The Trump administration unveils a stealth attack on people with preexisting conditions
tulc(KAG by doublespeak?)Trump administration officials apparently are prepared to go to their graves insisting that they did everything possible to protect Americans with preexisting medical conditions, even as they pull out the stops to undermine those protections.
The latest example of this subterfuge came in late October, when the Centers for Medicare and Medicaid Services (CMS) issued new rules for states contemplating alterations in the Affordable Care Act.
The administration followed up a few weeks ago with further guidelines. “This administration remains firmly committed to maintaining protections for all Americans with preexisting conditions,” that document says. The “concepts presented here do not open any flexibility for states to undermine these protections.”
Unfortunately, according to an analysis by Jennifer Tolbert and Karen Pollitz of the Kaiser Family Foundation, the administration’s proposals could do just that.
“They seem to be aiming to lay out a path for state officials who are interested in undermining the ACA,” Pollitz told me.
The CMS, a part of the Department of Health and Human Services, is responsible for overseeing compliance with the act. Its guide applied to waiver applications under Section 1332 of the act. That section allows states to propose limited changes in Affordable Care Act rules; before approving the waivers, CMS has to find that they don’t disproportionately harm patients with costly conditions, among other restrictions.
The Trump guidelines loosen some of those restrictions materially. Let’s see how.