May 14, 2017

Rumors circulating among opposing Democrats surrounding the Republican health care bill have spread that’s the messy violence, rape and ulcers are now being labeled as pre-existing conditions that will be uninsurable under the bill. However, these claims make it sound simpler than it really is.

These claims integrate the verbiage of the bill with possible outcomes. Although the bill could decrease the current protections provided to citizens that have the listed pre-existing conditions and in turn increase the cost of insurance, what the end result will actually be is largely determined by the decisions made by the insurers and state governments.  More significantly, the bill fails to specifically define a pre-existing condition, nor does it grant permission for insurers to flat out deny coverage, even though there is nothing stopping them from raising the premiums so high that they are much too expensive for some individuals who are sick.

Here is an overview assessment.

Liberal websites like the Resistance Report have suggestions that the bill permits insurers to exercise discriminatory practices against rape victims.

“Under Trumpcare plan, rape would be considered a pre-existing condition.”

The new health care bill this not specifically label rape as a  pre-existing condition and at no point and time before the Affordable Care Act had ever been defined that way either. The possibility does exist that sexual assault victims could pay higher costs for insurance, not due to the assault in particular but because of the sexually transmitted diseases and trauma that comes about as a result.

Iterations about these claims begin to catch when about a year ago during the Affordable Care Act debate. Search engine reports showed that inquiries about whether rape will be deemed as a pre-existing condition became popular on Wednesday, only a day prior to the House vote concerning the repeal replacements of the current health care law.

It appears as if this action came about after a Rawstory article called “Trumpcare could make sexual assault a pre-existing condition again — depending on where you live”  was published. Even though the headline of the publication is nuanced, the accusations that it may have been responsible for inspiring hardly ever are and are often considered to be inaccurate. Prior to the affordable care act, insurers were allowed to practice “health status underwriting”  which allows them to review an individual’s health records in order to assess their medical tests which would allow them to charge higher premiums, perhaps even deny insurance coverage because the conditions will be considered more costly.

Insurance companies typically do not inquire directly about the patient’s sexual assault, and even less use it as part of the consideration when calculating the premiums for insurance. But they may have inflated the prices  “if they see that you’ve been screened for S.T.D.s, had treatment for an S.T.D., taken H.I.V.-preventive medication, had more than annual pelvic exams or had other follow-up encounters with the medical system,” as stated by Sabrina Corlette, a  Georgetown’s Health Policy Institute research professor.

Under the affordable care act, “community ratings” were mandated, which forced insurance companies to charge consumers the same price without regard to their health status, as well as “guaranteed issue” policies that will force the insurers to offer coverage to any and all applicants.

The Republican health care bill that received the needed votes in the house the past will permit states to submit an application for a waiver from the community – rating regulation for those who have not secured and maintained continuous coverage, which in turn officially permits health status underwriting to be conducted again – only if the Department of Health and Human Services approves the waiver. And even though the bill imposes a requirement on the states to provide other cost-sharing or healthcare options as an alternative to being inserted to the committee rating, the bill does not states to issue a waiver on the guaranteed issue policy.

This means that if the state opts to approve a waiver for the regulation, insurance companies will be permitted to charge more for pre-existing conditions like trauma and HIV, not including rape, but the insurers are not given permission to deny coverage to anyone because of those pre-existing conditions.

Distractify and other similar websites have also proclaimed that domestic abuse had been defined in the healthcare bill as a pre-existing condition. Prior to the Affordable Care Act, there were several states that did not have laws in existence that prevent insurance companies from deeming the vested violence as a pre-existing condition. But there is a lot of uncertainty as to whether the insurance companies did indeed effectively deny coverage to domestic violence victims in the years immediately preceding the health care law passage.

In the five states of South Carolina, Wyoming, Idaho, North Carolina and Vermont, insurance companies are not legally prohibited from deeming domestic violence as a definable pre-existing condition, according to Gretchen Borchelt, the vice president for reproductive rights and health at the National Women’s Law Center.  According to multiple surveys conducted, insurance companies had indeed denied coverage to victims of domestic violence in the 1990s.  PolitiFact performed an examination of the topic in 2009, in which no evidence was discovered that would prove that this was a widespread or ongoing practice.

Other publications, such as the People for Bernie Sanders, began circulating an image to proclaim that the bill would put it into insurance from individuals suffering from pre-existing conditions.

Circulated by Senator Sharad Brown, the image specifies medical issues that were defined as pre-existing conditions prior to the affordable care act. But the new health care bill would not completely and totally and coverage because of these conditions because the bill does not eliminate the affordable care act’s rule on guaranteed issue and enforces the requirements for state waiver process.

Of all of the conditions listed on the image; evidence discovered by the Kaiser Family Foundation that’s approximately 36 of the conditions were the callable – conditions ranging from diabetes and lupus to severe obesity and HIV and AIDS. Other conditions such as migraines, allergies, acne and ear infections could decrease the benefits and increase the costs.

The Kaiser foundation also proclaimed that the overwhelming majority of individuals who have these conditions acquire insurance through public options like Medicaid or through their employers.

Again, this is not to be interpreted to mean that the Republican health care bill grants insurance companies a free pass of denial of coverage due to the existence of these conditions,

Although individuals who are unable to afford higher costs could be dropped from their insurance and states that are granted the waiver from community ratings.

This healthcare bill could result in  “astronomically high premium increases for people with many of these conditions, if they buy insurance on their own and have a gap in coverage,” according to Larry Levitt, an executive with Kaiser. “Even if states seek a waiver, not everyone with these conditions would lose insurance, but some certainly would.”

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