Senate GOP files bill to shield Americans with pre-existing conditions

Skittish over the chance that a Texas lawsuit will gut Obamacare, a group of Senate Republicans are pushing legislation that would permanently enshrine the law’s protections for Americans with preexisting conditions.

The bill by Sen. Thom Tillis of North Carolina is part of a push by some Republicans to assure skittish voters that they’ll work to keep the popular parts of the law, no matter what the outcome in the courts.

It would write Obamacare’s protections into a Clinton-era law, the Health Insurance Portability and Accountability Act, known as HIPAA, putting them on firmer footing than they are right now.

“This legislation is a common-sense solution that guarantees Americans with preexisting conditions will have health care coverage, regardless of how our judicial system rules on the future of Obamacare,” said Mr. Tillis, who’s sponsoring the bill with nine other Republicans.

The move comes as Obamacare is increasingly popular — a Fox News poll last week said it’s more popular than the GOP’s new tax cuts, 51 percent to 40 percent — and voters even in deep-red states are signaling they want to preserve much of the 2010 law.

Nebraska on Friday certified signatures collected by the Fairness Project, a grass-roots coalition, to put on the ballot in November an initiative to have the state embrace Obamacare’s expansion of Medicaid.

The Fairness Project already secured similar votes in Utah, Montana and Idaho — a remarkable feat as Mr. Trump pushes to reel in spending on public insurance for the poor.

“I think if we can win in these states, we can win anywhere,” said Jonathan Schleifer, the project’s executive director.

Senate Democrats are counting on that support in pro-Trump states to help Democrats win re-election there.

Democratic Sens. Joe Manchin III of West Virginia and Claire McCaskill of Missouri have chastised their Republican opponents — Patrick Morrisey and Josh Hawley, who serve as attorneys general in their states — for joining the Texas lawsuit to undercut Obamacare.

Sen. Heidi Heitkamp, North Dakota Democrat, also is poking her Republican opponent, Rep. Kevin Cramer, over the suit, prompting him to say he’ll vote for a bill that preserves the protections.

The lawsuit argues that Obamacare’s legality rested on Congress’s taxing power. When last year’s tax cuts revoked the tax penalty for people who don’t buy insurance — the so-called individual mandate — Texas and its allies say much of the rest of the law must also fall.

The case is scheduled for oral argument in two weeks.

Should Texas prevail, Democrats warn insurers could raise premiums on people based on age or sex, and could again begin to deny coverage altogether to people with costly preexisting conditions.

Centrist Senate Republicans urged Democrats to put down their pitchforks and back the Tillis bill as a preemptive fix.

“Support for the legislation will separate those who really want to protect people with preexisting conditions and those who would rather have a political talking point to scare Americans who are already worried enough,” said Sen. Chuck Grassley, Iowa Republican and a co-sponsor. “I hope the former is more important.”

Democrats slapped the offer away, deeming it a “gimmick” that wouldn’t stop insurers from raising prices based on gender or age, nor would it reverse Mr. Trump’s decision to let people to hold onto “short-term” plans for up to three years. Those plans don’t have to comply with the protection and serve as an alternative to Obamacare coverage.

Larry Levitt, senior vice president at the nonpartisan Kaiser Family Foundation, said if the courts accept Texas’ lawsuit, the GOP bill may not even accomplish the GOP’s goal. He said while insurers might be forced to extend coverage to those with preexisting conditions, the GOP bill doesn’t make the companies actually pay for the kind of care they might need.

“It makes guaranteed access to insurance a bit of a mirage for people with preexisting conditions,” Mr. Levitt said.

Mr. Tillis’ office pushed back, saying the bill is an opening bid that could change depending on what the courts actually do.

“In the event that the Affordable Care Act is struck down in its entirety, Congress would put forward a more comprehensive response,” said Tillis spokesman Adam Webb.

Sen. Dean Heller, Nevada Republican a closely watched vote on health care who faces a tough re-election bid in November, is cosponsoring the effort.

Other Republican backers are Senate Health Committee Chairman Lamar Alexander of Tennessee and Sens. Joni Ernst of Iowa, John Barrasso of Wyoming, Lindsey Graham of South Carolina, Roger Wicker of Mississippi, Bill Cassidy of Louisiana and Lisa Murkowski of Alaska.

Ms. Murkowski joined every Senate Democrat two other Republicans in dooming the Senate GOP’s repeal effort last year, citing in part the impact of Medicaid cuts in her state.

The Fairness Project said the grass-roots backlash to curtailing Medicaid last year proved the value of going around politicians and straight to red-state voters.

The strategy already worked in Maine, they said, where voters in “MAGA” hats joined Hillary Clinton supporters in signing a petition to get expansion on the ballot.

Voters approved expansion in 2017, though Republican Gov. Paul LePage has stalled the effort, saying legislators haven’t found an acceptable way to pay for the state share. The state’s highest court ordered Mr. LePage on Thursday to submit an expansion plan to the federal Health and Human Services Department.

The Fairness Project says it’s optimistic that governors in Nebraska, Idaho and Utah won’t block the looming initiatives, citing public comments that suggest they won’t overrule the people.

Montana already expanded its program, though petitioners want to ensure it is extended before a sunset provision forces it to expire in 2019, imperiling coverage for 90,000.

“The movement to expand and protect health care has become one of the most powerful forces in politics today,” Mr. Schleifer said. “If the last year has taught us anything, it’s that Americans want more, not less health care and they’re willing to fight for it.”