White House doubts states will choose to charge sicker people more

WASHINGTON – White House Chief of Staff Reince Priebus said Sunday he doubts states will take the option of letting insurance companies charge sicker people more if the GOP health care bill the House narrowly passed Thursday becomes law.

“It doesn’t affect anyone with continuous coverage, even if a governor — which I’m not sure that’s ever going to happen — takes the waiver option,” Priebus said on “Fox News Sunday.”

The bill, which now moves to the Senate, would let states seek waivers from the federal government to allow insurers to base premiums on a person’s health status —  a practice that was prohibited by the Affordable Care Act.

The higher price could be charged to people who buy coverage on the health exchanges set up by the ACA, instead of getting it through an employer or a government program like Medicare and Medicaid. It would apply for one year for people who were purchasing insurance after a lapse in coverage. And it would lower premiums for healthier people.

That provision was added to the bill to gain the support for hardline conservatives. To satisfy moderates, $8 billion was added to help subsidize the cost of the plans for people with pre-existing conditions through high-risk pools or some other means.

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Ohio Gov. John Kasich, a GOP critic of the bill, called that amount of funding “ridiculous.”

“States are not going to opt for that,” Kasich said on CNN’S “State of the Union.” “There would be no reason to move to a high-risk pool, because a high-risk pool is not funded. So, I would just stay in the traditional program on the exchange.”

But Gov. Scott Walker, of Priebus’ home state of Wisconsin, told reporters Friday he would consider seeking a waiver, depending on what’s in the final version of the legislation.

Walker, chairman of the Republican Governors Association, said Wisconsin had a successful high-risk pool for people with serious health problems before major provisions of the ACA went into effect in 2014. Premiums in 2013 were as high as $1,500 per month for a 60-plus-year-old man with a $1,000 deductible, according to the Associated Press.

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Sen. Susan Collins, R-Maine, whose state was a model for the high-risk pool funding included in the House bill, said it worked in Maine because there was sufficient funding.

“That could work and it could be part of the solution,” she said on ABC’s “This Week with George Stephanopoulos. “But the devil is really in the details.”

Collins is among the senators critical of the House bill, saying it’s unlikely it would give people better coverage than they have now as President Trump has promised.

“The Senate is starting from scratch,” Collins said. “My goal is to actually expand coverage for those 28 million Americans who still lack coverage despite the ACA.”

House Speaker Paul Ryan told Stephanopoulos the Senate will make the bill better.

“We’ve already acknowledged we think we need to do even more support for people who are older and also more support for people with preexisting conditions,” Ryan said.

But Republicans are still trying to cut overall spending to pay for repealing the taxes on the wealthy, sectors of the health care industry and others that were included in the ACA to pay for expanded coverage.

“We’re just throwing the baby out with the bathwater in order to give a tax cut,” Sen. Joe Manchin, D-W.Va., said on CBS’s “Face the Nation.”

The nonpartisan Congressional Budget Office projected 24 million fewer people would have coverage under an earlier version of the House bill than they would under the ACA.

“The fundamental issue here are the resources,” said Kasich, who is concerned about the Ohioans who gained coverage through the law’s expansion of Medicaid eligibility. “It’s about half the resources in this bill that were in Obamacare.”