trumpcare would be granted to states “very easily,” thus setting up a catastrophic scenario for those with preexisting conditions.
Take a look at this chart, prepared using data from the Centers for Medicare and Medicaid Services. For a person with metastatic cancer, under the Republican plan, they could face an annual insurance premium of $140,000. Those with non-metastatic cancer could pay over $70,000 a year. People suffering from heart disease would likely face premiums of well over $50,000. For rheumatoid arthritis, which affects over 1 million Americans, insurance could cost $26,000 a year.
Are you ready for the kicker? The rates shown in this chart are a surcharge. That means it’s what those with preexisting conditions will pay over and above what everybody else pays.
So, what do you think? Do you know anyone who is battling cancer or living with arthritis or who has heart disease? What about diabetes or asthma? Depression, back pain, traumatic brain injury? Or any of the hundreds of other preexisting conditions with which Americans live? All of these people can look forward to being priced out of the market for insurance. And no insurance means no care. And for many of these people, no care means death.
It would seem we have finally found those death panels Sarah Palin was talking about. They seem to be part and parcel of Trumpcare.