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Who could be at risk for higher premiums under GOP?
20 May 2017, 12:12 | Marion Schneider
It would depend on how many states opt to waive the provision and how many consumers let their coverage lapse.
Prospective patients who have had a gap in their insurance coverage lasting 63 days or more within the previous year could see their premiums go up based on their health status for at least one year before being eligible for a community-rated premium that would not be impacted by pre-existing conditions.
A new study by the non-profit Kaiser Family Foundation reveals just how devastating the American Health Care Act will be to individuals with pre-existing conditions. Under the waiver option, known as the MacArthur amendment, insurers in opt-out states would be able charge those with pre-existing conditions more than the the standard premium rate if the consumers had a lapse in coverage longer than 63 days.
But according to the analysis released Wednesday, 6.3 million people who have a pre-existing condition also have had gaps in coverage that would lead to a substantial premium increase.
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Republicans have come under fire for the bill's rollback of the ACA's protections for pre-existing conditions.
Even with major insurers, such as Anthem Inc., assuming that the cost-sharing reduction subsidies will be continued, proposed premium increases filed for 2018 for ACA exchanges in Virginia, Delaware and CT are in the range of 30 percent to 40 percent.
The three-year Obamacare reinsurance program provided about $6.5 billion a year while the AHCA would provide more than $12 billion a year, Blase said. States can't get a waiver unless they have a high-risk pool or a reinsurance program. The Kaiser Family Institute estimates that more than a quarter of non-elderly adults have preexisting conditions that would have negatively affected their coverage prior to the passage of the Affordable Care Act.
The Senate is now working on its own health care bill, and the version that emerges could make significant changes to the version that passed in the House. For one, the tax credits under the GOP bill are less generous for certain groups of people - particularly lower-income and older consumers - than the current Obamacare subsidies, meaning more people could have a harder time affording continuous coverage.
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