Pre-existing positions on pre-existing conditions

PRE-EXISTING POSITIONS ON PRE-EXISTING CONDITIONS…. In June, House Minority Leader John Boehner (R-Ohio) declared, with precious little wiggle room, “Quality health coverage must exist for every American, regardless of preexisting health conditions.” Three months later, he described coverage of people who have preexisting conditions “essential.” As recently as last week, Boehner told Fox News that Republicans wanted to focus on helping “those with preexisting conditions.”

Now that the House Republican reform plan fails to prevent insurers from discriminating against patients with pre-existing conditions, this pre-existing rhetoric is something of a problem.

Many of the most respected health care voices in the GOP have historically treated the idea of eliminating pre-existing condition exclusions as an obvious plank in any reform effort. Even deeply conservative figures like Senator Tom Coburn (R-Okla.) insisted as recently as August that “everyone agrees” that legislation should “eliminate pre-existing conditions” as an excuse for denying coverage.

Coburn’s colleague in the Senate, John Barrasso (R-Wyo.), explained in July that after listening to people in his home state, he understood that Congress needed “to take care of things like pre-existing conditions so that that doesn’t stop them from getting insurance.”

Another Senate Republican who was heavily involved in negotiating health care reform, Chuck Grassley of Iowa, has unequivocally declared that the government has “to prohibit insurers from denying coverage to people with preexisting medical conditions and charging higher premiums to people who are sick.”

Even the Republican Whip in the Senate, Jon Kyl of Arizona, has stressed the need to make sure that patients “cannot be denied care because [they] have a pre-existing condition…”

Now, as far as GOP lawmakers are concerned, the House reform plan doesn’t completely ignore those who can’t get affordable coverage due to a pre-existing condition. Republicans have “high-risk pools” in mind for these folks.

But this approach has already proven to be ineffective. Karen Tumulty noted yesterday, “These pools already exist in more than 30 states, but they tend to be too expensive for those with limited means to buy into. And often, people cannot get into them for as long as a year after they apply.” Harold Pollack had a helpful piece on the subject two weeks ago, explaining, among other things, that those covered through high-risk pools “pay higher premiums than private insurers typically charge healthy individuals. Individuals face average deductibles exceeding $1,500 and lifetime expenditure caps. People also endure waiting periods before they can enroll.”

It’s worth noting, as Matt Corley does, that the Democratic plans include high-risk pools as a short-term fix until 2013, when reform measures and consumer protections are fully implemented. In other words, for Dems, HRPs are a stop-gap measure to hold us over until real reform kicks in. For Boehner & Co., HRPs are the entirety of the reform plan for those with pre-existing conditions.

It’s a proposal only an insurance company executive could love.