One of the most hotly debated elements of the newest Republican attempt to repeal and replace the Affordable Care Act has come over the bill's protections for people with preexisting conditions.
While the authors of the Graham-Cassidy-Heller-Johnson plan say the bill protects people with preexisting conditions, critics and health policy experts argue that it leaves openings for those people to get charged much more for insurance.
One of the bill's authors, Sen. Bill Cassidy of Louisiana, got in a Twitter fight with NPR over the issue.
One GOP senator on Thursday, however, seemed to suggest that the new bill could leave sick Americans worse off. Sen. Jeff Flake of Arizona, a Republican supporter of the Graham-Cassidy bill, said on MSNBC's "Morning Joe" Thursday that the new plan could allow states to undermine protections for people with preexisting condition. He argued, however, that that wouldn't end up happening.
"There are provisions in there, I've heard it said, that would allow a race to the bottom and states to deny coverage or allow insurance companies to deny coverage [based] on preexisting conditions," Flake said. "If they're able to, de jure, de facto, they won't be able to."
Many policy experts have argued that the waivers created in the Graham-Cassidy bill could allow states to remove some of the regulations that protect people with preexisting conditions under Obamacare — as long as it lowers overall costs.
The legislation includes a line that states must show how their new system "intends to maintain access to adequate and affordable health insurance coverage for individuals with preexisting conditions."
The vague language, according to healthcare analysts and industry groups, gives significant leeway to the Department of Health and Human Services and states to determine the definition of "adequate and affordable."
This could, in theory, bring down the overall cost for the system as sicker, more expensive to cover people would effectively be priced out of the system. Lowering the overall costs for insurers would allow them to lower premiums. It would, however, undermine the protections for sick people.
Flake acknowledged that possibility, but said it would never happen because states would not pass a law or request a waiver that included such a provision.
"In reality, is any governor or state legislature going to deny coverage based on preexisting conditions?" Flake asked.
"Yes, yes they are," host Joe Scarborough said in response.
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