President Trump appeared to suggest on Sunday that the GOP’s
new iteration of its healthcare bill to repeal and replace the
Affordable Care Act would cover pre-existing conditions for all
Trump, seeming to break from House Republicans’ latest proposal that covering
pre-existing conditions would be left up to the states, told CBS’ John Dikerson on “Face the Nation”
that congressional leaders were making changes to the newest bill
to provide for nationwide pre-existing conditions coverage.
“Pre-existing conditions are in the bill. And I mandate it.
I said, ‘Has to be,'” said Trump.
Trump’s first replacement bill included that provision,
but it was pulled from the floor of the House before it could
come to a vote after it became clear the bill did not have enough
support to pass, largely because the ultraconservative House
Freedom Caucus said it did not go far enough to repeal Obamacare
in its entirety.
In order to bring members of the Freedom Caucus on board, leader
of the Tuesday Group, NJ Rep. Tom MacArthur, introduced an amendment on Tuesday that would allow
states to opt out of the two largest Obamacare provisions.
In addition to allowing states to waive coverage for
essential health benefits — like maternity care and
emergency-room visits — the amendment also allows states to waive
parts of the community rating. Community-rating rules under
the Affordable Care Act prohibit insurance companies from
charging higher premiums to those with pre-existing conditions.
Under MacArthur’s proposal, states would have the option of
waiving that requirement, meaning insurance companies could
ostensibly charge higher premiums to sicker people. States would
be eligible to apply for a waiver if they provide some
funding for people with preexisting conditions to get coverage,
participate in the “invisible high risk pools” established by the
AHCA, or “provide incentives to appropriate entities” to
But in Sunday’s interview, Trump seemed to suggest
that the amendment will be altered to ensure pre-existing
conditions coverage for people regardless of where they
“In one of the fixes that was discussed, pre-existing
[coverage] was optional for the states,” Dickerson
“Sure, in one of the fixes,” Trump replied. “And they’re
“So it’ll be permanent?” Dickerson asked.
“Of course,” Trump said.
When Dickerson sought to get a clearer answer from Trump,
however, the president seemed to hedge. “So what I hear you
saying is pre-existing is going to be in there for everybody,
it’s not going to be up to the states?” Dickerson
“Pre-existing is going to be in there and we’re also
going to create pools,” Trump said, referring to the high-risk
pools Republicans have proposed in order to cover the cost of
healthcare for those who are sicker. “And pools are going
to take care of the pre-existing.”
Vice President Mike Pence also echoed Trump’s point
on high-risk pools when he was asked to address the issue of rising premiums for
sicker people on Sunday’s “Meet the Press” with Chuck
“We’re basically borrowing an idea from the state of
Maine that has seen a significant drop in premiums for people on
their health insurance, because you take people that have
pre-existing and costly conditions and put them into a high risk
pool,” Pence told Todd. “And you subsidize that so that it
is affordable to those individuals.”
Although Republicans have championed the idea of state
high-risk pools, critics say that an inevitable effect of
isolating the sickest people into separate groups is skyrocketing
The effectiveness of state high-risk pools has been
contested, because the program’s success depends on whether the
federal government decides to adequately subsidize them —
likely through raising taxes. Some notable high-risk pools
have also failed in the past.
Dickerson continued to press Trump, asking, “But on that
crucial question, it’s not going to be left up to the states?
Everybody gets pre-existing, no matter where they live?”
Trump then spent some time talking about how he ultimately
wanted healthcare to be managed by the states, saying he’d
“rather have the federal government focused on North
When Dickerson repeatedly asked Trump whether he could
guarantee that the new Republican healthcare proposal
would not lead to unaffordable costs for those with
pre-existing conditions, Trump said, “Well, forget about
unaffordable. What’s unaffordable is Obamacare, John.”
“So I’m not hearing you, Mr. President, say there’s a
guarantee of pre-existing conditions,” Dickerson
“We actually have — we actually have a clause that
guarantees. We have a specific clause that
guarantees,” Trump said.
If the president and congressional Republicans are working on
making changes to the healthcare bill to ensure pre-existing
conditions coverage, it will likely pick up more support among
moderate Republicans who have expressed concerns about the
legislation as it currently stands.
“It could affect people with preexisting conditions
and it’ll make different insurance probably much more expensive
for them, and in some cases perhaps inaccessible,” said
Pennsylvania Rep. Charlie