Repeal By A Thousand Cuts

House GOP fights for pre-existing condition coverage, against Obamacare


House Republicans on Tuesday called on the Obama administration to reinstate a temporary measure designed to insure Americans with preexisting conditions that the administration plans to phase out.

Republicans suggested using money from the 2010 Affordable Care Act's Prevention and Public Health Fund to pay for the effort. Critics have called that program a "slush fund."

The Centers for Medicare and Medicaid Services announced last month that they would stop enrolling people in Pre-Existing Condition Insurance Plans (PCIP), which were created to insure individuals with pre-existing conditions until state-based health insurance exchanges come online in 2014. CMS said the program was underfunded.

Seven top House Republicans, including Speaker John Boehner (R., Ohio) and Majority Leader Eric Cantor (R., Va.), asked President Barack Obama in a Tuesday letter to fully fund the PCIP until the exchanges are set up.

"We believe allowing those with pre-existing conditions access to health insurance is another worthy reason to reprogram these funds," the members wrote.

Obamacare remains unpopular, but Americans have shown support for provisions that prohibit insurance companies from denying coverage based on preexisting conditions.

"Obamacare was more focused on funding big government than actually helping the sickest Americans gain access to affordable health care," a senior House leadership aide told the Free Beacon.

"There’s no reason the sickest Americans should continue to be denied access when we can simply eliminate a slush fund and fix the problem," the aide added.

The president is not likely to support legislation that significantly weakens Obamacare. However, previous efforts to eliminate unpopular taxes in the law have received support from congressional Democrats even when those efforts entailed trimming other parts of the law.

The president signed in 2011 the repeal of new tax reporting provisions that critics said would dramatically raise tax compliance costs for small businesses.

Republicans wanted to pay for the repeal of the 1099 provision by eliminating health care subsidies for individuals who filed for benefits afforded to low-income households but unexpectedly saw their incomes rise.

Democrats claimed the move was an effort to undermine a key provision of the Affordable Care Act and amounted to a tax hike on middle class Americans. The president signed the legislation despite those objections.

Republicans also attracted the support of 37 Democrats for legislation passed in June 2012 that would repeal a controversial tax on medical devices and recover the lost revenue by requiring Americans who purchase subsidized insurance through an Obamacare exchange to return all overpayments.

The Senate has yet to consider that legislation.

"Repeal is a distant goal for the time being; but defunding, dismantling, cannibalizing—these are all achievable, with smart tactics," said Dean Clancy, vice president for health care policy at FreedomWorks.

"We absolutely support using Obamacare slush fund money to fully fund pre-ex pools, even the law’s somewhat flawed pools," Clancy added.

Republicans maintain that their ultimate goal is full repeal and that current efforts are simply improving what they say is a fundamentally flawed law.

"The only reason to extend PCIP is to better position Republicans to repeal Obamacare at some future point," according to Manhattan Institute senior fellow Avik Roy, an expert in health care policy.

Roy said the administration would argue that "all people, beginning on Jan. 1, 2014, will be guaranteed access to health insurance, regardless of their prior health status," making the PCIP unnecessary.

However, Republicans are already pointing to the personal travails of Americans who have been denied coverage through PCIP.

Republicans cited a Washington Post story that "highlighted the plight of Joyce, a 61-year-old Virginia woman who is battling stage four breast cancer, whose application was due to the finalized three days after the CMS announcement. It is unclear if she will be able to receive care."

The White House has used those sorts of personal stories to sell its own legislative proposals, including Obamacare.

The senior House leadership aide said the effort to re-implement PCIP "is one part of an overall effort to both highlight the problems with Obamacare, rein in its most reckless elements, while also helping those with pre-existing conditions get the care they need."

The PCIP is what is known as a high-risk insurance pool. Conservative groups have pushed such pools as viable alternatives for covering Americans with pre-existing conditions.

Lachlan Markay   Email | Full Bio | RSS
Lachlan Markay is a staff writer for the Washington Free Beacon. He comes to the Beacon from the Heritage Foundation, where he was the conservative think tank's first investigative reporter. He graduated from Hamilton College in 2009, and currently lives in Washington, D.C. His Twitter handle is @lachlan. His email address is

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