Part of the problem for Republicans in proposing and promoting “replacement” plans for the Affordable Care Act is that, given the GOP’s general opposition to regulation and federal spending, anything they propose will necessarily be less generous and less comprehensive than the ACA. This makes the marketing of those plans a bit tricky, especially since some of the ACA’s more popular features are rooted in regulating insurance company behavior and paying out subsidies to make insurance more affordable.
To get around this problem, the authors of the most recent Obamacare “replacement” have hit upon a novel strategy: just lie about what their plan does.
In an Op-Ed for USA Today, Sen. Orrin Hatch, Sen. Richard Burr, and Rep. Fred Upton hype their new healthcare reform framework – which is very similar to the framework Hatch and Burr released last year – as a collection of “specific ideas that could replace Obamacare with more choices and higher quality, while protecting those with pre-existing conditions.” Sounds pretty good, right? Better than Obamacare, even!
Let’s drill down on that “protecting those with pre-existing conditions” bit, since that’s a key part to the success of any healthcare reform proposal. Hatch, Burr, and Upton would completely repeal the ACA, which means they’d get rid of the law’s blanket ban on denying people coverage based on pre-existing conditions. What would protections would they put in place instead? Here’s what their Op-Ed says:
What our plan would not allow is a return to the days before Obamacare when insurance companies turned away patients simply because they were sick.
Under our proposal, no patient could be denied coverage based on a pre-existing condition. We create a new "continuous coverage protection," and if you change your job and buy a plan on your own, we would provide protections so you could not be denied coverage or be forced to pay a higher premium because of a pre-existing condition.
This is a lie. The Hatch-Burr-Upton plan absolutely does allow for insurers to deny coverage to or discriminate against people who are already sick. “Continuous coverage protection” means that in order to shield yourself from insurance company discrimination, you have to continuously maintain your insurance coverage. Their plan sets up a one-time-only open enrollment plan for people with pre-existing conditions to buy coverage at normal rates. After that, you have to keep that coverage going without significant interruption. If your coverage lapses for a month or two because you lost your job or something, you’re once again thrown to the mercies of medical underwriting.
Here’s the relevant section from the actual Hatch-Burr-Upton plan, which smoothly transitions from asserting that “no one can be denied coverage” to explaining precisely how you can be denied coverage:
Under our plan, no one can be denied coverage based on a pre-existing condition. To help consumers with preexisting conditions, our proposal would create a new “continuous coverage” protection. Under this new protection, individuals moving from one health plan to another—regardless of whether it was in the individual, small group, or large employer markets—could not be medically unwritten and denied a plan based on a preexisting condition if they were continuously enrolled in a health plan. This new consumer protection helps incentivize responsible behaviors by encouraging consumers to keep their health coverage.
Their Op-Ed promoting the plan just left all that out and made it seem like Obamacare’s ironclad protection against discriminating based on pre-existing conditions would continue in a different form under the new Republican scheme. It won’t. A lesser version of it would be put in place that restores, at some level, the insurance industry’s ability to refuse to sell you insurance. But coming right out and saying that is a political nonstarter, so they just told a little lie and hoped no one would notice.