Memo: Marshall & RSC's plan to roll back protections for pre-existing conditions - Bollier for Kansas

Memo: Marshall & RSC’s plan to roll back protections for pre-existing conditions

TO: INTERESTED PARTIES
FROM: BOLLIER FOR KANSAS
DATE: SEPTEMBER 8, 2020
RE: MARSHALL & RSC’S PLAN TO ROLL BACK PROTECTIONS FOR PRE-EXISTING CONDITIONS

In 2019, the Republican Study Committee’s Healthcare Task Force released a policy report titled A Framework For Personalized, Affordable Care. As Chairman of the Healthcare Task Force, Roger Marshall played a key role in developing this disastrous plan that would erode hard-won protections for Kansans with preexisting conditions and raise healthcare costs for families across the country. Marshall claims that his plan would protect Americans with preexisting conditions, but in reality, his plan simply recycles policy proposals from the 2017 Republican attempts to repeal the Affordable Care Act, such as underfunded high-risk pools, elimination of essential health benefits, introduction of short-term health plans and cuts to Medicaid.

Not only would these changes weaken current protections for people with pre-existing conditions, including COVID-19, they would drive up the cost of healthcare for our most vulnerable people and reduce coverage for many other Kansans.

WEAKENED PROTECTIONS FOR PRE-EXISTING CONDITIONS

In a major blow to the coverage of preexisting conditions, the plan would allow an exclusion from coverage of preexisting conditions if a person does not have 12 months of continuous coverage. This is a controversial idea from past ACA repeal attempts that would result in at least four million fewer Americans in the individual insurance market and trigger premium increases of up to 30 percent. In the middle of a global pandemic and an economic crisis, this provision would be devastating to Kansans who lost jobs because of COVID-19.

MORATORIUM ON MEDICAID EXPANSION

Perhaps most concerning is the plan’s call for an immediate moratorium on Medicaid expansions and replacing Medicaid’s current structure with block grants. Blocking future Medicaid expansion efforts would prevent Kansas from expanding affordable health care coverage to more 130,000 people and strengthening critically needed rural hospitals.

Converting the Medicaid structure to block grants would hamper the existing Medicaid program significantly. This would cause disastrous cuts in Medicaid benefits that serve as a lifeline for Kansas seniors in nursing homes and families across the state.

UNDERFUNDED HIGH RISK POOLS

Marshall’s plan establishes federally funded and state-administered Guaranteed Coverage Pools that the committee claims would be used to cover the costs of Americans with expensive medical conditions and treatment requirements. But it’s just a recycled version of the high-risk pools proposed during the 2017 ACA repeal debate. Before the Affordable Care Act, those underfunded high-risk pools left medically vulnerable Americans with significantly higher premiums, exclusions for pre-existing conditions, lifetime annual limits and high deductibles. A return to that would be devastating for many Kansans.

ELIMINATION OF ESSENTIAL HEALTH BENEFITS

The plan would also undo current law on essential health benefits, one of the most fundamental protections required by the Affordable Care Act, which mandated coverage for Americans’ costs for prescription drugs, mental health services, maternity and newborn care and chronic disease management. According to the Center on Budget and Policy Priorities, curtailing federally defined essential health benefits would allow insurers to “discourage enrollment by people with costly health needs: they would do so by cutting covered health services and raising out-of-pocket costs.” Bad faith arguments that the RSC plan ensures coverage of preexisting conditions rest on the idea that companies would not be able to charge sick consumers higher premium rates but fail to mention that many of the medical treatments these sick consumers need would no longer be covered.

SHORT-TERM, LIMITED DURATION HEALTH PLANS

Echoing regulatory changes by the Trump administration, Marshall’s healthcare plan includes language seeking to codify the availability of short-term, limited duration healthcare plans. Despite Marshall’s claims about the benefits of more flexible insurance options, these plans fail to adequately cover preexisting conditions, discriminate based on medical history, exclude key services, impose dollar limits for covered services and eliminate guarantees that coverage will be renewed.

Not only would short-term health plans undermine vital protections for Americans with preexisting conditions, analysts warn that the Trump administration’s regulations allowing broader use of these plans could result in higher premiums and costs for those that are participating in the ACA marketplace.

SUMMARY

As chairman of the RSC Healthcare Task Force, Roger Marshall played a key role in developing a plan that would erode hard-won protections for Kansans with preexisting conditions and raise healthcare costs for families across the country. Marshall claims that his plan would protect Americans with preexisting conditions but in fact it would weaken protections and cause healthcare premiums and costs to skyrocket for vulnerable Kansans with preexisting conditions. 

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