WASHINGTON (CN) – House Democrats approved legislation Thursday to nullify Trump administration guidance on the Affordable Care Act that could make it easier for insurers to deny coverage to people with pre-existing conditions.
H.R. 986, or the Protecting Americans with Preexisting Conditions Act, passed 230-183 in the House late Thursday.
Its passage, however, is largely symbolic as it is likely to die on arrival in the Senate, where the Republican majority has long fought to repeal the law known colloquially as Obamacare.
Last October, the Trump administration issued guidance which altered a portion of the ACA known as Section 1332.
Originally, under President Barack Obama’s administration, the provision allowed states to get coverage waivers but only if they met several criteria: they must prove that low-cost, low-coverage policies offered by insurers are at least as comprehensive as the ACA’s coverage plans and that protection from out-of-pocket costs would also be roughly equivalent.
Before President Donald Trump’s revisions to the law last year, it also stipulated that waivers could only be granted if a state could prove, at the very least, that it would have a comparable number of residents with health coverage under the waiver than not.
But the Trump administration changed the criteria, and said states need only show a comparable number of its residents would have coverage available to them, not that they would actually be enrolled.
House Speaker Nancy Pelosi said Thursday the GOP push against the bill was merely an attempt by the party to stand up “junk insurance plans” and in effect, give insurance companies an opening to deny coverage to people with pre-existing conditions like cancer, diabetes and more.
Oregon Republican Greg Walden came out swinging against the bill Thursday, saying the legislation – sponsored by Democrats Ann Kuster of New Hampshire and Don Beyer of Virginia – had “nothing to do” with protecting people with preexisting conditions.
“It has everything to do with eliminating health care options for states,” he said.
Representative Frank Pallone, D-N.J., said he was at a loss for words after an hour of intense debate unfolded on the floor ahead of the vote.
“Republicans started out the debate saying they wanted to substitute the title of the bill,” Pallone said, noting the numerous amendments Republican lawmakers filed to alter not the content of the bill, but its name only.
Such amendment from Republicans included the suggested titles “Don’t Let States Innovate Act” and “This Bill Actually Has Nothing to do with Protecting Americans with Pre-existing Conditions Act.”
“My colleagues are not looking to protect people, they’re looking to repeal the ACA,” Pallone said, noting the Trump administration’s lawsuit in a federal court in Texas just last week seeking to unravel ACA entirely. “This is what this all about for them, it’s about a repeal, move it into courts, get it declared unconstitutional. There’s no effort to worry about the millions of Americans who have received coverage because of ACA. I don’t know what else I can say at this point but at least [the Republicans] have revealed their true motives.”
Thursday’s vote was also a strategic maneuver by Democrats since it put Republicans on the record anew on health care. The White House, however, was already on the offensive Thursday morning as Trump unleashed guidance aimed at curbing surprise medical bills, namely charges for services provided out of network.
While just half of states have enacted legislation curbing this type of unexpected billing, the anxiety over the practice is widespread. According to a recent Georgetown University study, more than two-thirds of Americans surveyed say they are “very” or “somewhat” worried they or someone in their family could be subjected to surprise sticker shock.
On Thursday, the White House outlined key points it wants to see in legislation to curb unexpected medical bills, like rules which would bar hitting patients with fees that exceed the amount paid to in-network providers.
A more thorough understanding of costs associated with elective procedures should also be included in any upcoming legislation, the White House urged. Patients should know what is covered in a procedure and if not, what additional costs may look like.
This follows the administration’s announcement Wednesday on new rules for drug companies, which must now list the cost of medications in pharmaceutical ads if over $35 per month.
During a press conference at the White House on Thursday, the president also expressed interest in developing a program to lower prescription drug costs.
"We may allow states to buy drugs in other countries if we can buy them for a lesser price, substantially less price, and that is going to be very unique," Trump said. "But we will allow them to go to other countries because the drug companies have treated us very, very unfairly, and the rules and restrictions within our country have been absolutely atrocious."
There may be “certain permissions” involved for states, Trump said, which would allow them to purchase drugs internationally – but only if they can be purchased at 40% to 60% less than the retail price.
The president’s comments mirror a proposal recently passed by the Florida Legislature which would make prescription drugs from Canada accessible to Floridians. Critics of the legislation, including the pharmaceutical lobby, say the plan invites counterfeit or adulterated drugs.
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