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Massachusetts health care — wonky, with a healthy dose of reality

Mass Blue Cross President On Pre-existing Conditions: "we are all created equal, and our health insurance system should reflect this"

Mass Blue Cross President On Pre-existing Conditions: "we are all created equal, and our health insurance system should reflect this"

June 1, 2017

Andrew Dreyfus, the President and CEO of Blue Cross Blue Shield of Massachusetts, just published an op-ed in The Hill, a key source of news for Capitol Hill and people following federal legislation. Dreyfus argues strongly that the Senate should reject the provision in the House-passed ACA repeal bill that penalizes people with pre-existing conditions. While economics is an important consideration, he roots his arguments in the core American values of fairness and equality. This adds a new, and important dimension to the debate in Washington:

Our nation is already struggling with enough division — economic, racial, geographic, and political. It would be both tragic and unnecessary to create a new divide between those who are seriously ill and those who are healthy. Rather than trying to fix the pre-existing condition provisions in the House bill, the Senate should take them off the table, permanently. ...

Since 2010, the ACA has guaranteed that individuals with pre-existing conditions are eligible for the same coverage as everyone else, at the same cost. My state, Massachusetts, is one of seven that had pre-existing condition protections in place even before the ACA became law. It’s arguably one of the ACA’s most popular provisions, and it has maintained broad, bipartisan support. Unfortunately, a last-minute addition to the House-passed American Health Care Act (AHCA) reopens the issue by giving states the option of once again allowing insurers to charge higher premiums for individuals with pre-existing medical conditions. The CBO found that, in states choosing this option, “less healthy people would face extremely high premiums.” The Senate should settle the matter by rejecting this provision as unnecessary and divisive.  ...

A return to charging higher premiums for people with pre-existing conditions would also reinforce the mistaken notion that serious illness stems largely from personal choice. Most illness and disability is due not to choice but to bad luck and bad circumstances — the accidents of birth and life, including genes, economic and social factors, workplace conditions, and exposure to infection and toxins. 

Dreyfus also critiques other parts of the proposal, including the deep cuts to Medicaid (our MassHealth program), and the reductions in assistance for people buying coverage through health insurance marketplaces like our Health Connector.

But he concludes that our national comittment to impartiality and equal opportunity should guide our policy:

The net effect of these provisions would be to make health insurance unaffordable for many of the older and poorer Americans who are currently insured under the ACA. Bipartisan solutions to these problems should be within reach and may emerge in the Senate. But before we tackle these problems, we should agree that, whether we are healthy or sick, we are all created equal, and our health insurance system should reflect this American principle.  

We appreciate's his forthright voice in support of fair health policy, that provides not just the healthy and well-off, but to everyone in need.

                                                                                                                                                             Brian Rosman