Seeking to show Republicans’ commitment to protecting those with pre-existing conditions, a group of GOP senators led by Sen. Thom Tillis of North Carolina is reviving and expanding a bill that would retain at least some of the protections built into Obamacare.
The move is an attempt to address concerns that the popular and ironclad provisions secured by the Affordable Care Act may disappear amid President Donald Trump’s renewed drive to overturn the landmark health reform law. It comes as Democrats offer up an array of new proposals for universal, government-backed health coverage.
The bill’s introduction comes less than two weeks after the Trump administration said in a federal appeals filing that the entire Affordable Care Act should be struck down, a surprising shift from its earlier position that only key pre-existing conditions protections were unconstitutional. The Justice Department now says it agrees with a Texas federal judge’s ruling that invalidated Obamacare because Congress effectively eliminated penalties for not having insurance.
The administration’s new stance put the GOP back on the defensive against claims that it is not committed to making sure that people with complicated medical histories can still get comprehensive insurance. And it placed a spotlight on the fact that the party still has no solid plan to replace law should it fall.
Trump has said Republicans would unveil a new health care plan, but Senate Majority Leader Mitch McConnell quickly tamped down any expectations that the chamber would pursue such legislation.
McConnell has made clear, both privately to Trump, and publicly, that he has no plans to take up broad health care reform legislation until after the 2020 election. But he did say he was open to smaller-bore measures related to prescription drug prices – and the Tillis bill may become a more palatable GOP backstop if the courts do end up striking down Obamacare in full.
Like last year’s version, the Tillis bill doesn’t have the votes to move forward in the Senate. Democrats have dismissed GOP health care efforts, which they view as a way to undermine Obamacare, and it’s an open question whether all Republicans in the chamber to support it. Fifteen Senate Republicans co-sponsored a similar Tillis measure in the last Congress. House Democrats, now in control of the chamber, have focused their energy on defending Obamacare or more expansive health care overhauls, making it exceedingly unlikely they’d ever consider the bill.
Tillis first introduced the legislation shortly after the Justice Department announced it would not defend Obamacare’s pre-existing protections in the Texas case. The senators marketed that bill as ensuring that those with imperfect health histories would be able to get insurance. It became a talking point for some Republicans on the midterm campaign trail.
However, experts quickly pointed out that the bill would allow insurers to exclude coverage of the pre-existing conditions and to adjust premiums based on gender, which could increase rates for women, especially those of child-bearing age. Obamacare, on the other hand, requires insurers to provide comprehensive policies and bars them from using gender as a factor in rates.
This year’s legislation would bar insurers from excluding such coverage, according to The Wall Street Journal, which first reported the new Tillis bill.
Tillis is up for re-election next year in a state that has politically swung back and forth between Democrats and Republicans over the last decade.