NPR Fact-Checks Republican Defense Of GOP Health Bill : Shots - Health News In TV appearances and meetings with constituents, House Republicans are highlighting parts of the law that protect consumers, while glossing over loopholes that allow insurers to avoid paying.
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Fact-Checking Republicans' Defense Of The GOP Health Bill

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Fact-Checking Republicans' Defense Of The GOP Health Bill

Fact-Checking Republicans' Defense Of The GOP Health Bill

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KELLY MCEVERS, HOST:

Many House Republicans are back in their districts this week after voting for a replacement for the Affordable Care Act, or Obamacare. A few are holding town hall meetings. And in some cases, those town halls are loud.

(SOUNDBITE OF ARCHIVED RECORDING)

TOM REED: I'll tell you...

UNIDENTIFIED WOMAN #1: If you get health care (unintelligible).

REED: ...I will tell you where I stand on the issues.

UNIDENTIFIED WOMAN #2: Do you think health care is a right?

REED: I do not support...

MCEVERS: Other House Republicans are making their case on television that the plan they voted for is better than the status quo. NPR Health Policy Correspondent Alison Kodjak is with us now to fact-check some of the things that they are saying. Hi there, Alison.

ALISON KODJAK, BYLINE: Hi, Kelly.

MCEVERS: So we just heard Congressman Tom Reed's town hall in Ashville, N.Y. Sounds like the audience was pretty riled up.

KODJAK: Yeah, they sure were. Reed held a series of town halls, which pretty brave. And there were definitely some voters who liked the bill because they thought it might cut their premium costs. But over and over again, people were asking how it would deal with people who have expensive medical conditions. Here's one exchange from a town hall in Busti, where a constituent was worried about a child with severe allergies.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED WOMAN #3: Copays and deductibles that are going to be through the roof because he's going to be in a risk pool because he has a pre-existing condition.

REED: No, because we're not - the pre-existing condition reform is not repealed by this legislation.

MCEVERS: Alison, is that true or false?

KODJAK: Well, it's not exactly true. That language is in the bill. So on its face, there is this protection. But there's also a huge loophole. The bill allows states to get waivers to get out of a lot of the regulations under the Affordable Care Act. One of those waivers allows insurance companies to do what's called medical underwriting. That means that they can charge people more if they have pre-existing conditions. And they can also exclude coverage for certain conditions and medications.

MCEVERS: The question of pre-existing conditions seems to be an ongoing theme among House Republicans. Steve Scalise, the Louisiana congressman, said this on Fox News over the weekend.

(SOUNDBITE OF ARCHIVED RECORDING)

STEVE SCALISE: No matter what kind of plan you have today, if you have a pre-existing condition, under our bill, you cannot be denied coverage and you cannot be charged more than anybody else.

KODJAK: Yes. And he's right that people can't be completely denied coverage. But they can, in fact, be charged more, just as I said before. And again, that's going to depend on where you live, whether you're in a state that gets a waiver. And I have in front of me a whole list of medications and conditions that insurance companies used to use to exclude people or to charge them more. And those medications, especially, include anti-arthritis medications, anti-cancer medications, drugs for AIDS. So there's a lot of ways that they could not give people the coverage they need.

MCEVERS: There also seems to be confusion about exactly who this new law would affect. Congressman Rod Blum in Iowa was telling his constituents the impact won't be all that widespread. Let's listen.

(SOUNDBITE OF ARCHIVED RECORDING)

ROD BLUM: If you're getting your insurance through the group health care marketplace, your employer, nothing changes.

(CROSSTALK)

BLUM: If you're getting your health insurance through Medicare, nothing is going to change.

(CROSSTALK)

BLUM: If you're currently getting your health insurance through Medicaid, nothing's going to change. You're still going to get your insurance.

(CROSSTALK)

MCEVERS: OK, so is that right, nothing's going to change?

KODJAK: Well, not exactly. If you work for an employer that's in a waiver state, that employer's not going to be subject to the Obamacare regulations either, so your insurance could end up having annual spending limits, lifetime caps. Before Obamacare, 60 percent of employer policies had lifetime caps. And if you're on Medicaid, a lot could change. The Medicaid expansion states will rollback benefits. So people who have benefits that aren't required under the program - and that's a lot of the benefits for people who have home health care and care for people with disabilities - those are going to probably be rolled back over time, too.

MCEVERS: That's NPR Health Policy Correspondent Alison Kodjak. Thanks a lot for the fact check.

KODJAK: Thank you, Kelly.

(SOUNDBITE OF VINCE GUARALDI TRIO'S "CHARLIE BROWN THEME")

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