Pre-existing conditions bill advances, but GOP rejects added protections




A bill that would ensure pre-existing conditions for Arizonans are still covered if a GOP-backed lawsuit against the Affordable Care Act succeeds in striking down the 2010 law won preliminary approval in the Arizona House of Representatives Wednesday, but Republicans rejected an attempt by Democrats to add protections to the measure.

But critics of Senate Bill 1397 say that, while it might guarantee coverage, it does nothing to ensure that coverage is affordable – and insurance that people with pre-existing conditions can’t afford isn’t much different than denying them coverage altogether.  

The federal government estimates that as many as half of all Americans have a pre-existing condition that is affected by the Affordable Care Act’s provisions. That law, the hallmark of President Barack Obama’s time in office, did away with the practice of insurance companies raising rates – or completely denying coverage – for people with pre-existing conditions.

The measure, backed by legislative Republicans and supported by insurance companies, says that insurance companies cannot deny coverage or impose any restrictions on Arizona policy holders due to pre-existing conditions. 

The bill comes as a lawsuit that aims to declare the Affordable Care Act unconstitutional is making its way through the federal appellate courts. Arizona is one of the plaintiffs in the case, known as Texas v. United States, which is seeking to overturn the whole law on the grounds that the mandate that everyone purchase insurance is unconstitutional. 

The bill would only go into effect if the lawsuit is successful.

The bill on Wednesday cleared the House Commerce Committee and won approval on the floor on a preliminary vote. During floor debate, Republicans blocked Democrats from amending the bill to add more protections for Arizonans. 

Rep. Kelli Butler, D-Paradise Valley, attempted to amend the bill to include language that would prohibit an insurer from denying certain essential benefits – such as mental health and maternal care –  as well as require insurance for an insured’s child until the age of 26. 

The amendment would have also prevented an insurer from imposing an annual or lifetime dollar limit on any benefit deemed essential. Those provisions are in the Affordable Care Act.

One of the main critiques from Butler is that the bill does nothing to address a rule within the ACA called community rating.

Community rating requires health insurance providers to offer plans in an area at the same price to everyone, regardless of their age, sex or health status. Butler contended that, without this sort of a provision in the bill, it does not do enough to protect those with pre-existing conditions. 

A University of Pennsylvania study found that, prior to the implementation of the ACA, women spent approximately $1.5 billion more annually due to higher insurance ratings than men, despite the fact that men and women generally do not differ on mortality rates due to health issues. 

The bill’s sponsor, Sen. J.D. Mesnard, R-Chandler, said the bill isn’t intended to replicate all of the Affordable Care Act’s provisions, and is meant simply to ensure that people with pre-existing conditions aren’t prevented from obtaining insurance.

“It doesn’t seek to solve all problems,” he said during the Commerce Committee hearing. 

Mesnard added that amendments he had been planning for the bill cannot be pursued because the Senate has adjourned for the session. 

“I still think it’s better than nothing,” he said.

Because the Senate has adjourned its business for the year, the House is limited in how it can proceed with bills that have already passed the Senate. The biggest limit is that amendments cannot be added, since the Senate is unable to approve those changes.