True to form, N.C. Republicans are wasting little time making life more difficult for the vulnerable in our state.
This time, that means those among us who have preexisting health conditions — the kind that used to result in high insurance premiums or denial of coverage altogether before the Affordable Care Act made those practices illegal. Protecting Americans with preexisting conditions is one of the most popular elements of Obamacare, but Republicans from Washington to Raleigh are nevertheless doing their best to eliminate such benefits.
In Raleigh, the newest effort is a legislative provision that allows for non-profits to offer health benefit plans to its members. Those plans would offer varying degrees of benefits, including some less expensive tiers that don't cover preexisting conditions.
Lawmakers and other supporters of the proposal are careful not to call the health benefit plans "insurance," but that's exactly what they are. The plans would do all the things that insurance does without having to worry about those Obamacare rules and state accountability.
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Supporters of the plans say they're about offering coverage to people who don't want or can't afford pricey Obamacare plans. But Republicans know that nothing happens in a vacuum with health insurance, and the cascade that would result from such plans is clear. Health benefit plans would allow non-profits to pluck young and healthy customers from the ACA, which in turn would force insurers to raise premiums even more to cover the costs of the less healthy folks and elderly who remain on Obamacare.
Eventually, people with preexisting conditions will pay much more for insurance, especially if non-profits are allowed to let non-members join for a small fee to get access to the cheap health plans. The result: Obamacare will be gutted. So will its preexisting conditions benefit.
That's why Donald Trump wants to expand such plans, called Association Health Plans, not only for non-profits but small businesses. One state, Iowa, already has passed a bill this year allowing for AHPs. But when another state, Idaho, tried to expand AHPs with an executive order from Gov. Butch Otter, a federal administrator struck down the plan because it violated ACA rules.
There's clearly some sorting out to do not only within the administration, but in the courts as Trump continues to look for new ways to kill Obamacare. Just last week, the administration's Department of Justice argued in a Texas case that because the new tax law made the ACA's individual mandate illegal, it also invalidated ACA protections for Americans with preexisting conditions. If true, that could allow insurers to eliminate those protections on all plans, not just those on the ACA exchanges.
That argument surprised and rattled Republicans in Washington, who understand the political cost of messing with preexisting conditions coverage. Republicans in Raleigh don't seem to share that concern, but they should pump the brakes on their health plan proposal until the courts and Washington settle what's next in the health care landscape.