Confused about how people with pre-existing conditions will fare under the AHCA? No need to panic.
The perversity of it all is that the legislation is properly understood as doing more to preserve the Obamacare regulation on pre-existing conditions than to undermine it. The legislation maintains a federal baseline of protection in such cases, and says only that states can apply for a waiver from it, provided that they abide by certain conditions meant to ensure that no one is left out in the cold.
Since these provisions only involve the individual insurance market, a small slice of the overall insurance picture (about 18 million are on the individual market), and merely make possible state waivers, they are inherently limited. You’re not affected if you get insurance through your employer (155 million people), or through Medicaid or Medicare.
You’re not affected if you live in a state that doesn’t request the waiver, a category that will certainly include every blue state and most red states, too. Even if you buy insurance on the individual market and live in a state that gets a waiver, you’re not affected if you’ve maintained insurance coverage continuously and not had a gap in coverage longer than 63 days.
By this point, we’re talking about a fraction of a fraction of a fraction of the population. If you do have a pre-existing condition in a waiver state and haven’t had continuous coverage, you can be charged more by your insurer only the first year. The state will have access to $8 billion in federal funds explicitly to ease the cost of your insurance, and the state must further have a high-risk pool or similar program to mitigate insurance costs for the sick.
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