Lawmakers allow health insurance plan to bypass federal protections for people with pre-existing conditions


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The Texas House on Friday passed a bill allowing a health insurance company to circumvent federal health care laws — including protections for pre-existing conditions.

House Bill 3924 is a little-known measure that allows the Farm Bureau Health Care Plan to act like insurance, but circumvent some of the regulations applicable to insurers under the Affordable Care Act. Coverage through the Farm Bureau, an insurance company and lobby group, would be available to anyone paying the $35-50 membership fee.

Proponents of the bill say the workaround aims to create a more affordable coverage option, especially in rural areas.

But Stacey Pogue, senior policy analyst at policy think tank Every Texan, said those health plans won’t be required to provide the same protections under the ACA, including popular protections for people with pre-existing conditions. such as diabetes, cancer or heart disease. .

“[It] deliberately creates a loophole in these protections so that a single entity can offer coverage that may deny you based on your medical condition, or charge you more, or make you wait to get covered treatment for your care conditions health,” she said.

Pogue said the decision – led by Republicans – is surprising because both parties have adopted protections for people with pre-existing conditions.

According to a 2019 survey by the Episcopal Health Foundation, about 9 in 10 Texans think health insurance companies should not be allowed to discriminate against people with pre-existing conditions. In Texas, approximately 28% of the population age 64 and younger has a pre-existing condition.

Five other conservative states already allow the Farm Bureau to circumvent rules created by the ACA by not classifying their health coverage as insurance.

Under federal health care laws, states can determine which health plans should be classified as insurance, giving the state the ability to decide who can follow the rules that other insurance plans must follow. .

Pogue said if healthy people focus on plans like the Farm Bureau’s, it could affect other parts of the insurance market, especially the online market created by the ACA. This is because sicker people will be less able to get coverage through the Farm Bureau, while healthier people will have a financial incentive to choose a cheaper plan that excludes people with pre-existing conditions.

“What this does over time is that the pool of people covered by the health insurance market will get older and sicker on average,” Pogue said. “And that increases the cost of their hedging and that adds to market instability.”

The bill still needs to be approved by a committee and then re-passed by each house of the legislature before heading to the governor’s office.


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