Trumpcare 2.0 would make premiums spike for people with pre-existing conditions

The health care plan could result in premium surcharges as high as $142,000 for people with cancer.

House Speaker Paul Ryan of Wis., and the GOP leadership, meet with reporters on Capitol Hill in Washington, April 4, 2017. CREDIT: J. Scott Applewhite
House Speaker Paul Ryan of Wis., and the GOP leadership, meet with reporters on Capitol Hill in Washington, April 4, 2017. CREDIT: J. Scott Applewhite

Moderate and hard-right Republicans may have finally reached a deal on Trumpcare 2.0, but their latest health care plan would cause premiums to skyrocket for people with pre-existing conditions, according to a new report from the Center for American Progress.

A deal between House Freedom Caucus Mark Meadows (R-NC) and Tuesday Group co-chairman Tom MacArthur (D-NJ) would let states waive the community rating provision, according to The Huffington Post. The community rating provision stops insurers from charging higher premiums to people with pre-existing conditions. Moderate conservatives would allow this as long as Trumpcare 2.0 includes the Essential Health Benefits provision that was taken out of the previous version of the health care plan. However, under certain circumstances, states could waive this provision as well.

This means that under the latest Republican healthcare bill, enrollees could have premium increases of tens of thousands of dollars. The invisible risk pool Republicans have proposed would do little to offset those costs for the least healthy Americans. The CAP analysis found that people with asthma would face a premium surcharge of $4,340 and people with diabetes would face a surcharge of $5,600 a year. For pregnant individuals, insurers would charge $17,320 more for premiums. But the results were worst for patients with chronic illnesses. People with metastatic cancer would be charged $142,650 more.

The Federal Invisible Risk Sharing Program, which establishes a $15 billion fund to pool together people with expensive health conditions, would be ineffective for several reasons. First, the $15 billion would only lower annual premiums by about 1 to 2 percent each year. Second, the administrative burdens would be expensive, since it only covers the costs of certain conditions and that would require a lot of paperwork.

In an interview with the Washington Post, Kaiser Family Foundation Senior Vice President Larry Levitt reacted to the report’s findings. “No insurance company will want to cover people with expensive health conditions if they don’t have to, so they will set premiums to make sure the coverage is out of reach,” Levitt said. “Health care costs are highly concentrated among a small number of people who are sick, and they would find it impossible to get affordable coverage.”

The report noted that before the passage and phase-in of Obamacare, insurers would underwrite, or evaluate people’s health, and raise premiums or decline coverage accordingly. A 2001 Kaiser Family Foundation study found that insurers quoted premiums as high as 50 percent more for depression and 100 percent more for breast cancer, with many of the most expensive, and thus, sickest, people getting rejected.

ThinkProgress is an editorially independent news site housed in the Center for American Progress.