When you talk about “preexisting conditions,” you probably think of things like diabetes, heart disease and cancer. But the reality is that healthcare companies consider a whole slew of common health concerns preexisting conditions. Odds are, if you’re a mom, you probably already have one of them. And now that the American Healthcare Act passed the House of Representatives today—if it becomes law, your health insurer could charge you thousands more for your coverage or reduce your insurance coverage because of these "preexisting conditions."
"Things that are incredibly common for women, including C-sections, pregnancy and postpartum care, will all be considered preexisting conditions," says Kristyn Brandi, OB/GYN at Boston Medical Center, and current fellow at Physicians for Reproductive Health. "A lot of women would end up paying out of pocket for healthcare, which would definitely be a big problem for most women across the country. Women are particularly at risk because they use more healthcare than other people do. They don’t think of pregnancy as a preexisting condition, so people don’t realize how much they will be impacted."
That's one of the main concerns with the revised American Healthcare Act, which has came back to the House for a vote this afternoon after failing to attract enough votes when first unveiled back in March. What's new with this one? Rep. Tom McArthur (R-NJ) added a new amendment that allows states to apply for waivers from enacting any portion of the law—including requiring insurers to provide any of the "essential health benefits," like emergency care benefits and preexisting condition coverage.
The law would allow states to create high risk pools for insuring those who have preexisting conditions, with $138 billion set aside to help offset what's expected to be a sharp increase in premiums for those with preexisting conditions. The Center for American Progress estimates that people with preexisting conditions would be charged $31,000 in premiums each year under the AHCA plan, while economic analyst Steven Rattner stated on Morning Joe this morning that pregnancy would increase premiums by $17,320, depression would increase it by $8,490, and autism would increase it by $5,510. But while the AHCA would allow states to set up these high risk pools, the law does not require them to create them for their citizens who can't afford the spike in premiums—and that could effectively leave millions of Americans without affordable options—especially as there are more than 50 preexisting conditions, with some as simple as heartburn and migraines, that could cause your premiums to spike.
In fact, a new Harvard study which looked at the impact of subsidies on healthcare for low-income families in Massachusetts, finds that even small increases in price of health insurance cause many families to forgo the cost and take the chance of being uninsured. “When premiums go up, it’s the healthier enrollees who drop out,” Amy Finkelstein of M.I.T., an author of the study, told the New York Times. According to the authors, they expect that the changes forecast with the American Healthcare Act will make insurance in the independent markets unaffordable for families who make less than $75,000 per year.
That's similar to the finding by the Congressional Budget Office (CBO) about the earlier draft of the AHCA, which estimated that 24 million people will lose coverage over the next decade under the plan—the CBO is still studying the current bill to determine its potential impact, but experts believe the changes will actually make this worse. "There’s not a CBO report, so we really don’t know how many people will lose healthcare," Dr. Brandi says. "They said 24 million with last report, but they’ve changed things since then—and the changes are not going to improve that number."
It's no surprise that many people and organizations associated with healthcare and patients have come out against the AHCA. "The American Medical Association, the American Congress of Obstetricians and Gynecologists, anyone whose interest is people and patients doesn’t support this bill," Dr. Brandi says. "We are trying to do what is best for our patients."
That's the big concern for Richlyn Burnham, senior manager for Newark Community Health Centers, a federally qualified health center that provides healthcare for communities who are medically underserved and uninsured. "It's going to have a huge impact," she says. "We are already stretched tight, and this will hurt our patients even more."
Julius Hobson, a health care lobbyist and attorney with Polsinelli in Washington, D.C., who served as the Congressional liaison with the American Medical Association, is also concerned about the unorthodox vote without time for review or getting CBO numbers, but he feels strongly that the bill that passed today will not be the final healthcare bill. "The Senate has already said that they're not going to take up the House bill—they’re going to start from scratch," he says. "A lot of the Medicaid provisions in the House bill, a lot of that probably won’t survive in the Senate. And a lot of the preexisting condition issues that emerged, I don't know if those will survive, or if they will be challenged."
We've seen some unexpected potential issues for families from the earlier bill—like a reduction in breastfeeding benefits or requiring Medicaid recipients to find a job within 60 days of giving birth or lose their family's coverage. But the updated bill may not be an improvement for your family's situation. "For a lot of families [on Medicaid], there is some need to be concerned whether or not they’re going to have medical coverage," Hobson says. "Democrats believe in health coverage, while the Republicans are arguing for access. But if the numbers [from the CBO] come back that even access won’t be available and it’s going to cost more money, it's going to be ugly for Republicans."
Now that the bill has made its way to the Senate, there's still time to let your opinion be heard. You can call 844-241-1141 to be connected to your senators and let them know how you feel about the American Healthcare Act.