Cassidy-Graham Would Make Thousands Of ACA Policies Illegal Next Year

The inestimable Charles Gaba has a brilliant post up at acasignups.net that uncovers the fact that millions of health insurance policies that currently exist would actually be illegal under Cassidy-Graham in 2018, as opposed to 2020 when most of the other worst effects of the bill really phase in.

Basically, this is all because Republicans want to strip out abortion coverage entirely and not have abortion coverage be eligible for any of the tax credits available under the ACA. Any abortion coverage would have to be purchased separately, off the exchanges. According to the text of the current bill, that requirement to eliminate abortion coverage starts in the tax year 2018.

Gaba points out that insurers have to file their 2018 plans in 8 days and tax credit must be available in the Qualified Health Plans that include abortion coverage. Assuming Cassidy-Graham gets passed at the last minute before the September 30 deadline, a reasonable assumption based on the way Congress works, that would mean that thousands of plans that insurers had filed in states that included abortion coverage would become illegal just 2 days later, creating chaos for insurers and subscribers who are relying on those tax credits to purchase health insurance.

Says Gaba, "What would the legal implications of THAT be? Would the contracts become null and void? Would they have to be resubmitted? Would no one be allowed to purchase them on the exchanges, or would they be allowed to enroll in the policies, but only at full price? Would only men be allowed to enroll in those policies (which wouldn't make much sense since, again, the issue is whether the policy actually covers the procedure, not whether the enrollee is physically able to require it)? The mind boggles."

In addition, a number of states, such as California, actually require abortion coverage for individual and small group policies. In California, that requirement is actually enshrined in the state's Constitution. For all their talk about states knowing better, the GOP is determined to override states' rights when it comes to abortion and, based on an amendment by Senator Kennedy of Louisiana, states would also lose their right to set up a single payer plan.

All these issues regarding the legality of the plans and the rights of states would have to be worked out pretty quickly. The re-enrollment period begins on November 1 and, thanks to Trump, ends early, on December 15th if the state is using healthcare.gov. That is surely not enough time to resolve these complex issues, especially when the courts get involved.

Obviously, one way to avoid these problems is to vote this cruel and disgusting bill down. In addition, the Senate parliamentarian may strike this abortion provision as not being eligible under reconciliation. Lastly, the implementation date could be pushed back to 2019 or 2020. But that would still not resolve the issue with California and other states that require abortion coverage.

What this does show is the haste and lack of thought and preparation that the GOP put into this brutal version of repeal and replace after seven years of sloganeering. But Republicans don't really know how to govern anymore, they just propose unwieldy and unworkable legislation that sounds good to their base and try to ram it through on their own, in any way possible, discarding governing norms whenever they seem to get in their way.