WASHINGTON – Today, U.S. Sens. Mark R. Warner (D-VA), Ben Cardin (D-MD), Jeanne Shaheen (D-NH), Tammy Baldwin (D-WI), and 26 of their Senate colleagues introduced the Protecting Americans with Preexisting Conditions Act of 2021 in an effort to undo Trump-era rulemaking and guidance that, if fully enacted, would destabilize the Affordable Care Act (ACA) health insurance market, weaken protections for Americans with preexisting conditions, and increase costs for millions of individuals with quality health plans. With nearly 30 million Americans diagnosed with COVID-19 – a disease disproportionately affecting minority populations – this legislation would ensure that health coverage for individuals living with preexisting conditions meets the ACA’s minimum quality and consumer protection standards.

“In the midst of an unprecedented health crisis caused by COVID-19, we should make it easier, not harder, for more Americans to get access to affordable health care coverage. Unfortunately, the Trump administration used every tool at their disposal to undermine the success of the Affordable Care Act, including by flooding the health insurance market with plans that don’t offer protections for the 30 million Americans who’ve been diagnosed with COVID-19,” said Sen. Warner. “With millions of Americans diagnosed with COVID-19 – a disease that can cause long-term lingering effects and complications long after recovery – we hope to provide peace of mind for individuals searching for affordable health care coverage that meets their needs.”

“For the hundreds of millions of Americans who have pre-existing conditions like arthritis, cancer, heart disease, asthma, diabetes, kidney disease, or pregnancy, it is critical that health insurance fully protect them and cover essential health benefits. The Trump Administration’s 1332 Waiver Guidance was one of many, blatant examples of the previous administration’s lack of support in protecting those with pre-existing conditions,” said Sen. Cardin. “It is essential that Congress restore the 1332 Waiver Guidance to protect Americans with pre-existing conditions from being left with higher out-of-pocket costs for less services, now including tens of millions who have recovered from COVID-19.”

“The Trump administration’s dangerous efforts to undermine and unravel the Affordable Care Act – and in the middle of the greatest health crisis of our lifetime – is shameful. It also demands a robust response to mitigate the damage done and ensure every American has access to the quality, affordable care they deserve. That’s precisely what this legislation aims to do,” said Sen. Shaheen. “Our legislation would reverse President Trump’s rule that promoted “junk health plans” which exclude safeguards for those with pre-existing conditions. Millions of Americans and thousands of Granite Staters live with pre-existing conditions, and that is not including the many who’ve been afflicted with COVID-19 which very well may be considered a pre-existing condition in the future. We cannot – now or ever – allow Americans with pre-existing conditions to be denied the care and coverage they need and deserve. Health care is a right, not a privilege.”

“It’s time to turn the page after the Trump Administration spent years sabotaging our health care system and threatening guaranteed protections for people with pre-existing health conditions,” said Sen. Baldwin. “We need to protect and expand access to affordable health insurance. Anyone who says they support quality health care coverage for people with pre-existing conditions should support this legislation. This is an opportunity for Democrats and Republicans to join together and protect people’s access to health care when they need it most.”

Since the ACA was signed into law in 2010, congressional Republicans have constantly attempted to overturn it. Unsuccessful in their legislative effort, the Trump administration carried the baton in an effort to bypass the consumer protections available for Americans under the ACA. 

Beginning in 2018, the Trump administration issued changes to the 1332 waiver guidance in its effort to sabotage Americans’ health care and undermine the critical preexisting condition protections that millions of Americans rely on. On January 14, 2021, on its way out the door, the Trump administration cemented its harmful October 2018 1332 wavier guidance – making it more difficult for future administrations to undo. Specifically, this rule gives states the green light to use taxpayer dollars to push “junk” health insurance plans that cost more and cover less. Under these plans, insurance companies can charge people more if they have a preexisting condition, can deny specific benefits – or can deny coverage altogether. In 2019, Sen. Warner led the entire Senate Democratic Caucus in introducing a resolution to force an up-or-down vote to reverse these harmful Section 1332 rule changes. Although Sen. Warner successfully forced a vote on this resolution, it was ultimately defeated by the Republican-led Senate.

The bill also boasts the support of numerous organizations, including the American Heart Association, Cystic Fibrosis Foundation, Alliance for Retired Americans, Virginia Poverty Law Center, Commonwealth Institute, March of Dimes, Hemophilia Federation of America, American Cancer Society Cancer Action Network, Susan G. Komen, National Hemophilia Foundation, Leukemia & Lymphoma Society, National Patient Advocate Foundation, Protect Our Care, Cancer Support Community, Planned Parenthood Federation of America, Families USA, American Federation of State, County and Municipal Employees (AFSCME), American Lung Association, the Asthma and Allergy Foundation of America, and the Association of University Centers on Disabilities (AUCD).

“The importance of ensuring individuals have access to high quality, comprehensive and affordable health insurance coverage cannot be overstated,” said Lisa Lacasse, President, the American Cancer Society Cancer Action Network. “COVID-19 has certainly shone a spotlight on the impact of not having access to care for millions of people. However, the need for health insurance is not only about the current pandemic. This bill takes a critical step to help ensure individuals have the coverage they need when they need it, helping to reduce cancer disparities and improve cancer outcomes.”

“People with bleeding disorders and other serious health conditions rely on comprehensive health care coverage and stable insurance markets. HFA is pleased to support this bill which would roll back harmful guidance and rules released over the past three years, restoring key guardrails around the section 1332 waiver process,” said Sonji Wilkes, Vice President for Policy and Advocacy, Hemophilia Federation of America.

“The Protecting Americans with Preexisting Conditions Act would overturn dangerous CMS guidance that allows states to undermine critical protections for millions of Americans living with pre-existing conditions. Under the guidance issued in 2018, ‘state innovation waivers’ could allow for the sale of cheap, inadequate health insurance plans that can deny coverage for individuals with pre-existing conditions, charge them more for being sick or retroactively rescind coverage. We thank Senator Warner for championing the patient protections under the Affordable Care Act that are strengthening access to life-saving care, and we urge lawmakers to support this important legislation,” said Emily Holubowich, Vice President of Federal Advocacy, the American Heart Association.

“The Virginia Poverty Law Center thanks Senator Warner for filing the Protecting Americans with Preexisting Conditions Act of 2021.  This legislation would reverse harmful actions taken by the previous administration and ensure that all consumer protections under the Affordable Care Act continue in states seeking certain waivers.  All consumers, especially lower income and vulnerable people with chronic health conditions, need and deserve these protections,” said Jill Hanken, Health Attorney, the Virginia Poverty Law Center.

“The Asthma and Allergy Foundation of America (AAFA) is proud to support the Protecting Americans with Preexisting Conditions Act of 2021. Access to quality, affordable health care coverage is critical to Americans with preexisting conditions like asthma and plays an important role in addressing health disparities. Inadequate health insurance coverage remains unequally distributed along racial and ethnic lines, contributing to inequity in health outcomes. We thank Senators Warner, Cardin, Shaheen, and Baldwin for ensuring continued protections for individuals with preexisting conditions,” said Kenneth Mendez, President & CEO, the Asthma and Allergy Foundation of America.

“For more than a decade, cancer patients have relied on the vital protections provided by the Affordable Care Act (ACA). Recent regulations expanded and promoted access to subpar insurance products, including Association Health Plans and short-term, limited-duration insurance (STLDI), which have undercut important patient protections and may leave patients vulnerable. These regulations also permitted states to use taxpayer dollars to subsidize inadequate insurance, exposing patients and consumers to greater risk while simultaneously increasing premiums for those who rely on the comprehensive coverage. This legislation is an important step in reining in subpar insurance and a critical component of ensuring patients have access to high-quality, affordable health insurance. We applaud Senator Warner for his leadership on this issue and look forward to working with Congress to protect the millions of Americans who live with a pre-existing condition,” said Gwen Nichols, M.D., Chief Medical Officer, the Leukemia & Lymphoma Society.

In addition to Sens. Warner, Cardin, Shaheen, and Baldwin, the legislation is also cosponsored by Sens. Tom Carper (D-DE), Chris Murphy (D-CT), Gary Peters (D-MI), Jack Reed (D-RI), Tammy Duckworth (D-IL), Tim Kaine (D-VA), Richard Blumenthal (D-CT), Bob Menendez (D-NJ), Tina Smith (D-MN), Jeff Merkley (D-OR), Catherine Cortez-Masto (D-NV), Chris Van Hollen (D-MD), Kirsten Gillibrand (D-NY), Cory Booker (D-NJ), Dick Durbin (D-IL), Ben Ray Lujan (D-NM), Ed Markey (D-MA), Elizabeth Warren (D-MA), Jacky Rosen (D-NV), Amy Klobuchar (D-MN), Debbie Stabenow (D-MI), Bob Casey (D-PA), Patty Murray (D-WA), Ron Wyden (D-OR), Jon Tester (D-MT), and Alex Padilla (D-CA).

A copy of the bill text can be found here. A copy of the bill summary can be found here.

The introduction of the Protecting Americans with Preexisting Conditions Act of 2021 comes on the heels of President Biden signing the American Rescue Plan into law, which includes key Warner health care priorities to expand access to affordable health care coverage for Americans during the ongoing COVID-19 crisis. 

The American Rescue Plan offers states additional incentives to expand their Medicaid programs to millions more Americans. More than 4 million Americans are eligible for Medicaid under the federal expansion included in the ACA, but live in states that have elected not to expand their Medicaid programs. The American Rescue Plan encourages states to expand their Medicaid programs by offering a two year federal matching payment of 95 percent. Additionally, the American Rescue Plan also ensures that Americans have access to affordable health care coverage by extending premium assistance and capping health care costs at a maximum of 8.5 percent of household income. These provisions are similar to actions Sen. Warner called for in legislation he led this year – the SAME Act and Health Care Improvement Act.

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