Republican senators are considering whether to let states allow insurers to charge sick people more money for healthcare coverage.
Senate leadership is aiming to reach consensus on healthcare legislation and vote on the bill by the end of July. Top senators said that waivers to let states opt out of a requirement called community rating are still being discussed, despite initial reports that the waivers wouldn’t include that option.
Sen. John Thune, R-S.D., said Wednesday that community rating is still under discussion.
“There are still conversations about it,” he said. “What we are gonna do with this is try to find a consensus.”
A community rating is a mandate that forces an insurer to charge the same rate for an age group and can’t take into account a person’s health history when setting rates. It ensures that people with pre-existing conditions aren’t hit with exorbitant prices.
Some senators were reluctant to take a firm stance against letting states opt out of community rating.
Sen. John Cornyn, R-Texas, the second-ranking GOP senator, said that was “a very good question and I haven’t given much thought to it.”
When asked whether he supports giving states the option, Sen. Tim Scott, R-S.C. pivoted to ongoing negotiations.
“I think the waiver conversation is going to be a meaningful conversation, one that we haven’t concluded on,” he said Wednesday.
But some Republicans said they are unwilling to eliminate the community rating.
Sen. Dean Heller, R-Nev., told reporters Thursday that he would “tend not to support” letting states opt out of community rating or the requirement that insurers cover 10 essential health benefits such as hospitalization.
Sen. Bill Cassidy, R-La., also said that he supported continuing the community rating.
The Senate is exploring a waiver system for states to give them the flexibility to opt out of key Obamacare insurer mandates.
A report in Axios said the waiver would not let a state opt out of community rating but would allow states to opt out of forcing plans to cover 10 essential health benefits such as maternity care and hospitalization.
The American Health Care Act, which narrowly passed the House last month, included a last-minute amendment that lets states opt out of community rating. States that receive a waiver would have to set up a high-risk pool that subsidizes coverage for people with pre-existing conditions.
However, the Congressional Budget Office found that people with pre-existing conditions who live in states with a waiver would face higher premiums and eventually not be able to buy affordable coverage. The CBO also found that $23 billion for high-risk pools was not nearly enough money to cover the pools.
