Verify: Does the new Republican healthcare plan keep pre-exisiting conditions?

VERIFY – YOU’VE GOT QUESTIONS, WE’LL FIND ANSWERS

A 9NEWS project to make sure what you’ve heard is true, accurate, verified. Want us to verify something for you? Email verify@9news.com

THE QUESTION

A viewer reached out to 9NEWS and asked us to verify a claim we made about a new Republican healthcare plan to repeal and replace the Affordable Care Act.

Here’s what we said during Tuesday's 7 a.m. newscast:

“This week Vice President Mike Pence led a late-night trip to Capitol Hill, trying to convince skeptical conservatives that the plan is still on. They're working on a compromise that would allow states to opt out of mandates -- like covering maternity and mental health. And [it] would allow insurers to charge sick people more. But covering pre-existing conditions and young adults on their parents’ insurance would stay.”

The last line caught the attention of one of our viewers.

Kat Stewart tweeted, “@9NEWS morning show reported exact opposite of [New York Times]. Can you find the truth?”

Here’s the headline from the New York Times article Stewart mentioned, “Republican Health Proposal Would Undermine Coverage for Pre-existing Conditions.”

WHAT WE FOUND

At first glance it looks like the two are at odds with each other, but both statements are true.

The compromise proposal floated Monday night keeps the rule about pre-existing conditions – even the times article acknowledges this.

“Technically, the deal would still prevent insurers from denying coverage to people with a history of illness,” according to the New York Times article.

But the proposal makes changes to other parts of Obamacare that could render the rule meaningless.

Monday night’s draft would let states decide what benefits insurance companies must provide. Obamacare has a set list of 10 essential benefits that all plans must cover.

These include coverage for things like childbirth, hospitalization, preventative services and prescription drugs.

Supporters say letting people buy insurance a la carte will create cheaper plans. Opponents say that will increase prices for sick people – essentially eliminating the protection against denial for a pre-existing condition.

The new proposal would also allow states to opt out of what’s called community rating.

It’s a requirement that insurers provide coverage to a group of people for the same price regardless of their current health status, according to HealthCare.gov.

Here’s what those proposed changes mean.

Let’s assume you’re young without any known medical conditions, and you’re shopping for an insurance plan.

The Republican proposal could let you buy a plan without prescription drug coverage, and it would probably be cheaper than what you could buy today.

If you suddenly needed daily medications, you’d have two options. Buy the medicine yourself or buy a plan with prescription drug coverage.

Your insurance company would have to sell you a plan that covered your medication, but they’d be able to charge any price they wanted.

BOTTOM LINE

It’s true that the new plan being floated by Republicans would keep the rule prohibiting insurance companies from denying coverage because your medical history.

But it’s also true that the more context 9NEWS can provide our viewers, the better. We hope this helps clear up any confusion and provides you with more information about what the proposed changes might me for you or your family.

And one final note, there’s no guarantee this new plan will get a vote or remain intact if it does. 

© 2017 KUSA-TV


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