Conservatives Demand End to Pre-Existing Conditions Ban


I guess I was wrong last night. The New York Times says President Trump has caved in to demands to repeal the minimum set of required benefits for health care insurance:

President Trump agreed to the demands of conservative House Republicans to remove federal requirements that health insurance plans provide a basic set of benefits like maternity care, emergency services, mental health and wellness visits as he struggles to round up enough votes to pass a broad health care overhaul.

But the Washington Post reports that this still wasn’t enough:

Conservative House Republicans rebuffed an offer by President Trump on Thursday to strip a key set of mandates from the nation’s current health-care law, raising doubts about whether House Speaker Paul D. Ryan (R-Wis.) has the votes to pass the bill.

….Rep. Justin Amash (R-Mich.), asked whether the White House had made its final negotiating offer, said that if that’s the case, “They’re not going to pass the bill.”…As of mid-afternoon Thursday, 37 House Republicans — mainly Freedom Caucus members — had announced their opposition to the bill, known as the American Health Care Act.

So what do conservatives want? Here’s the Post again:

Conservative lawmakers have asked to eliminate much of [Obamacare’s] Title I, which….bars companies from setting insurance rates based on a person’s sex, medical condition, genetic condition or other factors.

In other words, insurers could charge you more if you have a pre-existing condition. That would effectively kill off the Obamacare provision that requires insurers to cover everyone who applies. They’d simply price policies out of reach for people with expensive pre-existing conditions and that would be that.

Would this pass muster with the Senate parliamentarian, who has to agree that repealing Title 1 “directly affects” the budget? I doubt it. Would Mike Pence go ahead and overrule her? Maybe. Is this whole thing a debacle beyond imagining? Oh yes.

POSTSCRIPT: It’s worth pointing out that if Republicans go down this road, they’ve essentially killed the filibuster completely. Basically, they would have set a precedent that anything can be added to a reconciliation bill—which can’t be filibustered—and the vice president will overrule the parliamentarian and declare that it’s OK. At that point, the Senate can include reconciliation instructions for just about anything in its annual budget resolution. As long as the president and vice president are from the same party, they can then pass anything they want with 51 votes.