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Shawn Vestal: McMorris Rodgers walking back on promise to protect people with pre-existing conditions

Rep. Cathy McMorris Rodgers, R-Wash., listens during a news conference at the Republican congressional retreat in Philadelphia, Wednesday, Jan. 25, 2017. McMorris Rodgers joined other Republicans in applauding President Trump’s decision to recognize Jerusalem as the capital of Israel. (Matt Rourke / AP)

She called it a “top priority.” A “fundamental principle.”

She promised it in big letters on the House Republicans’ web site: “We Will Protect People with Pre-Existing Conditions.”

She co-sponsored the Pre-Existing Conditions Act of 2017 in the U.S. House.

She said, in a post on Facebook, “The Pre-Existing Conditions Protection Act, which I’ve co-sponsored, will ensure those with pre-existing conditions have access to health care, and that insurance companies can’t raise rates based on an individual’s health.”

In a February news release, she said, “With this bill, we are giving individuals with pre-existing conditions the peace of mind that they will have protections beyond Obamacare.”

So, what’s the status of Rep. Cathy McMorris Rodgers’ top priority? Her fundamental principle?

Not so top. Not that fundamental.

McMorris Rodgers and the beleaguered House leadership are squeezing lemons to pass a bill that would apparently allow insurers to do exactly what her previous legislation would have prevented: Raise rates based on an individual’s health.

House Speaker Paul Ryan and company are putting as hard a spin on it as possible, insisting that the emperor is fully clothed, if you just squint your eyes in a certain way. They argue that the change would still provide protections for people with pre-existing conditions by allowing them to enter high-risk pools or to benefit from other future solutions that states would come up with down the road. Through these mechanisms, sick people and the disabled would be protected from rising premiums, they say.

In an effort to win moderate votes Wednesday, according to news reports, GOP leadership added $8 billion to their health care bill to help people with pre-existing conditions afford insurance.

Which tells you what you need to know about what would happen to insurance for people with pre-existing conditions if the House Republican plan becomes law. It would get a lot more expensive. It would be possible for insurers to set your premiums based on your health status. And these high-risk insurance pools that are supposedly going to provide the “protection” that everyone from the president to Paul Ryan to McMorris Rodgers herself has promised? Critics, such as the liberal Center for American Progress, estimate that even $8 billion in legislative bribery would cover less than a quarter of the increased cost estimated to result from all that protection.

The list of organizations opposed to the idea is long. The American Medical Association said this week that it feared the proposal would result in millions of Americans losing their health insurance.

So, whither McMorris Rodgers and her fundamental principles? Her spokeswoman, Molly Drenkard, said Wednesday the congresswoman remains committed to protecting those with pre-existing conditions from costly increases, and noted that under the proposed legislation, the federal default position for outlawing health status rating would remain the same.

That would change only in states that obtain waivers by providing a way to keep premiums from becoming “unaffordable,” and affect just those who do not maintain continuous insurance coverage.

“The congresswoman is not taking away affordable coverage from people with pre-existing conditions,” Drenkard said, adding, “If you have a pre-existing condition and you have – and maintain – coverage, you won’t be affected. No insurer is allowed to deny access to coverage for individuals with pre-existing conditions.”

Talks were expected to drag into the night Wednesday, as lawmakers tried to fashion something that would appeal both to conservatives and to moderates primarily concerned about pre-existing condition coverage.

Like McMorris Rodgers’ February bill, earlier versions of the American Health Care Act provided more protections for people with pre-existing conditions. But the most conservative House members – like Idaho’s Raul Labrador – could only be seduced into supporting a bill if it removed some of those protections and gave more freedom back to insurers to limit coverage and raise rates.

A new amendment this week would allow states waivers to duck out of requiring “essential health benefits,” such as maternity coverage and mental health care, and to permit insurers to charge more money based on health status, if they have a high-risk pool or other program to subsidize coverage for people with pre-existing conditions.

Who knows how this will all shake out. Even if the House manages to squeeze this through, the Senate could be a bigger challenge, and for good reason. A lot of people are flatly opposed to “health status” pricing. A lot of people say it is a road back to a system that bankrupts sick people. A lot of people say it should be against the law.

One of those people used to be Cathy McMorris Rodgers.

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