— Rep. Martha McSally (R-Ariz.), in a campaign ad for her Senate race, released Oct. 24
“I support forcing insurance companies to cover preexisting conditions.”
— Gov. Rick Scott (R-Fla.), in an ad for his Senate race, released Oct. 24
“Obama would force insurance companies to cover preexisting conditions.”
— Barack Obama “coin” ad, released Oct. 2, 2008
Did it suddenly become 2008 all over again?
When Barack Obama first ran for president a decade ago, he promised to force insurance companies to cover preexisting conditions, contrasting his stance with Republican nominee John McCain, who the ad said would let insurance companies “continue to do as they please.”
Obama became president and, in the face of universal Republican opposition, pushed through the Affordable Care Act, commonly known as Obamacare. Before Obamacare, insurance companies could consider a person’s health status when determining premiums, sometimes making coverage unaffordable or even unavailable if a person was sick or had a condition that required expensive treatment. The ACA included a series of provisions that prohibited such practices, but then Republicans spent years trying to repeal the law.
Now some Republicans are stealing Obama’s rhetoric and claiming they will do what the ACA – which remains largely intact, despite President Trump’s efforts – already does. It’s certainly an interesting turnaround.
Scott is not in the House or Senate, so we included his quote because of its “huh” factor. We will now turn our attention to Taylor and McSally, and their claims about having fought insurance companies.
The statement in Taylor’s ad is cleverly divided into two parts. He says he “stood up to insurance companies” and voted to “protect people with preexisting conditions.” It does not quite have the direct link in the other two ads.
But it’s still fishy. The Taylor campaign cited a 2017 vote in favor of ending health insurance company anti-trust exemptions in the McCarran-Ferguson Act of 1945. In the House, this was not a controversial bill, as it has the support of dentists, surgeons and other physicians who want more clout to negotiate contracts with insurance companies. Insurers would be prohibited from engaging in price-fixing, bid-rigging and market allocation in an aim to increase competition and lower premiums. It passed 416-7, but the Senate.has taken no action.
The campaign also points to Taylor’s co-sponsorship of a bill called the Transparent Health Care Pricing Act of 2018. No action has been taken on it. In addition, the campaign points to two relatively minor bills on drug pricing that became law. Both originated in the Senate and were passed by a voice vote in the House.
None of these actions really counts as standing up to insurance companies. As for voting to protect people with preexisting conditions, that refers to Taylor’s vote for the GOP’s American Health Care Act (AHCA), which narrowly passed the House, 217-214, but failed to proceed in the Senate.
Twenty Republicans voted against the AHCA, in part because of their uneasiness with the changes proposed for the provisions regarding preexisting conditions. That unease was confirmed when the Congressional Budget Office issued a critical report three weeks after the vote. (We have written at length about this before.) The CBO was skeptical that the AHCA would work without harming people with preexisting conditions, in part because of inadequate funding.
So while there was language in the bill saying nothing in it would “limit access to health coverage for individuals with preexisting conditions,” that still did not protect people from price increases. The CBO said that in some states, insurance might simply become unaffordable for people with certain diseases.
Regarding the McSally ad, it says she was leading the fight – for something people already had under the ACA. Her campaign did not respond to a request for an explanation but told our colleagues at PolitiFact that she “successfully negotiated $8 billion in additional funding to bring down insurance costs for people with preexisting conditions.” The amendment helped swing some votes that assured passage, but remember how the CBO said the bill did not have enough funding? That was specifically referencing that $8 billion.
While the CBO expects “that federal funding would have the intended effect of lowering premiums and out-of-pocket payments to some extent, its effect on community-rated premiums would be small because the funding would not be sufficient to substantially reduce the large increases in premiums for high-cost enrollees,” the report said. “To evaluate the potential effect of the $8 billion fund, looking back at the high-risk pool program funded by the ACA prior to 2014 is useful. Within two years, the combined enrollment of about 100,000 enrollees in that program resulted in federal spending of close to $2.5 billion.” The CBO then referenced a report that said “these high-risk pools likely covered just a fraction of the number of people with preexisting conditions who lacked insurance.”
In other words, the $8 billion was woefully inadequate. During the debate over the Senate version of repeal, which did not pass, Trump said the House version was “mean” because it did not go far enough to protect individuals in the insurance markets. He urged the Senate to add more funds to cover people with preexisting conditions.
McSally also voted for the GOP’s AHCA. Moreover, earlier in her tenure as a member of Congress, she voted to repeal Obama’s ACA without a replacement in effect.
The Pinocchio Test
Under fire from their Democratic rivals for their votes on health care, McSally and Taylor are misleading voters. The protections for people with preexisting conditions are already pretty strong in the ACA. Both lawmakers cast votes that the CBO said weakened protections against price increases, especially in states that took advantage of waivers in the law. The money contained in the bill to mitigate those problems was inadequate, the CBO concluded.
The irony is rich: After years of trashing Obamacare, these Republicans are now saying they will do what he promised he would if elected president.
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