Gardner’s Bill is “A Fig Leaf for a Political Problem Rather Than a Means to Guarantee Protections”
On day four of Senator Cory Gardner’s televised lie about pre-existing conditions, Politifact took a hard look at his claims and declared them to be flat-out “FALSE.” These independent fact checkers said “the brevity of Gardner’s proposal makes it appear to be a fig leaf for a political problem rather than a means to guarantee protections for people with preexisting conditions.”
And the experts Politifact spoke to agreed:
- “It’s an adorable little bill but does not address any of the main issues. You need a package of policies working together in order to create real protections for people to have coverage to meet their health care needs.” – Linda Blumberg, Urban Institute’s Health Policy Center
- “It’s probably about 100 words too long. It could have said, ‘I’m running for election. I’ll do whatever is necessary.’” – Thomas Miller, American Enterprise Institute
- “A lot more is needed to overcome legitimate objections that almost certainly will be made from both sides of the political aisle.” – Mark Hall, Wake Forest University
Read more from Politifact about Gardner’s lies HERE or highlights below, and stay tuned for another update tomorrow.
Politifact: Gardner’s bill has as much to do with politics as preexisting conditions
Sen. Cory Gardner, a Republican running in a tight race for reelection in Colorado, says he wants to protect people with medical conditions,
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That got us thinking: Would Gardner’s legislation, dubbed “The Pre-Existing Conditions Protection Act,” actually guarantee these protections if the ACA didn’t exist? We decided to investigate.
The bill, which was introduced in August, still has no co-sponsors. It’s very short, only 117 words in total.
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Thomas Miller, a resident fellow at the American Enterprise Institute, a think tank in Washington, D.C., quipped that the main goal might be something else entirely.
“It’s probably about 100 words too long,” Miller said. “It could have said, ‘I’m running for election. I’ll do whatever is necessary.’”
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Since the law went into effect in 2014, it has faced many efforts by Republicans in Congress, including Gardner, to repeal it.
It has also faced three Supreme Court challenges. It survived the first two, although one ruling allowed states to opt out of its expansion of Medicaid programs for the poor. The still-pending case was first brought in 2018 by 20 states and is supported by the Trump administration. That case could overturn the entire law, although the court won’t hear arguments on the issue before the election. And that brings us back to Gardner’s bill. An obvious difference between that proposal and the ACA is length. Gardner’s bill is one page, while the ACA runs to several hundred.
And Gardner’s claim seems pegged to the legislative language that says insurers can’t impose a “pre-existing condition exclusion,” which sounds fairly straightforward.
But it’s not, experts say.
“It’s an adorable little bill but does not address any of the main issues,” said Linda Blumberg, a fellow at the nonprofit Urban Institute’s Health Policy Center. “You need a package of policies working together in order to create real protections for people to have coverage to meet their health care needs.”
For instance, the bill does not explicitly bar insurers from outright rejecting applicants with medical conditions, something known as “guaranteed issue.”
“‘Guaranteed issue’ is not in the language of the bill,” said Miller at AEI.
Instead, the language may simply prohibit insurers from restricting services related to a medical condition only if they choose to sell an individual insurance in the first place, he said.
Compare that with the ACA, which says every insurer selling individual or group coverage “must accept every employer and individual in the State that applies.”
Also needed in legislation aiming to protect people with medical problems, said Blumberg, are provisions for subsidies to help people of low and moderate income afford their premiums. The ACA has those, along with specific enrollment periods, so that people don’t wait until they are sick to sign up. Without them, mainly those with medical conditions might sign up, driving up costs and premiums. That, in turn, can price people, especially the sick, out of future coverage.
Another way Gardner’s bill differs from the ACA is that it does not list benefits that must be included in a health insurance policy. The ACA requires insurers to cover 10 broad categories of care, including hospitalization, prescription drugs, childbirth, substance abuse treatment and mental health care.
“Without that, insurers could sell products that don’t cover very much, which is what we had prior to 2014,” Blumberg added, which is one way to discourage those who are sick from even applying. “It was difficult to find a product that covered prescription drugs, and we even saw policies that didn’t cover chemotherapy.”
So, what about costs?
Gardner’s legislation says insurers can’t “factor health status into premiums or charges.”
So insurers could not charge people more simply because they have diabetes, say, or cancer. Still, that leaves open a whole lot of other things that insurers could consider when setting premiums for individuals, such as such as gender or occupation, which could stand in as a proxy for health. Unlike the ACA, it does not bar insurers from setting annual or lifetime dollar limits on coverage, which could disproportionately affect people with costly medical conditions.
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“A freestanding protection of pre-existing conditions without any supporting provisions to keep insurance affordable or encourage people to purchase it before they become sick, is almost certain to cause serious harms to the market,” Hall wrote in an email. “Therefore, a lot more is needed to overcome legitimate objections that almost certainly will be made from both sides of the political aisle.”
Our ruling
Because protecting people with medical conditions requires many moving parts, the brevity of Gardner’s proposal makes it appear to be a fig leaf for a political problem rather than a means to guarantee protections for people with preexisting conditions.
The legislation is unclear on whether it guarantees that people with health problems will be able to buy insurance in the first place. And, even if they can, they may well find it priced out of reach because the legislation does not bar insurers from varying premiums widely on the basis of age, gender or occupation.
Viewed in its most favorable light, Gardner’s 117-word proposal would only serve as a place holder for larger legislation, upon which more protections would have to be layered to bolster the effectiveness of its guarantee.
We rate this statement False.
