PHOENIX — A House panel agreed Tuesday to provide some protections for Arizonans with pre-existing health conditions if the U.S. Supreme Court voids the federal Affordable Care Act.
But that doesn't mean it will be affordable.
Sen. J.D. Mesnard, R-Chandler, told members of the House Commerce Committee that there is fairly broad agreement across the political spectrum that people should not be denied health insurance because they have some underlying condition or ailment. And that is a key provision of what has become known as ObamaCare.
Only thing is, the Trump administration is trying to void the federal law as illegal.
So SB 1397 says if that happens between now and June 30, 2023, Arizona would have its own similar provision in state law.
But Rep. Kelli Butler, D-Paradise Valley, said similar is not identical.
More to the point, she said Mesnard proposal fails to provide for something in federal law: affordability. Butler said it does little good to tell someone with a pre-existing condition if the insurance company can charge whatever it wants.
There's also a political component to all this.
Butler pointed out that it isn't just the Trump administration that is trying to kill the Affordable Care Act, a move that would eliminate the protection for pre-existing conditions.
She noted that Arizona Attorney General Mark Brnovich has joined with other Republican attorneys general in asking the Supreme Court to void the law. And Mesnard acknowledged that he, too, believes the Affordable Care Act is not within the powers of the federal government.
But without price protections, she said, the legislation is little more than window dressing.
"It sends the message we are fixing it," Butler said. "It's a cynical effort to make it try to sound good."
But Rep. Jeff Weninger, R-Chandler, said it is the Democrats who are making the issue political.
He did not dispute that the measure does not go as far as the Affordable Care Act. But he said it does provide something for Arizona residents should the federal law go away.
Wrapped up in the debate on SB 1397 is the Affordable Care Act and the efforts by Trump, Brnovich and others to undo the 2010 law.
That wide-ranging measure requires employers to provide health insurance for their workers asnd individuals to obtain their own coverage. It also created insurance exchanges to provide discounted coverage for those who meet income guidelines, expanded Medicaid coverage, and eliminated lifetime monetary caps on insurance coverage.
The Supreme Court upheld the law in 2012, with the majority saying the mandate for individuals to purchase insurance fits within the power of Congress to impose a tax.
But that fell apart in 2017 when Congress eliminated the financial penalty for failing to have insurance, a move that the current round of challengers say eliminated any legal basis for the law.
Butler lashed out at those trying to kill it, saying that it would eliminate coverage for about 700,000 Arizonans who get care one way or another under the law. But she said if that's going to happen, Arizona needs to be prepared to deal with the 2.8 million residents who have pre-existing conditions.
Mesnard said his bill does precisely that.
"Does this bill do anything to help someone with the cost of that insurance or does it do anything to control the cost of insurance?" Butler asked. "If you have a pre-existing condition and you shop for insurance out in the world the way it used to be, the cost would be astronomical if you wanted coverage for that actual condition."
Mesnard acknowledged that SB 1397, by itself, has no cost controls. But he argued that there are provisions in existing laws that preclude insurers from discriminating between members of the same class of policyholders. And he said the Department of Insurance requires that rates be "actuarily sound."
Butler sniffed at that explanation, saying none of that keeps insurance companies from charging a different set of rates to all people with similar pre-existing conditions, rates that could be substantially higher and unaffordable.
"It is not clear at all that there is going to be any ability at the Department of Insurance — or desire at the Department of Insurance — to control costs," she said.
What that left is Mesnard telling foes, in essence, that this is a take-it-or-leave it situation.
"I still think this is better than nothing," he said.
Butler ended up voting for it, calling it "a tiny bit better than nothing."
But Rep. Mitzi Epstein, D-Tempe, refused to go along. She said the people who have pre-existing conditions are telling her they would rather have no measure at all than this one.
"It doesn't help," she said.
The measure, which had gained unanimous Senate approval earlier this session, is set for House floor debate on Wednesday.