The Congressional Budget Office has concluded that under the $61 billion Republican amendment to the House health care bill, the number of uninsured Americans would increase to 52 million by 2019, but deficits would decrease by $68 billion over the 2010–2019 period. The bill could slightly reduce premiums for Americans who purchase coverage independently.
Millions of Americans would remain uninsured and continue to pay higher premiums. In fact it’s unlikely that any of the members of the Republican House Leadership would be able to find affordable insurance under their own proposal, should they chose to give up their government-sponsored plans.
The six men and one woman in the Republican House leadership have an average age of 52 and, as a group, are more susceptible to cardiovascular disease, different cancers, high blood pressure, and host of other chronic diseases. The Republican health alternative would allow insurers to discriminate against these conditions and price the Republican leaders out of the market:
1. Leadership would not find coverage in the individual market:
Republicans hope to increase access to coverage in the individual market by giving individuals the opportunity to purchase insurance licensed in different states. But it’s unlikely that any of the House Republicans would be able to find an affordable coverage option. Insurers that sell policies in the individual market-place usually deny coverage to older Americans with pre-existing conditions or those at risk of developing chronic disease. In fact, over the last three years, “nearly three-quarters of people who tried to buy coverage in this market never actually purchased a plan, either because they could not find one that fit their needs or that they could afford, or because they were turned down due to a preexisting condition.”
2. Leadership would not find adequate coverage in high-risk pools:
When the Republican leaders are denied coverage in the individual market, they could apply for insurance in expanded state-based high risk pools, which typically provide very expensive coverage for the so-called “uninsurables.” But their legislation does not adequately fund these pools and would compel states to limit services, deny coverage for pre-existing conditions, and impose high cost sharing.
3. Leadership would not find stable coverage in association health plans:
If Republican leaders can’t purchase affordable coverage from state-run high risk pool, they could join an association-sponsored plan. Unfortunately, under their own legislation, associations are not required to provide a standard package of benefits and have an incentive to craft skimpy policies that attract healthier applicants.
The Republican legislation lowers costs for younger and healthier Americans by segregating risk pools and offering individuals who rarely use their health insurance cheaper premiums — so long as they remain healthy. The legislation doesn’t offer new choices or lower costs for the majority of the population.
