The Great Debate Resumes

January 18, 2011

As House reps meet to discuss repealing health reform, a study is released saying millions will be denied coverage they need. Yup, the debate is back on.

After a brief respite, the health care reform debate has returned—with a vengeance.

On the same day that House representatives met to debate the proposed repeal of the Affordable Patient Care Act, the Department of Health and Human Services released a study suggesting that nearly half of all Americans have pre-existing health conditions, adding fuel to a fire that had briefly cooled off.

The HHS report suggests that without the health reform law, as many as 129 million non-elderly Americans with pre-existing conditions like diabetes would be at risk of losing health insurance—or denied coverage altogether. Repealing the law, said Secretary Kathleen Sebelius, would leave millions of Americans worrying about whether coverage will be there when they need it.

“The Affordable Care Act is stopping insurance companies from discriminating against Americans with pre-existing conditions and is giving us all more freedom and control over our health care decisions,” she said in a press release.

Findings from the report are as follows:

  • The percentage of Americans living with a pre-existing condition ranges between 19% and 50%; for older Americans, the odds are increased, as 48% to 86% of those between the ages of 55 and 64 have a pre-existing condition;
  • 15% to 30% of people under age 65 in perfectly good health today are likely to develop a pre-existing condition over the next eight years;
  • Up to one in five Americans under age 65 with a pre-existing condition—25 million individuals—is uninsured.

House Republicans and members of the health insurance industry, however, dismissed the figures from the study as “a gross overstatement.” According to Robert Zirkelbach, spokesperson for America's Health Insurance Plans spokesman, the HHS study creates a disconnect between conditions and coverage.

"It's exaggerating the number of people who are actually impacted by pre-existing conditions," he said in a Fox News article. "Most people who are applying are getting policies."

A 2009 AHIP study found that nine in 10 people under 65 are insured through their employers, which generally don't withhold health coverage over pre-existing conditions,” according to Zirkelbach. It also found that nearly nine in 10 people who apply for coverage in the individual market are accepted.

The HHS report also showed most people have insurance through an employer. However, the study showed a high proportion of those Americans have a pre-existing condition, and if they become self-employed or leave their jobs could face hurdles in getting coverage elsewhere.

The study comes as the administration and Democratic allies in Congress fight back against GOP efforts to strip their landmark domestic policy achievement of the past two years. House members returned Tuesday to Capitol Hill to debate the repeal bill after a weeklong hiatus in activities due to the shooting of Rep. Gabrielle Giffords (D-AZ) and 18 other people in Tucson.

A vote is expected Wednesday. Although the move by Republicans is largely symbolic and not likely to lead to an overturn, it could “kick-start substantive changes to provisions at the law's core,” according to a Wall Street Journal blog.

On Thursday, a day after the repeal vote, the House will pass a measure directing committees to craft new legislation. The committees will begin "the exploration of better policy alternatives designed to lower costs, improve access, protect the doctor-patient relationship and get lawyers out of operating rooms," said John Murray, deputy chief of staff for Majority Leader Eric Cantor.

Stay tuned to HCPLive for more coverage of the health care reform debate.

For more:

House Launches Health-Law Challenge (Wall Street Journal)

Video: Renewed Health Care Debates Begin (MSNBC)

Do Americans really want health law fully repealed? (Washington Post)