Fact-Checking Republicans’ Defense Of The GOP Health Bill – Alison Kodjak May 9, 20176:17 PM ET


People attending Rep. Rod Blum’s town hall event in Dubuque, Iowa, this week held up red sheets of paper to show disagreement with what the Republican congressman was saying and green to show they concurred. The GOP health care bill was a major concern of many.

Scott Olson/Getty Images

Town hall meetings got loud for some Republican members of Congress this week, as they defended the passage of the American Health Care Act by the House of Representatives. Constituents have been asking a lot of questions, and we’ve been fact-checking the answers given by some leading GOP lawmakers.

Tom Reed, R-N.Y., at a town hall meeting in his district

“The pre-existing reform is not repealed by this legislation.”

Fact check: That’s not the whole truth

Reed was responding to a constituent who was concerned about a child with severe allergies: “His co-pays and deductibles will be through the roof,” the parent told Reed, “because he’s going to be in a high-risk pool — because he has a pre-existing condition.”

“No, no, no,” Reed told the parent.

The bill does have language that says insurers cannot deny people coverage or charge them more just because they have a pre-existing condition.

However, the GOP bill also has an enormous loophole in that regard. The plan allows states to apply for waivers from the federal government that get them out of many of the regulations put in place under the Affordable Care Act — including one that bans insurance companies from charging people with pre-existing conditions more for a health plan. A waiver would allow insurance companies to consider a person’s health status when determining what to charge for coverage. And that means that although someone with a pre-existing condition who lives in a state that got a waiver would have to be offered a policy, it could be very expensive.

Steve Scalise, R-La., on Fox News this week

“No matter what kind of plan you have today,” Scalise told Fox News, “if you have a pre-existing condition, under our bill, you cannot be denied coverage and you cannot be charged more than anybody else.”

Fact check: Not exactly true

Scalise, like Reed, is pointing to the language in the bill that retains the Obamacare rules that prohibit insurers from charging people with expensive medical conditions more than their neighbors of the same age for an insurance policy.

But the state waivers allow insurers a way around that guarantee.

qBefore the Affordable Care Act, insurance companies denied coverage or charged more if the person who wanted insurance had any of a long list of conditions — including arthritis, diabetes, heart disease, muscular dystrophy, obesity and sleep apnea, according to a list compiled by the Kaiser Family Foundation from insurers’ underwriting guidelines.

Insurers also could refuse to cover many medications, including drugs that treat cancer, diabetes, AIDS or arthritis, according to Kaiser.

If you have cancer and buy insurance that doesn’t pay for your cancer treatment, your pre-existing condition is effectively excluded.

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