AHIP: Cruz proposal would destabilize the ACA exchanges

Oceane Deschanel
Julho 17, 2017

The conservative coalition launched ObamacareOptOut.com to encourage Americans to call their Senators to include the consumer choice amendment sponsored by Sens.

The Cruz-Lee version of the bill is being touted as a potential compromise that could bring together the warring sides of the GOP by finding a way to satisfy both the most conservative members of the caucus, who want to see the ACA destroyed root and branch, and the more moderate members who don't want to be accused of throwing millions of Americans off of their health insurance coverage.

In the alternate plans, insurers could reject applicants or charge them more based on their health history.

The Affordable Care Act prohibited those practices, forcing insurers to sell policies with comprehensive benefits and at uniform prices to everybody, no matter their medical status.

In the days leading up the revised bill's unveiling, expected late Thursday morning, other Republicans were already throwing out suggestions to tweak Cruz's idea to make it more workable and appealing to the conference.

"If we drive down the cost of premiums so that people who are struggling can more easily afford health insurance for their family, we will have succeeded", Cruz said. But they don't do much for Americans with pre-existing conditions.

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David McIntosh, president of the Club for Growth, explained that despite the Cruz amendment's criticisms, it does not rescind protections for pre-existing conditions. Mike Lee that critics say could make plans with adequate coverage unaffordable to those who have certain medical conditions. They could offer skimpier policies that don't offer maternity, mental health and prescription drugs. America's Health Insurance Plans, a national association for health insurers, criticized the Cruz option, saying it would fracture the market.

Subsidies would still shield some from the increases, but they would generally be smaller than the subsides under the Affordable Care Act and would be available to fewer people. Meanwhile, those who earn too much to qualify for subsidies could be priced out of the market.

The amendment, however, has been key to getting Cruz to vote for the GOP plan to overhaul Obamacare. "My hope is that our congressmen and senators will realize that more people will die, will become grossly ill" without it.

The substance of the warnings was not new. But experts say insurance simply doesn't work this way, and the "Cruz amendment" would unleash destructive forces for individuals without employer-sponsored coverage as well as for the system.

"This is still a bill that will result in very large reductions in insurance coverage and reductions in the quality and affordability of the insurance coverage for many people who retain coverage", Matthew Fiedler, a fellow at the Brookings Institute, told Business Insider in an email.

But Friday night's blast from the insurer groups is noteworthy because AHIP, in particular, has a relatively conservative outlook and tends to have close relationships with Republicans. Republican leaders have softened their approach a tiny bit around the edges by carving out exceptions meant to deal with public health emergencies, for instance, but the basic thrust hasn't changed. Two Republican senators, Susan Collins of ME and Rand Paul of Kentucky, have already said they oppose it ― and would not vote yes on a so-called motion to proceed, which is necessary to begin formal debate and, eventually, have a vote on the bill. A vote on the measure is possible next week.

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