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Rosendale Vague On Protections For Pre-Existing Conditions

Matt Rosendale at the Republican Senate primary debate in Helena, April 26, 2018.
Corin Cates-Carney
/
Montana Public Radio
Matt Rosendale at the Republican Senate primary debate in Helena, April 26, 2018.

A piece of the Trump administration’s attack on Obamacare, the Affordable Care Act, takes effect this week, and Matt Rosendale, Montana’s insurance commissioner, who’s running to defeat Senator Jon Tester in November is really happy about that.

“We’re working on new health insurance options authorized by the Trump Administration under federal regulations short term plans and Association Health Plans," Rosendale at a state insurance summit he put on as insurance commissioner in September. 

It wasn’t a campaign event, but as a candidate Rosendale has consistently advocated for giving Montanans more and cheaper health insurance options, like short-term plans. They cost a lot less than regular insurance plans that meet Affordable Care Act standards, which require insurers to cover people with pre-existing conditions, and to cover a lot of other health problems.

“The problem with short term insurance is that they are not subject to the same level of regulation," says Bryce Ward, an economist at the University of Montana. "Short term insurance essentially becomes junk insurance.”

Ward says short term plans can be good for people who are pretty healthy and probably won’t need to get much health care, but what’s good for individuals can be bad for health insurance markets overall.

"When you allow people to have these options, you are basically starting to segregate the market into healthy people and to sick people," Ward says, "and that places more of the burden of illness on the sick.”

A burden like they had before the Affordable Care Act, when sick people - or those with pre-existing conditions - were routinely denied health insurance, or charged prices too high to afford coverage. In Saturday night’s Senate candidates debate, Rosendale said that’s unacceptable.

“Since I entered into the Auditor’s office, I’ve worked to try and cover pre-existing conditions," Rosendale said. 

But that’s about as specific as Rosendale has been on how he thinks people with pre-existing conditions could remain covered if Obamacare is repealed. When we asked Kyle Schmauch, a spokesman for the auditor’s office about details, he said: "It depends on what kind of bill Congress would vote on. So it’s entirely possible that we could see a repeal of Obamacare but still a requirement on insurers to keep people with pre-existing conditions covered.”

Rosendale has also cited something called “re-insurance” as a way to make sure people with pre-existing conditions can get coverage.

U-M Economist Bryce Ward: “Reinsurance might be a way of trying to help. But it will certainly not be able to get you all the way there. And you’ll probably go back to a world where at least some people with pre-existing conditions are finding it very difficult to obtain insurance.”

Congress failed last year to reach an agreement on a replacement for Obamacare. Matt Rosendale says he won’t "give up on repealing and replacing Obamacare."

Rosendale’s Democratic opponent, Jon Tester, has said that the Affordable Care Act that he had a hand in passing isn’t perfect. The cost of both health care and health insurance has continued to rise at rates well above inflation since the health care law passed.

But Tester has continued to defend it because it has expanded coverage to millions of Americans who didn’t have health insurance before, and because it has required insurance companies to cover everyone, regardless of pre-existing conditions.

"Everybody knows that healthcare costs are too high, there’s no doubt about that," Tester said, "and I think they look to the federal government to try to make sure that we can get them affordable."

That’s where Tester and Rosendale differ sharply on health care. Rosendale calls the Affordable Care Act a “top down, one size fits all” approach that needs to be scrapped in favor of state control.

Opponents of the Affordable Care Act like Matt Rosendale say that federal requirements for comprehensive health coverage make insurance too expensive. Those who helped pass the health care law, like Jon Tester, say that without those requirements, America will go back to the days when insurance companies routinely denied coverage to people with pre-existing conditions.