The latest version of a proposed GOP Obamacare overhaul is winning praise from low-tax, small-government advocates for its potential to lower costs for healthy people, but older consumers and those with pre-existing conditions in places like Florida fear it is a nightmare in the making.
A South Florida breast cancer survivor said Wednesday she would find it “devastating” to be forced out of coverage she now considers affordable and into a potentially much more costly option, such as a high-risk pool, under the revised GOP House plan.
“I can’t imagine being put in a high-risk pool because I can’t afford it basically,” said Stella Mariani-Gonzalez, 62, of Miami.
She described herself on a conference call organized by senior advocacy organization AARP as a self-employed cancer survivor who currently receives coverage through a policy on the Affordable Care Act exchange.
Back in 2001, long before the ACA passed, she said her scaled-back insurance plan paid for only a handful of chemo treatments. She was forced to pay out of pocket and go hundreds of thousands of dollars in debt until she reached the point where she was indigent and could be covered by Medicaid, she said.
“My insurance was pretty much useless,” she said.
States could opt out of certain Obamacare requirements under an amendment to the GOP House replacement plan, the American Health Care Act, by U.S. Reps. Tom MacArthur, R-N.J., and Mark Meadows, R-N.C.
Under the plan, states could let insurers offer skinnier plans that don’t necessarily include things like preventive care, maternity or drug benefits. People with pre-existing conditions could be charged more if the state sets up a separate arrangement for them, such as a high-risk pool.
Whether and when that will win consensus House GOP support — let alone buy-in from Democrats or Senate approval — remains to be seen. A House plan with 17 percent support in polls collapsed in March.
But supporters of the revised proposal including the small-government advocacy group FreedomWorks say it brings the prospect of lower costs for healthy people. President Adam Brandon said the latest version provides “states with much-needed flexibility to stabilize the market, enroll more people in health plans, and bring down the cost of premiums.”
Yet it means many older and lower-income people and those at higher risk for illness could be effectively priced out of affordable coverage, AARP officials said.
A state could let insurers sell health coverage that “charged different prices and offered different benefits for people who had pre-existing conditions, such as cancer survivors, people who have survived heart attacks or strokes, people with diabetes and other health conditions,” an AARP statement said.
About 43 percent of Americans ages 50 to 64 who don’t have insurance through an employer or Medicaid have such a pre-existing condition, the group figures.
High-risk pools in most U.S. states have “functioned poorly in the past, providing inadequate coverage at exceptionally high prices,” AARP said. As of 2011, Florida’s own high-risk pool covered only two hundredths of one percent of Floridians in the non-group insurance market , the lowest percentage of any of the 35 states that offered high-risk pools then, officials said.
Because of changes to government subsidies that bring down consumer costs, many older residents were already facing staggering cost increases under the original replacement plan, AARP warned.
For example, a 64-year-old in Palm Beach County with income of $15,000 would have to pay $11,195 more per year by 2026 in insurance premiums, the AARP Public Policy Institute calculated.