Liberal political blogger Kevin Drum just said this, based on his initial read of the Senate Healthcare bill proposed by Republicans:

This is tentative, but….

I’ve just taken a quick look at the Senate health care bill. Neither preexisting nor continuous are anywhere in the bill. None of the section titles deal with preexisting conditions. It doesn’t appear that the Senate bill affects Obamacare’s protections for preexisting conditions at all. This is almost certainly because the Senate parliamentarian ruled that this had nothing to do with spending or outlays.

My question is, is Kevin Drum right that the Senate Healthcare bill doesn't change Obamacare's protections for people with preexisting conditions in any way?

If that's true, then the abolition of the individual mandate (which this bill does) would lead to a death spiral in the individual insurance market, due to adverse selection problems. (I think that's what happened in the pre-Obamacare individual insurance market in New York State.) Are there any provisions in the Senate healthcare bill designed to remedy the death spiral/adverse selection problem?

  • I'm guessing this won't be answerable for a while until someone reads the entire bill and thoroughly reports on the contents. From what I've been able to read thus far today, this is just basically a dismantling of the ACA in general. Back to the way it was.
    – user1530
    Jun 22, 2017 at 23:18
  • @blip Well, even the House bill doesn't totally repeal Obamacare, it's only a partial repeal. And from what I understand, the Senate bill doesn't go quite as far in repeal as the House bill; that's why so many Tea Party Republicans are opposing the Senate bill. So given that the House bill didn't take us completely "back to the way it was" pre-ACA on pre-existing conditions, I assume the Senate bill won't either. It will either keep Obamacare's protection completely or it will only partially remove the protection. Jun 22, 2017 at 23:32
  • Semantics, I suppose, but there really isn't a way to 'partially repeal' it in practice. It's a fragile thing to begin with so getting rid of any one pillar (pre-existing conditions, individual mandate, etc.) pretty much dooms it.
    – user1530
    Jun 23, 2017 at 0:12
  • You'll have to find what's in the bill after they pass it. Isn't that how Obamacare legislative process works?
    – user4012
    Jun 23, 2017 at 14:32
  • 1
    @user4012 That was said during a committee meeting when it needed to be moved to the next vote quickly. But the ACA had over a year of hearings and hundreds of amendments. Any of those politicians could have taken the time to read it if they wanted. Unlike the GOP bill which was crafted behind closed doors or during a lunch break.
    – DCook
    Jul 28, 2017 at 19:24

1 Answer 1


It does cover pre-existing conditions and does not allow insurers to charge people with pre-existing conditions more, however, it allows insurers to offer reduced services to these people.

Politico shows what has changed with pre-existing conditions in new Senate health care bill from the House version and Obamacare.


Related articles


Pre-existing conditions: The Senate bill would require insurers to cover those with pre-existing conditions and ban them from basing premiums on consumers' health history.

But it would allow states to waive the federal mandate on what insurers must cover, known as the essential health benefits. This would allow insurers to offer less comprehensive policies, so those with pre-existing conditions may not have all of their treatments covered. Last-minute House concessions to conservatives would have allowed states to opt out of several protections for those with pre-existing conditions.

The Atlantic:

The concession that Speaker Paul Ryan and a few key moderates made to the Freedom Caucus was to allow states to opt out of some of Obamacare’s insurance regulations, most crucially on equal treatment for pre-existing conditions. But the concession that conservative lawmakers and outside groups made in return was just as significant: They agreed to back off their demand for full repeal and endorse—or at least not fight—a bill that fell far short of that goal.


Coverage for people with pre-existing conditions would also be preserved if this new draft is approved by the Senate.

  • You should append your first, bolded, statement as it's incomplete. The bill does cover pre-existing conditions, and doesn't allow insurers to charge more, but it does seem to allow insurers to offer reduced services to people with pre-existing conditions.
    – tim
    Jun 23, 2017 at 7:19
  • I feel that saying "allowing companies to reduce coverage" isn't equivalent to "charging people more" is chicanery. Jun 23, 2017 at 7:39

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