Pittenger: What I meant when I suggested people with pre-existing conditions could move to another state

Robert Pittenger
Robert Pittenger

About 600,000 North Carolinians were at risk of having zero health insurance options this year when Blue Cross, the only Obamacare option in 95 out of 100 counties, seriously considered pulling out. Humana will pull out of Obamacare nationwide in 2018, and Aetna and CareFirst are on record that Obamacare “is in a death spiral.”

While some would have us stick our heads in the sand, House passage of the American Health Care Act was “first base” in a responsible, multiple-step effort with the Senate to repair America’s health care system.

Obamacare’s actuarial projections were never valid, based on erroneous assumptions of younger individuals buying-in to support more costly seniors. Common sense reminds us Washington has a disastrous management record, with the VA and Post Office prime examples.

The American Health Care Act is based on the premise that states can best respond to their own unique needs, and ordinary Americans shouldn’t be forced into a one-size-fits-all plan picked by Washington. Personalized state-level management and increased options for individuals will result in better, more cost-effective choices for Americans.

Many are rightly concerned about protections for those with pre-existing conditions. Every bill I’ve supported to repeal and replace Obamacare has included protections for pre-existing conditions. Under AHCA, insurers are prohibited from denying coverage due to pre-existing conditions, prohibited from canceling coverage due to a new diagnosis, and prohibited from raising premiums for individuals who maintain continuous coverage.

States would have flexibility to apply for waivers of Obamacare’s “community rating provision,” but only if they have another plan to protect those with pre-existing conditions. This would be supported by $15 billion for an invisible risk sharing program (used successfully in Maine prior to Obamacare) and $8 billion for those with pre-existing conditions who don’t maintain continuous coverage and purchase insurance on the individual market.

Last week, a liberal blogger pressed me on the idea some states might have different provisions for pre-existing conditions. States currently have different policies on taxes, social services and even certain health benefits (for example, when I was in the N.C. Senate, we provided more optional Medicaid benefits than offered by neighboring states), and so I replied that in a very unlikely, worst-case scenario, someone might choose to move to a state which offered a specific benefit superior to the standard Obamacare-style benefits available in their state. Obviously, this would not be the normal or ideal option, but far better than continuing with the current, failing federal mandates.

The elephant in the room is the reality that Obamacare is collapsing. We are in real danger of millions of Americans not having access to any health coverage, in addition to the 28 million currently uninsured under Obamacare. Now is the critical time to act to provide a competitive market and responsible flexibility for states that will reduce premiums and enable cost-effective health coverage for all Americans.

Pittenger, a Republican, represents N.C.'s 9th District.