Conservatives pushing to bring down the cost of health care premiums by letting states ditch a controversial pricing mechanism in Obamacare are running into strong objections from many House Republicans.
At issue is the community rating mechanism, which is used today under Obamacare to equalize the cost of insurance within a region. Conservatives argue that system has caused premiums to spiral upwards, and discouraged young and healthy people from buying policies.
But other Republicans warn that removing the rating will allow insurance companies to charge much more for older or sicker people, which could put health insurance out of reach for them.
Removing the community rating is one of the options on the table as the White House works with conservatives and moderates to write a bill that can pass the House.
“There are those of us who want the community rating to stay in,” said Rep. Chris Collins, R-N.Y. “We will see how the discussion goes, but as a betting person, I think they stay in.”
The plan under discussion would allow insurers to drop the community rating system unless individual states already mandate that kind of price control. New York, for example, requires equalized insurance prices for young and old consumers.
In a state without community rating mandate, the insurance rate for those with pre-existing conditions or who are aged 50 to 64 could end up paying premiums five times as high as younger people.
The disagreement threatens to alienate House Freedom Caucus members who comprise the bulk of GOP holdouts.
House Freedom Caucus Chairman Mark Meadows, R-N.C., told the Washington Examiner that conservatives would be willing to vote for a repeal and replace bill that did not entirely repeal Obamacare if the legislation eliminated the community rating system, and Obamacare’s essential health benefits, which is a list of minimum benefits that insurance policies must provide to people, such as hospitalization, prescription drugs, and maternity care.
