In the most clever bill to date designed to dismantle Obamacare, H.R. 1549 “Helping Sick Americans Now Act”, takes money away from the public health fund and puts it towards coverage for patients with pre-existing conditions. Doesn’t sound too bad, does it? That’s why it’s so sneaky. But don’t worry; it has no chance of becoming law.

*Get all the details on this bill in podcast episode CD026: A Tale of Two Bills

Background

On March 2, 2013, the temporary high-risk pool set up for Americans with pre-existing medical conditions stopped accepting new applicants to the program. The program was given $5 billion to provide medical care for people who can’t get health insurance coverage from private insurers – the only kind available – who avoid customers with previous health issues because they have been proven to be unprofitable. The $5 billion is running out so in order to provide care to the approximately 100,000 people who have already signed up, the program was forced to refuse new applicants for the rest of the year.

The temporary high-risk pool is temporary because on January 1, 2014, it will be illegal for private insurance companies to refuse coverage to Americans with pre-existing medical conditions.

This bill takes the money away from the public health fund   – which has already been but by over 35% -to give to the temporary high-risk pool. The public health fund goes toward preventative medicine, the very thing that would have prevented the medical costs of the people who did sign up from being so high in the first place. This public health fund goes towards health screenings, immunizations, helping people quit smoking, nutrition education, and information campaigns so that people can find out about these programs.

The public health fund has also been used this year to set up health care exchanges. The exchange will be a website where you can go and buy your health insurance. It’s something Congress already has and it’s something that most of us will probably really, really like. The House has refused to fund the implementation of ObamaCare. The idea is that if they can’t repeal the law – which they can’t- then they just won’t let it function properly. Because the implementation of the exchanges hasn’t been funded, the Obama administration is using some of public health fund’s 2013 money to set up the exchange.

If this bill were to pass, on January 1, 2014, the temporary high-risk pool would expire and the public health fund would essentially cease to exist, at least through 2016.

Bill Highlights

Section 2: Moves funds from the public health fund to the temporary high-risk pool.

Section 4002 of the Affordable Care Act (better known as Obamacare) creates a public health fund:

“For prevention, wellness, and public health activities including prevention research and health screenings, such as the Community Transformation grant program, the Education and Outreach Campaign for Preventive Benefits, and immunization programs.”

This bill, H.R. 1549, transfers the rest of the money for 2013 and all the money for 2014, 2015, and 2016 away from the public health fund and puts it towards the temporary high-risk pool. The money will be available through December 31, 2013.

Section 3: Allow covered patients to apply for the temporary high-risk pool.

Section 1101(d) of the Affordable Care Act lists who would be eligible for coverage in the temporary high-risk pool. The 2nd paragraph of that section says that a person who wants to be covered in the temporary high-risk pool must have NOT have had health coverage for six months prior to their application. H.R. 1549 would eliminate this requirement.