Donald Trump has a long history of making claims about various Republican health-care bills that have nothing to do with reality. Back in January, he announced he’d come up with a way to provide “insurance for everybody” that was “much less expensive and much better” than Obamacare. That plan never materialized. Several months later, he declared, “If we’re not going to take care of the people, I’m not signing anything.” Then he celebrated the passage of a House bill expected to take insurance from 23 million people.
Trump repeated this ritual for the latest GOP health bill on Wednesday night when he proclaimed that Graham-Cassidy doesn’t threaten coverage for preexisting conditions, and he wouldn’t support it if it did.
He also declared that, despite what people might have heard from Jimmy Kimmel, Louisiana senator Bill Cassidy is no liar.
That’s a claim Cassidy has made himself in recent days:
Graham-Cassidy lets states opt out of Obamacare regulations that prohibit insurers from charging people more if they have specific health conditions. Cassidy claims that his legislation would still protect people with preexisting conditions because waiver applications must explain “how the state intends to maintain adequate and affordable health insurance coverage for individuals with preexisting conditions.”
Health experts say that’s no guarantee that the states will protect people with preexisting conditions because the legislation doesn’t define what it means for coverage to be “adequate” or “affordable.” As Vox’s Sarah Kliff reports:
“You could stretch the definition pretty broadly of what counts,” says [Chris Sloan, a senior manager at the health research firm Avalere]. “Maybe you fund a high-risk pool that only allows in some number of people, and that counts. It’s a pretty wide space.”
What’s more, that language does not outlaw discrimination against sick patients. An individual with a history of asthma, for example, could see health insurance plans that want to charge her 10 percent more because they expect she’ll have higher health care costs.
Is that discrimination against a preexisting condition? Absolutely. Does it bar her from getting “affordable” coverage? We don’t really know. That depends a lot on who that person is and what income they make.
Graham-Cassidy protects people with preexisting conditions the same way you’d be protecting a china shop if you told a toddler to “be a good boy” then set him loose with a baseball bat.
It’s possible that Cassidy has used that one mostly meaningless caveat in his legislation to convince himself that he’s covering people with preexisting conditions. The senator has made a bizarre shift in recent months, going from bucking his party to call for legislation that ensures truly decent and affordable care for all Americans to trying to ram through a bill that drastically cuts federal health-care funding and would likely lead to millions losing coverage.
The generous explanation for Cassidy’s shift is that he “found a right-wing health care ‘expert’ who has ‘explained’ to him” that offering states more flexibility is some kind of “magic elixir,” as Jonathan Chait put it. Another possibility is that some prominent Republican’s rampant lying made Cassidy realize there are no consequences to misrepresenting what your health-care plan would do.
One thing we’re fairly certain of is that President Trump’s analysis is based on Cassidy telling him his legislation protects people with preexisting conditions, not a careful reading of the bill and reams of complex expert analysis. As Kimmel quipped in his second takedown of Graham-Cassidy on Wednesday night, “Can you imagine Donald Trump actually sitting down to read a health-care bill? It’s like trying to imagine a dog doing your taxes. It just doesn’t compute.”