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Walden framework could shape post-ACA health underwriting

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Rep. Greg Walden, R-Ore., has put together a proposal that could shape how U.S. major medical underwriting workers if Republicans succeed at killing, de-funding, changing or replacing the Affordable Care Act.

Walden is circulating a discussion of the Preexisting Conditions Protection and Continuous Coverage Incentive Act of 2017 bill.

Related: Greg Walden to Manage House Transition

If adopted as written, the draft bill would take effect were the Affordable Care Act statutory package repealed.

The draft bill also would:

      • Forbid an insurer from considering whether an applicant had a pre-existing condition when deciding whether to offer the applicant coverage.

      • Forbid an insurer from excluding an enrollee’s pre-existing health problems from the coverage.

The current version of the draft would not put any restrictions on the cost of the health coverage offered to an individual with preexisting conditions.

The draft includes a placeholder for another section that will deal “continuous coverage” requirements. In the past, Walden has said that he would want any protection against health status-based discrimination to include a provision tying that protection to efforts to get and keep health coverage.

The ACA now forbids health insurers from considering individual health status information other than location when selling coverage, and it forbids insurers from considering individual health status information other than age, location and tobacco use when setting an enrollee’s premiums.

The House Energy and Commerce health subcommittee plans to hold a hearing on the Walden discussion draft and other health insurance-related discussion drafts at 10:30 a.m. Thursday. The subcommittee has posted the drafts, along with a hearing notice, on its section of the committee website.

A second discussion draft on the hearing website at press time, for a Plan Verification and Fairness Act of 2017 bill, would tighten ACA public exchange plan eligibility screening rules.

A third draft, for a State Age Rating Flexibility Act of 2017 bill, would let a health plan charge its oldest enrollees five times as much as it charges its youngest adult enrollees. The current ACA age band restrictions limit a plan to charging its oldest enrollees three times as much as it charges the youngest adult enrollees.

A fourth draft, for a Health Coverage State Flexibility Act of 2017 bill, would change the grace-period rules for ACA public exchange plans. An ACA exchange plan would have to use the same rules for grace periods that apply to other individual health plans sold in a state.


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