Protecting People with Preexisting Conditions: Upton Amendment, as Reported, is Not Enough to Get the Job Done

The Upton Amendment to the health care bill, American Health Care Act (AHCA), is not sufficient to protect people with preexisting health conditions.

According to one estimate, it would take $178 billion per year to adequately fund state high-risk pools, where people with preexisting health conditions would go to access health insurance coverage.

However, the AHCA would only provide $15 billion annually for two years and then taper off to $10 billion annually for seven more years. And, this is not even a dedicated funding stream; states could also use this money to pay for other things like health promotion activities, dental and vision care, or behavioral health treatment. In previous analyses, we found this level of funding woefully inadequate.

Apparently, some federal policymakers feel the same way. That’s why the Upton Amendment, as reported, adds in another $8 billion over five years in an attempt to shore up financial help for people with preexisting conditions.

But even this is not enough. We need policies that provide people who have preexisting conditions with access to affordable, comprehensive coverage. This is particularly crucial for older people because they tend to have more health conditions.

The AHCA modified by the Upton Amendment simply does not get us there.

 

Lynda Flowers is a Senior Strategic Policy Adviser with the AARP Public Policy Institute, specializing in Medicaid issues, health disparities and public health

 

 

 

Claire Noel-Miller is a senior strategic policy adviser for the AARP Public Policy Institute, where she provides expertise in quantitative research methods applied to a variety of health policy issues related to older adults.