Michigan: Mike Bishop scrapes the bottom of the barrel to try and defend his record on #PECs

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

There's so many Republican candidates running around trying to gaslight America into completely ignoring their relentless, repeated attempts to strip away protections for people with pre-existing conditions that I've alread stopped bothering to try to keep up with them (I think my Rogues Gallery post stops at around 24 or so at the moment).

Here in Michigan, while I'm pretty sure all nine of our Republican members of Congress who voted for the AHCA last year are lying through their teeth about how they suddenly support "protecting coverage of pre-existing conditions", the one which seems to be getting the most attention is Mike Bishop (MI-08). Part of this is no doubt because Bishop is embroiled in one of the two closest races in the state (the other is MI-11, where Dave Trott also voted for the AHCA, but he's retiring so it's an open seat).

Bishop is seriously feeling the heat on the issue due to this devastating attack ad by former CIA analyst (her full title was "Acting Assistant Secretary of Defense for International Security Affairs", which I admit is a bit wordy) Elissa Slotkin:

In response, Bishop has tried everything to try and flip the healthcare issue around on Slotkin. First, he falsely tried to claim that somehow she's the one trying to take away Medicare from seniors. Then the NRCC jumped in with an idiotic ad which, again, falsely attacks Slotkin on Medicare.

And then, this morning, there was this absurdity:

Don't let my opponents desperate political attacks fool you. I have a 19-year record, including five votes in favor, of supporting protections for pre-existing conditions. Learn more about my record protecting healthcare for Michigan families at this link> https://t.co/kkOnTKZAcP pic.twitter.com/KALj0BlM2T

— Mike Bishop (@ElectMikeBishop) October 23, 2018

The 30-second embedded video doesn't really say anything more than what's in the tweet, other than mentioning that his wife has a pre-existing condition (she has arthritis). When you visit the link, it sheds some light about what Mike Bishop bases his "19-year record" on...and it's laughable at best:

As a state representative, Mike Bishop voted several times to protect people with pre-existing medical conditions and ensure that those people could not be excluded from their health care plans based on those preconditions, including:

  • PA SB 749 (2001)
    Specify conditions under which an applicant for a Medicare supplement certificate would not be excluded from coverage because of a preexisting condition.
  • PA 304 , SB 748 (2001)
    Specify conditions under which an applicant for a Medicare supplement policy would not be excluded from coverage because of a preexisting condition.
  • SB 60 (PA 7)—1999
    The bill would amend the Nonprofit Health Care Corporation Reform Act, which governs Blue Cross and Blue Shield of Michigan (BCBSM), to prohibit BCBSM from excluding or limiting health care coverage for an individual eligible for nongroup coverage or other coverage who had been insured under a group health plan,

That's it. That's what Bishop's entire "19-year history" claim is based on:

  • A single vote in 1999 which appears to only apply to a small group of people who were previously enrolled in a Blue Cross group plan for at least 18 months straight;
  • Two nearly identical votes in 2001 which appear to only apply to a small group of people specifically enrolling in MediGap supplemental policies (and not even all of them...the bill summary just says that it "specifies conditions/individuals" who couldn't be excluded and/or would be eligible for coverage)

Since then? Nothing.

Mike Bishop has been either a state or federal legislator for 19 years straight, and that's the best he could come up with on this subject.

This would be like if I had once stated that “left-handed Jewish people who were born in April and play the banjo” shouldn’t be discriminated against “when applying for a hunting permit” in 1999...but then, 18 years later, voted to let the state charge ALL Jews 10x more for EVERY type of permit.

Bishop then tries to gaslight further by trying to claim that his vote for the AHCA actually protected coverage of pre-existing conditions, which it in no way did:

Additionally, under the American Health Care Act (AHCA), insurance companies cannot deny coverage based on pre-existing conditions – yet Elissa Slotkin continues to lie about Mike Bishop’s record. The AHCA states:

  • Sec. 137 of H.R. 1628
    “Nothing in this Act shall be construed as permitting health insurance issuers to limit access to health coverage for individuals with preexisting conditions.”

Under the bill, health status cannot affect premiums, unless a state asks for and receives a waiver—a condition of which is the state having other protections in place for those with pre-existing conditions. To obtain a waiver, states would have to establish programs to serve people with pre-existing conditions. No matter what, insurance companies cannot deny coverage based on pre-existing conditions.

OK, first of all, throwing in a warning about how it "shouldn't be construed" as limiting access to health coverage" doesn't really mean a damned thing. I have access to buy a Lamborghini; that hardly means I can afford one.

More to the point, the American Health Care Act (AHCA) did not “protect pre-existing conditions”. Coverage of those are already protected under the Affordable Care Act (ACA). What the AHCA did do was allow states to strip away those protections via an extremely easy waiver process.

The ACA includes the following protections for those with preexisting conditions (PECs):

  • 1. Insurance carriers can’t refuse to sell them policies outright (guaranteed issue).
  • 2. Insurance carriers can’t charge them more for having pre-existing conditions (community rating).
  • 3. Insurance carriers can’t deny coverage of the condition itself in their policies (Essential Health Benefits).
  • 4. Major medical policies have to cover a minimum of 60% of enrollee medical costs (Minimum AV), with rare exceptions.
  • 5. Major medical policies can no longer have an arbitrary maximum annual or lifetime claims cap.
  • 6. In addition, the ACA adds a cap on maximum out-of-pocket costs for in-network healthcare expenses.

The AHCA, which Bishop voted for, technically retained the first item on the list (guaranteed issue), but allowed states to opt out of the other five.

That means that under the AHCA, insurance carriers would have to offer a policy to those with PECs, but they could charge several times as much as they normally would for that policy (amounting to the same thing as not offering it at all for everyone except the wealthiest among us). Alternately, they could offer a policy including coverage of everything except the PEC itself, making it useless to the enrollee (Congratulations! Your flu shot is covered, but not your chemotherapy!). They could bring back annual/lifetime caps for those with PECs, which some premature infants were known to max out within a few months prior to the ACA becoming law, and so on.

Basically, the AHCA kept one type of protection but specifically made it stupid-easy for states to strip away the rest of them. That's why Slotkin was absolutely correct to use the term "gut" to describe what Bishop tried to do to these protections. To “gut” something is to leave the empty shell in place while literally ripping out its internal organs. That’s precisely what the AHCA would have done: It would have left an empty, meaningless shell of “guaranteed issue” in place while ripping out everything which gives it any substance.

Finally, Bishop also tried to pad his anemic #PEC protection resume by throwing in his vote for the utterly meaningless "Pre-existing Conditions Protection Act" which, once again, does little to actually..protect people with pre-existing conditions:

...These pieces of legislation are nothing more than hollow promises that read well but in reality fail to protect people with pre-existing conditions from attacks by the Trump administration and their own earlier votes. Here’s what you need to know:

Two thirds of those who signed on to the House resolution (H.Res. 1066) voted to repeal the Affordable Care Act last summer. Of the 28 members of the House who have signed on to the resolution expressing support for pre-existing condition protections, 19 voted for the Republican repeal bill last summer. Last year’s repeal bill, the AHCA, would have dramatically weakened protections for 130 million Americans with a pre-existing condition, allowing insurance companies to charge people more when they get sick, for instance up to $140,510 more for people battling metastatic cancer.

...None of the co-sponsors of either the bill or the resolution have shown they oppose the Republican lawsuit backed by the Trump Administration that would completely gut protections for people with pre-existing conditions.

And, in reality, neither piece of legislation actually protects people with pre-existing conditions.The resolution’s language, intentionally vague, includes no specifics on exactly which protections should be preserved. Though H.R. 1121 prevents insurance companies from denying coverage to people with pre-existing conditions, it does nothing to prevent insurance companies from charging people with pre-existing conditions more for coverage or reinstating annual and lifetime limits that insurers use to restrict the amount of coverage someone can use, and it does not preserve the Affordable Care Act’s essential health benefits, essentially allowing insurers to sell plans exempt from covering basic services like maternity care, hospitalization, and prescription drugs. Absent such protections, an insurance company could sell coverage to a cancer patient, but charge them more and drop their coverage once they reach their lifetime limit.

In other words, it amounts to essentially the same BS language surrounding PECs as the AHCA.

Oh yeah, one more thing: As for Bishops claim that states would "have to establish other protections" in order to obtain the waiver, that's a big pile of garbage as well:

Oh for Pete's sake...read this by David Anderson of Balloon Juice:

The Upton Amendment is out. It is $8 billion dollars to pay for the late enrollment penalty of people in states who elect to waive non-underwritten guarantee issue so that these people don’t get dropped into the high cost risk pool.

...What the hell does that mean? Well, remember that the AHCA would replace Obamacare's $695/year individual mandate penalty for not being covered...with a 30% surcharge for getting covered after a previous break in coverage. Apparently Upton's amendment would pay that 30% penalty for those people, completely defeating the point of having the penalty.

I think...as Anderson concludes:

Upton makes a complete hash of any personal responsibility and anti-free rider logic ever advanced in the bill. This is a mess.

This $8B targeted to take care of ppl w pre-existing conditions . . .doesn't have to be used for ppl w pre-existing conditions. 4

— Andy Slavitt (@ASlavitt) May 4, 2017

The number of times the words "pre-existing conditions" are used in the bill . . . Is ZERO. 5

— Andy Slavitt (@ASlavitt) May 4, 2017

First of all, high risk pools are terrible and at best provide 2nd tier coverage. In his case underfunded to about 30,000 ppl nationally.8

— Andy Slavitt (@ASlavitt) May 4, 2017

Second, it's not enough money. And as @AislingMcDL points out in her feed, Fred Upton knows that. 9

— Andy Slavitt (@ASlavitt) May 4, 2017

3rd, states only get the money if they CUT essential benefits & pre-ex. An incentive 2 cut. And the money goes from taxpayers 2 insurers.10

— Andy Slavitt (@ASlavitt) May 4, 2017

And now-- the kicker. The $ can go to subsidize healthy people anyway. 11

— Andy Slavitt (@ASlavitt) May 4, 2017

Bottom line: Bishop is busted.