GOP Looks Ready to Sacrifice Pre-Existing Condition Safeguards

"Anybody (especially Fake News media) who thinks that Repeal & Replace of ObamaCare is dead does not know the love and strength in R Party!" So proclaimed President Trump on Twitter on Sunday, and it wasn't an idle tweet. The AP reports that Vice President Mike Pence and two senior White House officials offered up a carrot in a closed-door meeting Monday night with their biggest GOP foe on the issue, the House Freedom Caucus. They reportedly offered the ability for states to apply for waivers to two ObamaCare coverage requirements: "essential health benefits," which mandates coverage in 10 categories, like prescription drugs and maternity care; and "community rating," which forces plans to charge all members of an age group the same price.

Doing away with those essentially means eliminating the pre-existing condition safeguards, an ObamaCare tenet that Trump has until now promised to maintain. The New York Times gives a hypothetical that clearly illustrates the potential impact:

• "Technically, the deal would still prevent insurers from denying coverage to people with a history of illness. But without community rating, health plans would be free to charge those patients as much as they wanted. If both of the Obamacare provisions went away, the hypothetical cancer patient might be able to buy only a plan, without chemotherapy coverage, that costs many times more than a similar plan costs a healthy customer. Only cancer patients with extraordinary financial resources and little interest in the fine print would sign up."

The Freedom Caucus expects to get the offer in writing Tuesday, and caucus head Rep. Mark Meadows responded favorably to it in comments to the Times. As for why conservatives are gunning for such changes, the paper explains that it could make premiums for healthy Americans much cheaper, while potentially forcing those with pre-existing conditions back into "high-risk pools." (More American Health Care Act stories.)