Washington, D.C.—Arguments will begin today in the U.S. District Court case, Texas v. United States, challenging the health care law known as the Affordable Care Act. The plaintiffs argue that because Congress repealed the individual mandate's tax penalty as part of tax reform legislation, the entire law is invalid and must now be struck down, including critical patient protections around pre-existing conditions and essential health benefits.
New legislation before Congress aims to protect patients should the plaintiffs be successful in their court challenge. The bill would prohibit health plans from charging people more or denying them coverage due to their health status or pre-existing conditions. However, it would allow plans to exclude or restrict coverage for those pre-existing conditions and charge more in premiums based on someone’s age, gender or job.
A statement on the legislation from Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN):
“ACS CAN is pleased lawmakers recognize the need to protect patients with pre-existing conditions given the ongoing court case. Ensuring cancer patients, survivors and all those at risk for the disease are able to obtain affordable, meaningful health coverage is essential to reducing death and suffering from cancer and other serious illnesses.
“The bill—as currently proposed—would prohibit health plans from charging more or denying people coverage based on their pre-existing conditions or health status. While these two provisions are important, their effect would largely be negated because the bill also allows plans to exclude payment for services related to those pre-existing conditions. Meaning a cancer survivor could enroll in a plan, but the plan could exclude payment for their follow-up survivorship care or any services if the cancer recurred. Additionally, the plans could also charge people more based on age, gender and job.
“Prior to the current health care law, people who needed health insurance the most often found it difficult or impossible to obtain affordable coverage. Outrageous premiums and inadequate benefit packages were often the only available options. Without access to comprehensive health coverage they could afford, patients were frequently forced to delay or forego necessary health care.
“While well intended, the current proposal would do little to prevent patients from facing those same difficult circumstances in the future if current law is negated by the courts. Cancer patients and survivors need to be able to purchase health plans that cover the entirety of their health care needs without exclusions or exorbitant premiums. This bill is an inadequate replacement for the patient protections under threat in this court case.
“We urge lawmakers to keep their promises to protect people with pre-existing conditions and stand ready to work with them to ensure all patients can access meaningful health care coverage.”