Republican Health Bill Could Remove Pre-existing Condition Protections : Shots - Health News House Republicans are considering a deal that would remove the requirement that health insurance plans cover 10 essential health benefits, hoping to secure the votes of conservative lawmakers.
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GOP Health Bill Changes Could Kill Protections For Those With Pre-Existing Conditions

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GOP Health Bill Changes Could Kill Protections For Those With Pre-Existing Conditions

GOP Health Bill Changes Could Kill Protections For Those With Pre-Existing Conditions

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AUDIE CORNISH, HOST:

For more now on those essential health benefits we heard about we're going to hear from NPR's Alison Kodjak. Welcome to the studio, Alison.

ALISON KODJAK, BYLINE: Thanks for having me.

CORNISH: So we hear a lot of members in Congress talking about certain benefits - maternity care, pediatric care, drug rehab. Why does this requirement exist?

KODJAK: Well, this is broadly what the government considers the definition of health insurance. So under the Affordable Care Act, the government was offering subsidies and tax credits to cover health care, and they wanted to make sure that when people bought a policy, it actually paid for their health care needs. So...

CORNISH: And before that, insurers offered whatever they wanted.

KODJAK: They kind of...

CORNISH: (Unintelligible).

KODJAK: Yeah, there was a lot of policies that excluded many of these things, including maternity care most famously. But mental health care or even your checkups or your lab work sometimes was not included in health insurance.

CORNISH: So let's say that in this next bill, they manage to get rid of this requirement. What would insurance look like?

KODJAK: Well, that's the big issue. This could totally change what health insurance policy consists of in the future. And it would really undermine - this is one of the things I think is really important. It would undermine the promise that Republicans have made to continue to cover people with preexisting conditions.

And that's not because they'll take away that provision in the law, but if you buy a policy that's so stripped down that it doesn't cover the medication you need to take care of your asthma or diabetes perhaps or doesn't cover mental health benefits and you have depression, then it doesn't matter if it covers your preexisting condition or not because you're not going to get the care you need.

CORNISH: Help us dig a little deeper into this debate in Congress over this list. What's the issue?

KODJAK: Well, this list has been sort of what members of Congress call Washington dictating the insurance you can buy. They say people should be allowed to buy the insurance they need, not what Washington tells them to do. And that's code for this list of benefits. You know, men buying up policies that cover maternity care is the most sort of obvious and one that bothers people the most.

But for a variety of political reasons, Speaker Ryan wants to have that pruning done via regulation. He wants the secretary of Health and Human Services to do this because a lot of the details were passed that way through regulation. And as Sue said earlier, the conservative Republicans want this done now in the law 'cause they want to be sure it actually happens.

CORNISH: But if it can be done through regulations and you now have a president who's amenable to doing it, can't President Trump roll these benefits back if Congress doesn't?

KODJAK: Well, it's a little more complicated than that because the list of benefits are in the law, and the details are in the regulations. So there would have to be some coverage for all of these things if it isn't taken out in the changes in the law. So that's why the conservative Republicans are asking for this to be done now instead of later.

CORNISH: That's NPR's Alison Kodjak Thanks for talking with us.

KODJAK: Thanks for having me, Audie.

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