The former chairman of one of the US House of Representatives committees that drafted legislation to repeal and replace large parts of the US’ Patient Protection and Affordable Care Act (ACA) came out against a new version of the bill on Tuesday, saying the measure now “torpedoes” protections for people with pre-existing medical conditions.
“I cannot support the bill with this provision in it,” US Representative Fred Upton — who chaired the House Committee on Energy and Commerce as the healthcare law repeal movement built steam — said on a local radio show, just as House Speaker Paul Ryan was insisting that the legislation would protect the sick.
The loss of Upton, an influential Republican voice on healthcare, was a huge blow, and it came as Republican leaders faced an onslaught of advocacy groups, political attack ads and even late-night talk show host Jimmy Kimmel saying the bill would harm the nation’s most vulnerable citizens.
A tearful Kimmel on Monday night offered up the story of his infant son’s near-death heart surgery, followed by an appeal to US Congress not to undermine the healthcare law’s ban on discrimination against people with pre-existing medical conditions.
After Kimmel’s monologue went viral on the Internet, former US president Barack Obama piled on, saying on Twitter: “Well said, Jimmy. That’s exactly why we fought so hard for the ACA, and why we need to protect it for kids like Billy. And congratulations!”
Upton was explicit: The concessions made to win over conservatives in the House Freedom Caucus were costing the leadership support from more moderate Republicans.
“I’m not at all comfortable with removing that protection,” Upton said of the pre-existing condition concession.
Ryan insisted that Republicans were “making very good progress with our members,” but he offered no indication of when a vote might be held on the measure.
Officials in the administration of US President Donald Trump have said a vote could come as early as yesterday, but as House Republican leaders scrambled to assemble a majority, a quick vote appeared unlikely.
“There are a few layers of protections for pre-existing conditions in this bill,” Ryan said at a news conference. “What’s important is we want to have a situation where people can afford their health insurance. We want to have a situation where people have a choice of health insurers. That’s not happening in Obamacare.”
Ryan and his fellow Republican leaders, under intense pressure from the White House, are struggling to round up the support for a revised version of their bill to repeal and replace Obama’s signature domestic achievement.
After the failure of their earlier repeal bill in March, they have held off moving forward with a vote while they try to build support for the updated measure.
At the heart of the debate is an amendment to the repeal bill proposed by Representative Tom MacArthur with the blessing of House Republican leaders.
The amendment last week won over the House Freedom Caucus, in part by giving state governments the ability to apply for waivers from the existing law’s required “essential health benefits,” such as maternity, mental health and emergency care, and from rules that generally mandate the same rates for people of the same age, regardless of their medical conditions.
The MacArthur amendment has given pause to numerous moderate Republicans, in large part because of concerns over whether it would allow states to gut those consumer protections.
As Ryan was defending the plan, the Association of American Medical Colleges came out against it, joining the American Medical Association and a host of disease advocacy groups.
Association of American Medical Colleges president and chief executive Darrell Kirch said the newest version of the repeal bill “dilutes protections for many Americans and would leave individuals with pre-existing conditions facing higher premiums and reduced access to vital care.”
Under the amendment, states could obtain a waiver from a provision of the healthcare law that prohibits insurers from charging higher rates to people with pre-existing conditions.
With a waiver, states could permit insurers to charge higher premiums based on the “health status” of a person who had experienced a gap in coverage. To qualify for a waiver, a state would have to have an alternative mechanism, such as a high-risk pool or a reinsurance program to provide or subsidize coverage for people with serious illnesses.
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