A new report from the House Committee on Energy and Commerce has found that the top four insurers “denied health coverage to 49 percent more people in two years for reasons such as pregnancy and the likelihood of adopting a child,” resulting in some 651,000 rejected applicants between 2007 and 2009. Before the Affordable Care Act, moreover, “each company had a business plan to exclude pre-existing conditions, said the report, citing internal insurer documents the panel obtained“:

A year-by-year analysis shows a significant increase in the number of coverage denials each year. The insurance companies denied coverage to 172,400 people in 2007 and 221,400 people in 2008. By 2009, the number of individuals denied coverage rose to 257,100. Between 2007 and 2009, the number of people denied coverage for pre-existing conditions increased 49%. During the same period, applications for insurance coverage at the four companies increased by only 16%.

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The report also concludes that certain medical conditions like pregnancy, surgery, or infertility treatments triggered an automatic denial, which “no longer require a review for declination.” In some cases, the companies granted coverage to sicker individuals “but used medical riders to exclude coverage or increase deductibles for the pre-existing conditions. In the case of one of the companies, nearly 15% of the company’s customers in the individual market in 2010 had policies with riders limiting coverage or increasing deductibles for certain medical conditions.”

Insurers considered these tactics standard business practices and planned on developing new ways to avoid expensive risk, the report finds:

- Increasing the look-back period on pre-existing conditions: When an individual applies for health insurance, the company will “look back” at the applicant’s prior medical history for a certain period of time to identify pre-existing conditions that could provide a justification to deny coverage.

- Assessing separate deductibles specifically for identified pre-existing conditions: In a presentation concerning risk assessments in the individual health insurance market, executives at another company were provided a “[p]re-ex opportunity overview.”

- Denying payments for prescription drugs related to pre-existing conditions: Executives for a third company have recently introduced a project to withhold insurance reimbursement for prescription drugs if the medication is used to treat pre-existing conditions.

- Linking additional claims to pre-existing conditions exclusions: During an internal evaluation of the individual business, executives at the fourth company discussed “[c]ontrol[ling] cost by conducting Pre-Existing Condition Investigations.”

- Narrowing the definition of prior creditable coverage: Prior creditable coverage is a period of past health insurance coverage that can shorten the length of time a new insurer can exclude insurance coverage of pre-existing conditions. Internal documents reveal that executives at one of the companies considered changing “the definition of prior creditable coverage to exclude prior individual coverage.”

Repealing the Affordable Care Act could leave the door open to all of these abuses, but that last point is particularly relevant since the GOP’s repeal and replace health care Pledge would only extend pre-existing conditions exclusions to individuals with prior creditable coverage. Depending on how one defines that term, it could exclude millions of Americans.

During a somewhat uncomfortable interview with Ann Coulter, Mike Huckabee attempted to persuade the controversial columnist that he was more conservative than other potential GOP presidential contenders, going so far as to attack Mitt Romney’s health care reform plan for covering abortion services:

HUCKABEE: And I do appreciate you’re pro-life because you’ve been consistent on that except for one thing. During the campaign you called me a liberal, except you supported Mitt Romney whose health care bill is the blueprint for Obamacare and provides abortions for 50 bucks. So, is that conservative?

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For his part, Romney has tried to portray his law as a conservative measure, telling Fox News’ Chris Wallace in March, “that it’s saving lives” and “is the ultimate pro-life effort.” But his law does provide Massachusetts residents with a comprehensive package of benefits which include “doctor’s visits, surgery, radiology and lab” and abortion services — a procedure Romney says he now opposes.

Democrats in at least three tightly contested campaigns defended their votes for the Affordable Care Act last night, touting the most popular provisions of the law and insisting that the law represented a step in the right direction. Sen. Russ Feingold (D-WI) has been the most vocal supporter of the law on the campaign trail, but Sen. Michael Bennet (D-CO) and Rep. Brad Ellsworth (D-IN) — who is running for Evan Bayh’s seat — are also using their votes for the law’s consumer protections to distinguish themselves from their Republican opponents.

During a series of rapid fire questions about health care in the Colorado senate debate, Bennet’s challenger Ken Buck said he supported some of the popular provisions in the law, to which Bennet retorted, “until the very end, Ken Buck was for the health care reform bill.” Some other highlights:

ELLSWORTH: “I’m proud that we took it on. I think it does some great things. I think that it eliminates pre-existing conditions for children and then eventually for adults. It finally closes the doughnut hole for seniors… And I think that’s a very important step. Is the bill perfect? Absolutely not. Will it be added to and deleted from, it will? But it was a good first step and we should do it.”

FEINGOLD: “It’s really a compromise that’s sort of in the Wisconsin tradition…the bill is a good compromise that I think brings the country forward on the number one issue that’s been brought up to me over the years….I want this bill because I think it was the right solution. Yes, I would have preferred a public option because I think it would have made it even stronger.”

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Responding to Feingold’s strong defense of the health law, challenger Ron Johnson has softened his rhetoric on repeal, while Buck has conceded that the claim that the law would cut $500 billion from Medicare benefits is false.

Rep. Mike Pence (R-IN) promised that Republicans would restrict access to abortions if the party regains power after the midterm elections, telling listeners of WOWO AM 1190 this morning that President Barack Obama has led “the most pro-abortion administration since Roe v. Wade.”

In a year in which Republicans have downplayed abortion issues in favor of the economy and jobs — so-called traditional issues received no more than a line in the GOP’s Pledge — Pence left no doubt that the party will pursue an anti-abortion agenda. Along with repealing Obamacare “lock, stock and barrel,” Pence pledged to:

PENCE: [P]ush for legislation that would impose the Hyde amendment restrictions on abortion funding across federal spending… Reinstating the Mexico City policy to make sure our foreign aid isn’t used to subsidize abortion. Using the power of the purse to make sure that the federal budget reflects the values of the American people is mission critical. I think in all of those ways, you’re going to see — if Republicans are given the opportunity to lead again — you’re going to see a pro-life agenda on Capitol Hill. It will be a bipartisan pro-life agenda because there are more than a few pro-life Democrats who I believe will stand with Republicans in those efforts.

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Pence also referenced Gov. Joe Manchin’s (D-WV) support for repealing health care reform and suggested that Republicans may have a bipartisan majority to overturn President Obama’s veto of repeal legislation. “The reality is, you’ve got a Democratic candidate for Senate out in West Virginia, Gov. Manichin who has just announced that he’s for full repeal of Obamacare,” Pence said. “I don’t know how public opinion would shift if they thought we had the votes in the House and the Senate to repeal Obamacare.” “We do have this thing called veto-override. Which again, is a very tall hill under the constitution of the United States but too often in the public debate we leave the American people out of the conversation.”

Pence also promised to pursue the “dual track” of de-funding reform, saying that Republicans will use the “power of the purse to deny any funding for the implementation of Obamacare so at minimum we will have the ability to take their government takeover of health care to a national referendum in the next presidential election.”