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Romano: Cruz Amendment a game-changer on health care

17 July 2017

But Cruz was unbowed on Thursday, making clear the conditions for his support ahead of a crucial procedural vote that's expected to occur next week.

Released yesterday, the new Senate healthcare plan-modified by Sen.

But it also holds onto more of the structure put in place by the Affordable Care Act (ACA), also known as Obamacare.

But critics including the insurance industry say it would split the sick and the healthy, leading to unsustainably high premiums for people with medical problems and pre-existing conditions, who may get priced out of the market unless taxpayers bail them out. Ted Cruz, R-Texas, which would allow health insurers to sell rational, health-rated plans that do not meet Obamacare requirements, if they also offered a plan that meets all other Obamacare requirements including covering all those with serious pre-existing medical conditions. On the other hand, people in poorer health could purchase a plan that keeps these protections (we'll call this Plan B). The amendment would allow insurers to sell cheaper plans with fewer benefits that would likely attract younger and healthier Americans.

The provision would let insurers sell low-priced policies with skimpy coverage, as long as they also sell policies that meet a stringent list of services they're required to provide under Obama's law, like mental health counseling and prescription drugs.

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Insurers were not only forbidden to deny coverage to sick consumers, they also had to provide a basic set of benefits. The Congressional Budget Office (CBO) will release an analysis of the legislation sometime early next week.

The overall measure represents the Senate GOP's attempt to deliver on the party's promise to repeal President Barack Obama's health care law, which they've been pledging to do since its 2010 enactment.

These non-compliant plans wouldn't have to cover the "essential health benefits" that Obamacare plans on the exchanges are required to cover, but they'd be a lot cheaper. If they aren't, the insurance market could return to its pre-ACA dynamic, where it works well for the healthy, but options for the sick are underfunded and ineffective.

The other would provide comprehensive yet expensive policies.

Here's the big problem: As more sick people start signing up for Plan B, insurers will raise its premiums to make up for the fact that these folks need more expensive care.

In addition to the tweet, the CNN story refers to Cruz's amendment as "so-called". Although imperfect, these reforms would leave the health care system in a better place than it now finds itself with changes that respect the states and individual choice in insurance markets. The Senate bill still impacts middle-class Americans, as well as low-income families, people with disabilities, children, and senior citizens.

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"The overall bill adds $70 billion to the stability fund", he said.

"You have the possibility of two different risk pools", said economist Douglas Holtz-Eakin, a longtime Republican adviser.

To check what conservatives say is the "unsustainable" growth of Medicaid spending, the GOP bill lowers the rate of traditional Medicaid spending and caps how much is spent on each person.

One of the critical parts of the ACA was that it prohibits insurers from denying coverage to or charging more for people with pre-existing conditions. People at higher risk clustered in another, assuming they could afford insurance at all and could find a company to sell them a policy. A mother is smiling as she pays the bills at the kitchen table and declares: "Hey, I just saved $5,000 on my health care thanks to Sen". These include maternity care, mental health programs, prescription drugs, and substance abuse treatment.

Senate Majority Leader Mitch McConnell (R-Ky.) has said that he hopes the legislation will be scored by the Congressional Budget Office (CBO) early next week and approved by the end of that week. It's supposed to be available for high-risk or reinsurance pool. A few more compromises may be necessary - there is still much more that could be done to improve the bill - but conservatives would do well to note that moving in the direction of the original Cruz Amendment into the legislation to improve it is no small accomplishment.

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