The new repeal version is even worse than the first. It pretends to keep coverage for pre-existing conditions - but states could obtain a waiver of this fake provision, by establishing high-risk pools for expensive patients. These pools have failed in the past because not enough money is appropriated, leaving the patients to pay enormous premium surcharges. Last we heard, the new repeal proposal even makes the waivers automatic, unless the U.S. Health and Human Services rejects them within 60 days.
Waivers can also allow states to let insurance companies delete coverage for "essential health benefits," including:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy, maternity, and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits).
For more information see Washington Post columnists Eugene Robinson, www.washingtonpost.com/opinions/the-gops-latest-health-care-plan-is-comically-bad/2017/04/20/0627b162-2600-11e7-a1b3-faff0034e2de_story.html.
Our comment: The key problem is the excessive cost of U.S. healthcare. There are huge inefficiencies in its delivery, and real reforms are needed. For example, of course costs will rise without limit when pharmaceutical companies, hospitals, insurance companies, and doctors can charge anything, and government will pay whatever is asked so that millions of Americans are not locked out of care. But the Republicans want to save money only by abandoning the poor and sick - to put that money into tax reduction for the rich, more wars around the world, and the wall.