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house Bill H.R. 986

Should Trump’s Action Loosening Restrictions on State Innovation Waivers Under Obamacare Be Repealed?

Argument in favor

Trump’s executive action made it easier for states to use Obamacare waivers to take actions that ultimately weaken protections for individuals with pre-existing conditions. It must be reversed, and this bill would do just that.

···
05/06/2019
Until such time as a Medicare for All single payer system can be created, every aspect of the ACÁ that is currently functional should be reviewed and changed orb supported based on its effectiveness in meeting the needs of the American people. The original intent of the law was to allow states to choose to implement a Medicaid-based system of their own choosing and design, in the effort to expand coverage to all Americans in all states. The initial ACÁ bill gave states the option of whether or not to implement such a system, but some state governments controlled by GOP legislatures have refused to develop such programs despite their constituents’ clear meed for and approval of them. Consequently, not all Americans are benefiting equally or fairly from the ACÁ, and adjustments need to be made in the original law to ensure that ALL Americans have thus option available to them. This bill corrects the earlier dysfunctional design by requiring all states to comply. I fully support this change and ask you to do likewise!🇺🇸
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Bicycler's Opinion
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05/05/2019
Since 2011 Republicans have attempted 70 times to repeal the Affordable Care Act. They ran on the idea that they would repeal & REPLACE the Affordable Care Act. Trump himself tried to repeal the plan and it failed by one vote. Thank you Senator John McCain. In all these attempts they have talked about providing a much better plan that will cost you less money. We have never seen an actual replacement plan. Now we are told that there will be a new plan but you will have to flip the House, retain the Senate and keep Trump in office to view this miraculous plan which will cover your healthcare and cost less money. Let's look at this incredulous assertion: The Affordable Care Act was based on the premise that you get a decent plan, rather than existing plans, which typically had a Lifetime cap of one million dollars. Had cancer lately? Had a child in a neonatal intensive care unit? One million dollars for your family could be gone through very quickly. The Affordable Care Act covered the following 1. Coverage of preexisting conditions 2. Preventative care 3. Essential benefits including: 1. Ambulatory patient services (outpatient services) 2. Emergency services 3. Hospitalization 4. Maternity and newborn care 5. Mental health and substance use disorder services, including behavioral health treatment 6. Prescription drugs 7. Rehabilitative and habilitative services (those that help patients acquire, maintain, or improve skills necessary for daily functioning) and devices 8. Laboratory services 9. Preventive and wellness services and chronic disease management 10. Pediatric services, including oral and vision care 4. The ability to have your children covered till the age of 26 years old It also allowed the expansion of Medicaid throughout the country which had the effect of rural hospitals finally being reimbursed and not having to close their doors because of providing totally uncompensated care. When rural hospitals close it forces patients to drive hundreds of miles to urban centers for care. It will also have the chilling effect of shutting down rural healthcare clinics which opened to provide medical health homes to indigent clients, providing valuable tax paying jobs to physicians, PA's, nurses, billing clerks, receptionists, contractors, etc. Medicaid expansion also allowed Medicare to survive for many more years without losing senior coverage. Prior to the Affordable Care Act, many were forced into bankruptcy when they truly needed their coverage. Healthcare insurance CEO's always got paid, a lot, while you went broke, believing you had coverage which you were denied when you truly needed it. Seniors on Medicare receive many benefits from the Affordable Care Act as well. All of this will go away when the Affordable Care Act is gutted in the courts. Unfortunately the Affordable Care Act has been quietly and sometimes loudly eviscerated over the years. Good coverage costs money and if you believe you are going to get all of that coverage listed above, without it costing more money, you are the problem. Why should we believe that, a party which has given us numerous attempts to repeal the Affordable Care Act, with a complete no show of any replacement plan, will all of a sudden provide us with phenomenal low cost insurance?
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burrkitty's Opinion
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05/09/2019
Those “short term” junk plans were a scam to undermine the ACA from the get go. On our path to a universal single payer healthcare system, we must continually work to get people true, useful, affordable healthcare.
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Argument opposed

Broadening the use of Obamacare’s state innovation waivers has created opportunities for several states — including Alaska, Minnesota, and Oregon — to take actions that lowered health insurance premiums, giving consumers more choices and saving them money.

SneakyPete's Opinion
···
05/05/2019
A Broadening the use of Obamacare’s state innovation waivers is Good. Broadening the use of Obamacare’s state innovation waivers has created opportunities for several states — including Alaska, Minnesota, and Oregon — to take actions that lowered health insurance premiums, giving consumers more choices and saving them money. SneakyPete..... 👍🏻👍🏻👍🏻👍🏻👍🏻. 5*5*19.....
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Ronald's Opinion
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05/08/2019
Obamacare Must be completely repealed. Until then, small steps as relaxing state waivers will have to do.
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Kathy's Opinion
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05/08/2019
Obamacare should be totally repealed! Government should stay out of healthcare! We have Medicaid to help people but some abuse this . They can come into ER as many times they want cause they do not have to pay anything. If they go to their dr they have to pay a small fee. This is so unfair. That is why ER are so busy. Everyone should have to pay something for their insurance. I am sorry but a 26 yr old should not be on his parents insurance!
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bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house Passed May 9th, 2019
    Roll Call Vote 230 Yea / 183 Nay

    Your Representative Voted

    Rep Harris
    Voted nay
      house Committees
      Committee on Energy and Commerce
      Health
      Committee on Ways and Means
    IntroducedFebruary 6th, 2019

Log in or create an account to see how your Reps voted!

What is House Bill H.R. 986?

This bill would repeal an October 2018 guidance issued by the Dept. of Health and Human Services (HHS) related to “State Relief and Empowerment Waivers” under the Affordable Care Act (aka Obamacare). The guidance loosened restrictions of Section 1332 state innovation waivers, which became available to states in January 2017 under the ACA, by expanding the definition of coverage to include short-term plans and allowing existing state legislation about enforcing Obamacare satisfied the waiver requirement.

Impact

Health insurance consumers in states that have received ACA innovation waivers; health insurers; state regulators; and HHS.

Cost of House Bill H.R. 986

The CBO estimates that this legislation would have an insignificant impact on the federal budget because the state innovation waivers are required to be budget neutral.

More Information

In-Depth: Rep. Annie Kuster (D-NH) introduced this bill to “protect Americans with pre-existing conditions by preventing the promotion of junk health plans, which often lack protections for these Americans.” She explained:

“The Trump Administration has done its very best to undermine the Affordable Care Act and access to quality healthcare for millions of Americans. The ACA was a watershed piece of legislation that ensured protections for those who had been denied access to health insurance in the past because of pre-existing conditions. Our legislation would help to ensure that those protections do not fall victim to partisan attacks. I’m committed to working with my colleagues to strengthen and improve access to quality, affordable health insurance for all Americans.”

Original cosponsor Rep. Joe Courtney (D-CT) added:

“Time and time again this Administration has eroded key ACA consumer protections that are the bedrock of the law. The 1332 guidance the Administration issued further degrades the original intent of the ACA by creating a backdoor to provide Americans with coverage that doesn’t meet the law’s standards and weakens protections for people with pre-existing conditions.”

House Republicans expressed opposition to this bill and support for the Trump administration’s update to the innovation waivers regulation in this bill’s committee report, writing:

“To date, eight States have active waivers, all of which were approved under the Obama Administration guidance. Among these States, for 2018 alone: Alaska experienced a 26 percent premium reduction, Minnesota saw its rate increase reduced to 11.3 percent, significantly less than its 2017 57 percent increase; and, Oregon’s rate changes ranged from -1.6 to 14.8 percent, dropping to a range of -9.6 to 10.1 percent for 2019.

While this bill has a catchy title, it does little to protect individuals living with pre-existing health care conditions. House Republicans continue to support pre-existing condition protections and have offered solutions to give patients this assurance outside of the unpopular, unaffordable, and unconstitutional framework.”

This legislation was reported favorably by the House Energy & Commerce Committee on a voice vote, and has the support of 19 Democratic cosponsors and several healthcare trade organizations.


Media:

Summary by Eric Revell

(Photo Credit: iStock.com / Rostislav_Sedlacek)

AKA

Protecting Americans with Preexisting Conditions Act of 2019

Official Title

To provide that certain guidance related to waivers for State innovation under the Patient Protection and Affordable Care Act shall have no force or effect.

    Until such time as a Medicare for All single payer system can be created, every aspect of the ACÁ that is currently functional should be reviewed and changed orb supported based on its effectiveness in meeting the needs of the American people. The original intent of the law was to allow states to choose to implement a Medicaid-based system of their own choosing and design, in the effort to expand coverage to all Americans in all states. The initial ACÁ bill gave states the option of whether or not to implement such a system, but some state governments controlled by GOP legislatures have refused to develop such programs despite their constituents’ clear meed for and approval of them. Consequently, not all Americans are benefiting equally or fairly from the ACÁ, and adjustments need to be made in the original law to ensure that ALL Americans have thus option available to them. This bill corrects the earlier dysfunctional design by requiring all states to comply. I fully support this change and ask you to do likewise!🇺🇸
    Like (90)
    Follow
    Share
    A Broadening the use of Obamacare’s state innovation waivers is Good. Broadening the use of Obamacare’s state innovation waivers has created opportunities for several states — including Alaska, Minnesota, and Oregon — to take actions that lowered health insurance premiums, giving consumers more choices and saving them money. SneakyPete..... 👍🏻👍🏻👍🏻👍🏻👍🏻. 5*5*19.....
    Like (25)
    Follow
    Share
    Since 2011 Republicans have attempted 70 times to repeal the Affordable Care Act. They ran on the idea that they would repeal & REPLACE the Affordable Care Act. Trump himself tried to repeal the plan and it failed by one vote. Thank you Senator John McCain. In all these attempts they have talked about providing a much better plan that will cost you less money. We have never seen an actual replacement plan. Now we are told that there will be a new plan but you will have to flip the House, retain the Senate and keep Trump in office to view this miraculous plan which will cover your healthcare and cost less money. Let's look at this incredulous assertion: The Affordable Care Act was based on the premise that you get a decent plan, rather than existing plans, which typically had a Lifetime cap of one million dollars. Had cancer lately? Had a child in a neonatal intensive care unit? One million dollars for your family could be gone through very quickly. The Affordable Care Act covered the following 1. Coverage of preexisting conditions 2. Preventative care 3. Essential benefits including: 1. Ambulatory patient services (outpatient services) 2. Emergency services 3. Hospitalization 4. Maternity and newborn care 5. Mental health and substance use disorder services, including behavioral health treatment 6. Prescription drugs 7. Rehabilitative and habilitative services (those that help patients acquire, maintain, or improve skills necessary for daily functioning) and devices 8. Laboratory services 9. Preventive and wellness services and chronic disease management 10. Pediatric services, including oral and vision care 4. The ability to have your children covered till the age of 26 years old It also allowed the expansion of Medicaid throughout the country which had the effect of rural hospitals finally being reimbursed and not having to close their doors because of providing totally uncompensated care. When rural hospitals close it forces patients to drive hundreds of miles to urban centers for care. It will also have the chilling effect of shutting down rural healthcare clinics which opened to provide medical health homes to indigent clients, providing valuable tax paying jobs to physicians, PA's, nurses, billing clerks, receptionists, contractors, etc. Medicaid expansion also allowed Medicare to survive for many more years without losing senior coverage. Prior to the Affordable Care Act, many were forced into bankruptcy when they truly needed their coverage. Healthcare insurance CEO's always got paid, a lot, while you went broke, believing you had coverage which you were denied when you truly needed it. Seniors on Medicare receive many benefits from the Affordable Care Act as well. All of this will go away when the Affordable Care Act is gutted in the courts. Unfortunately the Affordable Care Act has been quietly and sometimes loudly eviscerated over the years. Good coverage costs money and if you believe you are going to get all of that coverage listed above, without it costing more money, you are the problem. Why should we believe that, a party which has given us numerous attempts to repeal the Affordable Care Act, with a complete no show of any replacement plan, will all of a sudden provide us with phenomenal low cost insurance?
    Like (72)
    Follow
    Share
    Those “short term” junk plans were a scam to undermine the ACA from the get go. On our path to a universal single payer healthcare system, we must continually work to get people true, useful, affordable healthcare.
    Like (58)
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    Share
    We must support the ACA until we increase coverage for all Americans.
    Like (33)
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    No junk health plans! Keep real pre existing conditions coverage!
    Like (27)
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    Yes. Trump has openly ranted about killing Obamacare & this was one way to do that. Allowing states to provide cheap plans that cover next to nothing draws the healthy, younger participates out of the full coverage Obamacare plans. This jacks up the premiums for the full coverage plans & gives next to no coverage to the younger, healthier people. Both of these things intentionally angered all Obamacare enrollees.
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    Obamacare Must be completely repealed. Until then, small steps as relaxing state waivers will have to do.
    Like (21)
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    Obamacare should be totally repealed! Government should stay out of healthcare! We have Medicaid to help people but some abuse this . They can come into ER as many times they want cause they do not have to pay anything. If they go to their dr they have to pay a small fee. This is so unfair. That is why ER are so busy. Everyone should have to pay something for their insurance. I am sorry but a 26 yr old should not be on his parents insurance!
    Like (20)
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    These "waivers" are just another Trump/Republican effort to destroy the ACA a little bit at a time. Unfortunately, many people will not understand that these "cheap" plans are cheap because they don't provide the coverage and protections of the ACA. Which may be fine until they really need the insurance and then they will be out of luck. Meanwhile, good insurance for everyone else will get more expensive as healthy people are lured away from the exchange pools. People need to understand that these efforts by the Trump administration are not intended to make insurance better for people. The goal is to destroy the insurance marketplace which they were unable to do legislatively. The system we have now is far from perfect and needs to be improved, but do you really want to go back to the days when getting sick meant discovering that your insurance didn't cover what you needed or that being sick meant you couldn't get any insurance? Don't be fooled, if they really wanted to help they could take action to control drug prices and medical price gouging. That is the real way to bring down the cost of insurance.
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    Ann kuster is another jackass democrat who thinks she knows better and has some right to tell everyone what kind of healthcare they should have.
    Like (14)
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    I am tired of the assnine chief executive and/congress repealing existing laws. Deal with it people. My insurance premiums have increased ten fold in the past 20 years due to paying for thise that don’t have coverage. It is time for insurance companies to stop raping consumers with their outrageous prices or we go to single payer medicare for all. We pay one way or another.
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    Innovation is a good thing, in healthcare it’s absolutely essential.
    Like (11)
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    Representative Mike Simpson. Do you really want to go down in our history books as being on the side of someone such Donald Trump. There is not much integrity in congress these days. I’m ashamed to admit my representative is a Trump supporter. Mr. Simpson. You should be ashamed too.
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    Never trust a democrat . They fixed healthcare with a tax .They only made things worse. Tax all democrats 70 percent! Let them pay for everyone’s healthcare !
    Like (10)
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    These so-called innovation waivers are just a fancy way of allowing states to permit worthless healthcare plans that give Americans meaningless healthcare coverage! We need Medicare-for-all so that all Americans are guaranteed healthcare coverage!
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    Please vote YES
    Like (10)
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    We need to repeal this unconstitutional disaster of a healthcare law. Immediately. Not just limitations the entire thing. I should have the right to choose to have healthcare coverage or not. Being forced to purchase goods and services is criminal.
    Like (9)
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    Obamacare conflates health insurance and welfare, raising the cost of both.
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    Trump shld go further to completely get rid of Obamacare- it’s a mess from beginning to end and I can say that firsthand.
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