GOP Pre-Existing Condition Bill Faces Unclear Path

On August 27, nearly a dozen Republican senators introduced legislation to bar health insurers from denying coverage to people with preexisting health conditions and from charging higher premiums due to a person’s health status.

The bill, Ensuring Coverage for Patients with Pre-Existing Conditions Act (S. 3388), was introduced to provide a fallback for patients with pre-existing conditions should a pending court case decide against the Affordable Care Act (ACA). The pending court case is Texas vs. United States and it will be heard on September 5 when 20 Republican state attorneys general and two individual plaintiffs will challenge the constitutionality of the individual mandate and, with it, the entire ACA.

In a joint release, the Senate sponsors of S. 3388 said that their legislation was a “common-sense solution” to guarantee health coverage, regardless of the court’s ACA ruling so that those with pre-existing conditions would be protected.  However, the bill has come under criticism because, while it requires health insurance plans to insure those with pre-existing conditions, it does not require coverage for the “care” specific to those pre-existing disease conditions, nor does it prevent age or gender discrimination – all issues Democrats have sought to highlight as significant ways the ACA would differ from what is offered in the Senate GOP bill.

And last week Maine Republican Senator Susan Collins called out the bill for failing to protect essential health benefits like maternity care and substance use disorder treatment, which she noted were important components also currently covered by the ACA and threatened by the court case. Nor does the bill require insurers to cover hospitalization – another essential health benefit currently required. S. 3388 has been referred to the Senate Health, Education, Labor and Pensions Committee and no further action has been scheduled.