Washington — The U.S. House approved a bill Thursday seeking to reverse guidance issued last fall by the Trump administration to loosen restrictions on states' abilities to waive certain requirements of the federal healthcare law.

Democrats and critics of the guidance say it weakened protections for people with preexisting conditions by exempting short-term and association health plans from certain standards set by the Affordable Care Act.  

The Democrats' legislation, approved in a 230-183 vote, would rescind the October guidance and prohibit any similar future guidance.

"This administration has told the courts not to defend preexisting conditions. They’ve destabilized the market,” said Democratic Rep. Debbie Dingell of Dearborn, a sponsor of the bill.  

"We’re sending a signal to people that we’re going to fight for them if they have preexisting conditions. Instead of sabotaging it, let’s work together."

Republicans said Democrats were mischaracterizing the bill, titled the Protecting Americans with Preexisting Conditions Act.

They argued the legislation, which is unlikely to pass the GOP-controlled Senate, is a partisan attempt to score political points and would have the effect of eliminating options for consumers who can't afford health care coverage.

"I understand the rhetoric on it, but frankly I’m offended they would use a title for the bill for political purposes," said Rep. Paul Mitchell, R-Dryden. 

"If they don't like the idea of giving waivers, just call it the 'we don’t think your waivers are right' bill or 'we think your policy sucks' bill. Don't find a term to make it a political hot potato.

Protections for preexisting conditions was among the most popular elements of the 2010 Affordable Care Act, known as Obamacare. They became a focal point of the 2018 elections, when Democrats hammered GOP candidates for undermining the provision.  

But GOP lawmakers such as Rep. Fred Upton, R-St. Joseph, said the House bill has nothing to do with protecting Americans with preexisting conditions, despite its name. 

"All it does is eliminate health care choice and innovation for states, and that’s not right," Upton said. 

"Moving forward, let’s work together in a bipartisan manner to develop real solutions that would actually protect individuals with preexisting conditions, increase access to quality health care and reduce costs for all Americans."

Mitchell agreed, saying current law prohibits states from limiting coverage for people with preexisting conditions, and that the legislation would block people from declining coverage for services they don’t want or need.

“What a 25 year-old needs for coverage is a whole lot different than what I need at 62,” Mitchell said. “One size certainly doesn’t fit all and isn’t affordable for all, and that’s one of the reasons for the waivers. This bill simply attacks the waivers.”

Rep. Elissa Slotkin, D-Holly, said some waivers amount to permission for states or insurers to provide inadequate coverage or "junk" plans that don’t cover essential health benefits, such as maternity or newborn care, emergency services or hospitalization. 

"That it's not to say that you can't have waivers. You can have waivers — you just can't give waiver guidance that contradicts the base principles of the ACA. And what's ended up happening is these plans," Slotkin said. 

"I had doctors come in from my district to talk to me about these junk plans and how this guidance has allowed for just a runaway train on these things."

She said the doctors gave the example of a woman who came in for her first prenatal visit only to learn pregnancy isn't covered by her plan. 

"It's just another backdoor way to discriminate against people with preexisting conditions," said Slotkin, who decided to run for Congress in part because of the issue. 

Her mother died in 2011 of ovarian cancer after struggling to afford health insurance for years due to the preexisting condition of breast cancer.  

"We've evolved as a country where most people, regardless of where you are on what side of the aisle you fall on, believe that (a) you shouldn't go broke when you get sick, and (b) that you shouldn't be penalized your entire life for happening to be born with a preexisting condition," Slotkin said.

"The other side continues to try and hack away or use sabotage or subterfuge to undermine those basic ideas. And for me, it's a red-line issue." 

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