How You’ll Be Affected by the GOP Health Plan Could Depend on Where You Live

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The American Health Care Act, passed by the House on Thursday to cheers from Republican members, would give states wide leeway over a host of provisions that many Americans have come to count on, creating a patchwork of different health insurance rules across the nation.

The legislation, designed as a replacement for the Obama-era Affordable Care Act, would allow states to apply for waivers to exempt insurers from providing coverage for 10 “essential health benefits,” including emergency services, maternity care, and mental health treatment, among others. The level of coverage would depend on what each state decides. 

It also would permit states to apply for waivers to allow insurers, under certain circumstances, to charge higher premiums to people with pre-existing health problems, something that the ACA forbids.

The AHCA allocates $138 billion over 10 years to fund a Patient and State Stability Fund for states that apply for waivers, an amount which critics say is not enough to cover the millions of Americans with pre-existing health conditions.

Granting these waivers would cause premiums to rise and also make it harder for people to get comprehensive coverage, especially those with health problems, says Betsy Imholz, special projects director for Consumers Union, the policy and mobilization arm of Consumer Reports.

“This proposal clearly allows states to do away with protections for pre-existing conditions, letting insurers charge our most vulnerable populations more,” says Imholz.

But House Republicans and other conservatives disagree, saying the waivers, which would vary from state to state, could actually lead to lower premiums and give consumers a wider choice of plans. 

Reducing regulatory burdens could encourage insurance companies to enter new markets or to modify their existing policies and rates, giving consumers more coverage options, says Edmund Haislmaier, a senior…

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