Wisconsin families worry about pre-existing conditions after health care bill passes House

Bill would allow states to use high-risk pools
Wisconsin families worry about pre-existing conditions after health care bill passes House

Families in Wisconsin with pre-existing conditions are asking congress to reconsider the health care bill passed Thursday that gives states more control over health coverage.

Kay Lock’s son Ian was diagnosed with a rare form of bone cancer at age 16 seven years ago, just after the Affordable Care Act was passed.

“After you hear the words ‘you have cancer’ your mind goes to a million different places and nowhere at once,” Lock said. “One thing we never had to worry about was appropriate health care for Ian.”

Ian Lock survived osteosarcoma and is now in college. But with the House passing a health care bill that could make changes for those with pre-existing conditions, Kay Lock is wondering what could happen next.

“I fear the day that he could be told ‘I’m sorry, I can’t provide health insurance for you because you have a pre-existing condition,'” she said. “It’s difficult for me to say those words because they have such a heartfelt meaning for me.”

The House bill allows states to decide how pre-existing conditions can be covered, possibly moving those people into a high-risk pool. It also allows states to decide whether plans would have to cover 10 “essential benefits” that are currently required under the Affordable Care act, like outpatient surgery, emergency services, prescription drugs or maternity care.

News 3 asked state Medicaid Director Michael Heifetz what that possible change could mean in Wisconsin.

“There hasn’t been a decision. We have to see what the legislation would truly look like if its signed by the president,” Heifetz said. “We have a great model here in Wisconsin and we don’t want to see that turned upside down and we don’t foresee that happening.”

Heifetz said the state was instead looking for flexibility in how Medicaid and insurance programs can be structured.

“The flexibilities being discussed are also designed to address pre-existing conditions but in a different manner,” Heifetz said. “That doesn’t mean we would do it or another state would do it; it’s a flexibility issue.”

Wisconsin and other states will now consider what to do if the Senate would pass a similar version of the bill.

Lock is concerned about her son, who will graduate from college next week and move to Utah to research osteosarcoma. She’s fearful for what any state might do to change plans.

“It terrifies me to think he could be put into one of those high-risk pools,” Lock said. “When you say ‘essential services’ my son received those services and that’s what kept him alive.”