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House tentatively approves bill to allow pre-existing medical conditions

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The state House voted Wednesday to provide some protections for Arizonans with pre-existing health conditions if the U.S. Supreme Court voids the federal Affordable Care Act.

But that doesn’t mean it will be affordable.

The measure is being touted as a fail-safe for Arizonans should the Trump administration be successful in its efforts to quash the law. That would include eliminating the broadly popular provision saying that people cannot be denied health insurance because they have some underlying condition or ailment.

SB 1397 says if that happens between now and June 30, 2023, Arizona would have its own similar provision in state law.

J.D. Mesnard

J.D. Mesnard

The move came over objections from Democrats who said that similar is not identical.

Sen. Kelli Butler, D-Paradise Valley, said the proposal by Sen. J.D. Mesnard, R-Chandler, fails to provide for something in federal law: affordability. She said it does little good to tell someone with a pre-existing condition if the insurance company can charge whatever it wants.

There’s also a political component to all this.

Butler pointed out that it isn’t just the Trump administration that is trying to kill the Affordable Care Act, a move that would eliminate the protection for pre-existing conditions.

Kelli Butler

Kelli Butler

She noted that Arizona Attorney General Mark Brnovich has joined with other Republican attorneys general in asking the Supreme Court to void the law. And Mesnard has acknowledged that he, too, believes the Affordable Care Act is not within the powers of the federal government.

But without price protections, she said, the legislation is little more than window dressing.

“It’s a pretend political ploy,” she said. “It’s smoke and mirrors.”

During floor debate Wednesday Butler attempted to amend the measure to add provisions on affordability and to allow children to remain on their parent’s policy.

She didn’t get a chance to do that as Republicans used a procedural maneuver to not only block her from offering the proposal but also to limit total debate on the legislation to just six minutes, three for each side.

Rep. Jeff Weninger, R-Chandler, did not dispute that the measure does not go as far as the Affordable Care Act. But he said it does provide something for Arizona residents should the federal law go away.

Wrapped up in the debate on SB 1397 is the Affordable Care Act and the efforts by Trump, Brnovich and others to undo the 2010 law.

That wide-ranging measure requires employers to provide health insurance for their workers and individuals to obtain their own coverage. It also created insurance exchanges to provide discounted coverage for those who meet income guidelines, expanded Medicaid coverage, and eliminated lifetime monetary caps on insurance coverage.

The Supreme Court upheld the law in 2012, with the majority saying the mandate for individuals to purchase insurance fits within the power of Congress to impose a tax.

But that fell apart in 2017 when Congress eliminated the financial penalty for failing to have insurance, a move that the current round of challengers say eliminated any legal basis for the law.

Butler lashed out at those trying to kill it, saying that it would eliminate coverage for about 700,000 Arizonans who get care one way or another under the law. But she said if that’s going to happen, Arizona needs to be prepared to deal with the 2.8 million residents who have pre-existing conditions.

Weninger did not dispute that SB 1397, by itself, has no cost controls.

But he argued that there are provisions in existing laws that preclude insurers from discriminating between members of the same class of policyholders. And he said the Department of Insurance requires that rates be “actuarily sound.”

Butler sniffed at that explanation, saying that’s not how the law actually reads.

Weninger disagreed, saying his advice comes from Brnovich. And he promised to seek a formal legal opinion backing up that position.

The issue has placed Democrats in a difficult position.

On one hand, even Butler acknowledged that it is “better than nothing” and she has to support it.

But others, including Rep. Mitzi Epstein, D-Tempe, have said they don’t view it that way. Epstein, during committee debate, said the people who have pre-existing conditions are telling her they would rather have no measure at all than this one.

“It doesn’t help,” she said.

The measure, which already has been approved by the Senate, now needs a final roll-call vote in the House.

One comment

  1. Kimberly Dorris

    Do you know who is NOT complaining about S.B. 1397? Insurance companies. That’s because they know that S.B. 1397 leaves plenty of loopholes that will allow them to deny coverage to patients with chronic illnesses if the ACA is dismantled. The cost of premiums, deductibles, copays, and coinsurance is just one factor. Insurers could also deliberately exclude the Essential Health Benefits that are currently mandated by the ACA, many of which are needed for managing chronic illnesses: laboratory tests, specialist visits, emergency care, and hospitalization. And we will no doubt see insurers bringing back annual and lifetime caps, meaning that patients could have their care cut off in mid-year when they reach an arbitrary dollar amount. SB 1397 has one sole purpose: to provide political cover for Republicans who like to SAY that they support Arizonans with pre-existing conditions without doing the actual hard policy work.

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