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House Republican Health Care Bill: Putting Families At Risk

The ideas that House Republicans have put forward as a substitute bill will let insurance companies continue to deny you coverage if you are sick; will do little to make insurance more affordable; and will put insurers ahead of consumers by undermining existing consumer protections. The plan would result in millions of Americans losing the coverage and security they currently have, while giving insurance companies more power to discriminate against patients while accumulating record profits.

Rhetoric: The House Republican health care plan expands coverage to those who cannot get insurance now.

Reality: The Republicans' bill substitute leaves affordable health insurance out of reach for millions of Americans.

  • No Elimination of Discrimination Based on Pre-existing Conditions: Nowhere in the bill substitute does it make it illegal for insurance companies to deny coverage based on pre-existing conditions. As a result, consumers will never be fully protected and guaranteed coverage options.
  • High-Risk Pools Will Not Provide Americans with Access to Affordable Coverage: The Republican bill substitute states that it improves access through high risk pools, but those states that currently do not have high-risk pools never need to develop them, and those states that have high-risk pools could close them.
  • Democrats Ensure No American Remains Uninsured Due to A Pre-existing Condition As a Bridge to REAL Health Insurance Reform. House Democrats support affordable access to a high-risk pool nationwide for individuals with pre-existing conditions as a bridge to real insurance reform in 2013.

Rhetoric: The House Republican substitute lets families and businesses buy health insurance across state lines.

Reality: Unlike the House Democrats' bill, the Republicans' bill substitute takes us backwards rather than forwards.

  • In the Absence of Insurance Reform, This Policy will Undermine Patients' Protections: This proposal, which would allow insurance to be sold across state lines in the absence of any broader reforms to prevent discrimination in the individual marketplace would undermine patients' protections, drive up premiums and create a race to the bottom on health care coverage and consumer protections.
  • Insurers Can 'Cherry Pick' Healthy Individuals: Without any additional protections, insurers would be allowed to cherry pick healthy enrollees by marketing strategies, benefit design, and targeting those states with the least consumer protections. That would drive up premiums for everyone else trying to buy insurance in the state.
  • Undermines Basic Protections for Consumers: Under such policies, states would have a further incentive to gut consumer protections, which would create a devastating race to the bottom.
  • Democrats embrace the concept with an actually workable, effective solution: Interstate Compacts are in the Affordable Health Care for America Act , but only because all of the bill's market reforms and consumer protections will be firmly in place in every state - ensuring that Interstate Compacts cannot become the race to the bottom that they will be under the Republican plan.

Rhetoric: The House Republicans' bill substitute allows individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do today.

Reality: So called 'Association Health Plans' will reduce choices for small businesses and leave consumers vulnerable to fraud and abuse. By contrast, the Democrats' comprehensive bill creates a Health Insurance Exchange where small business employees can obtain health insurance at rates like large groups get now, with a minimum level of benefits to guarantee quality coverage.

  • Association Health Plans are Exempt from State Consumer Protections: Association Health Plans (AHPs) allow small businesses from different states to pool together and buy health insurance that is exempt from consumer protections secured by many state laws.
  • AHPs Allow Insurers to Cherry Pick Healthy Workers: By avoiding state consumer protections, AHPs make it easier for insurance companies to 'cherry pick' healthy individuals and firms, leaving out those that are older or sicker, raising premiums for everyone else.
  • AHPs Leave Consumers Vulnerable to Fraud and Abuse: AHPs are exempt from state oversight and would undermine states' comprehensive tools to prevent, identify and shut down fraudulent plans and their plans ability to protect consumers. Such proposals 'exacerbate the current problem of health insurance fraud' and 'leave small businesses and their workers unprotected. The consequences are predictable: bankruptcy, delayed or foregone medical care, and loss of coverage for America's small businesses and workers.' [http://hpi.georgetown.edu/ahp.html]

Rhetoric: The House Republican bill substitute gives states the incentives through bonus payments to create their own reforms that lower health care costs and increase coverage.

Reality: The Republican bill substitute provides neither the means for cost containment nor the support that states need to get at cost drivers and affordability of health care. It includes:

  • NO policies to promote quality health care and efficiency of health care in private or public health insurance.
  • NO premium assistance for middle-income families that struggle to pay for health insurance.
  • NO increased support or options for states to build the platforms to improve the delivery system.
  • The Democrats' bill provides a number of incentives and resources for states to provide efficient, effective, and innovative health care delivery and affordability credits to help Americans afford coverage.

Rhetoric: The House Republican bill substitute ends junk lawsuits that contribute to higher health care costs by increasing the number of tests and procedures that physicians sometimes order not because they think it's good medicine, but because they are afraid of being sued.

Reality: The Republican bill substitute offers new no ideas; the bill caps the amount of damages a person injured can receive and will preempt state consumer protection laws.

House Democrats have included a voluntary state incentive grants program in our bill to encourage states to develop alternatives to traditional malpractice litigation.