The GOP health care plan "would allow health insurance companies to continue engaging in unfair and discriminatory practices like denying coverage to people because of a pre-existing medical condition."

Debbie Wasserman Schultz on Tuesday, November 3rd, 2009 in a press release


Wasserman Schultz says GOP alternative health care plan allows insurers to continue denying coverage for pre-existing conditions
Mostly True

The GOP's alternative health care plan hadn't even hit the streets before the Democratic push-back began.

The day before the plan was officially unveiled, U.S. Rep. Debbie Wasserman Schultz, D-Fla., took aim at the way the GOP plan was described by media outlets that had gotten early, leaked versions of it.

In a press release from the Democratic National Committee, Vice Chair Wasserman Schultz said the GOP plan, "would allow health insurance companies to continue engaging in unfair and discriminatory practices like denying coverage to people because of a pre-existing medical condition."

Requiring insurers to cover people with pre-existing conditions has been a popular element of the Democratic plan.

Now that we've seen the full 219-page GOP alternative plan, it shows Wasserman Schultz is correct that it does not prohibit health insurance companies from denying coverage to people due to pre-existing medical conditions.

But to listen to her, one might get the impression the Republicans have completely ignored the issue of pre-existing conditions. And they haven't. They have a different idea that they think will get at the problem.

More than 10 pages of the GOP bill spell out a plan to help people with pre-existing conditions by allowing universal access to expanded and improved state-run high-risk pools. They accept patients who have health conditions that might prompt private insurance companies to reject them. Already, 34 states have high-risk insurance pools.

"We want to encourage all states to have these," said House Republican Leader John Boehner. "And we put more money into these high-risk pools so that we can bring down the cost of health insurance. And at the end of the day, what we're doing with our proposal is lowering health care insurance premiums — lowering cost and expanding access."

The Republican plan calls for $25 billion in funding through 2019 to subsidize state high risk pool and reinsurance programs.

In an MSNBC interview on Nov. 4, U.S. Rep. Mike Pence, chairman of the House Republican Conference, said the cost of bolstering state funds and insurance programs to cover people with pre-existing conditions would be offset by savings from medical malpractice reforms that he said would "rein in some of these runaway massive lawsuits that drive defensive medicine and drive up the cost of premiums."

Democrats counter that high-risk insurance pools have done little to solve the problems faced by people with pre-existing medical conditions. Premiums in those pools are usually far more expensive than in your average health insurance plan, and therefore remain out of reach for many moderate to low-income people with pre-existing conditions.

The Republican plan tries to address that by requiring that the pool "must limit the pool premiums to no more than 150 percent of the average premium for applicable standard risk rates in that state." In other words, it might cost people with pre-existing conditions 50 percent more than average premiums paid by healthy people.

But a study shows that might make the price too high. A February 2005 study by the nonpartisan Commonwealth Fund found that in states with high-risk pools, the rates were typically 25 percent to 50 percent higher than average rates. People with lower incomes just couldn't afford to buy into the state pools. As a result, they found, high-risk pool subsidies tended to go to a small number of relatively high-income people, those who could afford premiums well above market rates.

The GOP plan for dealing with the issue of people with pre-existing conditions "is essentially the same as now, and now is not working," said Jonathan Beeton, a spokesman for Wasserman Schultz.

Wasserman Schultz was correct when she said the GOP plan does not prohibit health insurance companies from denying coverage to people with pre-existing conditions. We found nothing in the 219-page Republican plan that would do that. Insurance companies have argued that they can only absorb the cost of taking people with pre-existing conditions if they could offset that expense by expanding their customer base through mandates that everyone buy insurance. And the Republican plan doesn't do that.

Still, we think Wasserman Schultz's comments imply that Republicans have simply ignored the issue of pre-existing conditions altogether. They have not. They have taken a different tack from the Democrats. And Democrats may not agree that dealing with the issue through state-run high-risk pools is an adequate plan, but it is a plan. And so we rule Wasserman Schultz's comment Mostly True.

also;
Health care reform "establishes a new board of federal bureaucrats (the 'Health Benefits Advisory Committee') to dictate the health plans that all individuals must purchase."

House Republican Conference on Thursday, October 29th, 2009 in a news release

truth ometer reports half/truths and mostly false statements by Republicans.

http://www.politifact.com/truth-o-meter/ar...-truth-o-meter/

GOP Health Care Reform ; Republicans this week unveiled their own version,

• It doesn't do much to reduce the uninsured population. By 2019, the number of uninsured would drop by 3 million, leaving 52 million nonelderly Americans uninsured. That means 83 percent of legal non-elderly residents would have insurance coverage by 2019, roughly the same as it is today. The comparable coverage rate for the Democratic bill is 96 percent. The Democratic plan would reduce the uninsured by 36 million, leaving 18 million without coverage.

• It might reduce consumer protections. The flip side of several of the Republicans' new consumer options is a decrease in regulation. If insurance policies are sold across state lines, critics say, there could be an incentive for insurers to locate in the least-regulated states, allowing them to scale back coverage. And the Republican bill, unlike the Democratic bills, doesn't specifically bar insurers from excluding pre-existing conditions, even though that policy has broad support in both parties.

• Its idea of boosting high-risk pools for sicker patients may not be effective. The states that have tried high-risk pools in the past have not found them to be popular, largely due to the high costs for the consumer. In theory, experts say, such pools could be subsidized enough to make premiums low enough to be attractive. But it would be expensive to do so, and many experts say the Republican bill doesn't provide enough money to make them work. The Republican plan calls for $25 billion in funding through 2019.

• It misses an opportunity to trim Medicare spending. Health care experts have long pointed to the need to rein in the growth of Medicare spending, because if nothing is done, it could eventually eat up an enormous share of the federal budget. The Republicans' current stance of protecting Medicare Advantage may be politically popular among senior citizens, but critics say it allows the most generously reimbursed portion of the Medicare system to continue unabated, effectively delaying the fiscal day of reckoning for the program. (While the Democrats do propose cutting Medicare Advantage, and while they would impose permanent reductions in certain payment rates to the tune of $229 billion over 10 years, some critics have called their approach too timid as well.)