North Carolina: GOP Sen Tillis' office compares cancer treatment to clothes shopping, then insults everyone's intelligence

I've written several times about how Republican Senator Cory Gardner of Colorado has repeatedly shown sickening levels of chutzpah and gaslighting when it comes to the Affordable Care Act:

In a pathetic attempt to gaslight Colorado voters, Gardner is now trying to paint himself as supporting healthcare expansion, going so far as to try to claim credit for passage and approval of last year's Section 1332 Reinsurance Waiver program which dramatically reduced premiums for unsubsidized individual market enrollees throughout Colorado...even though a) he didn't have a damned thing to do with it and b) the reinsurance program was only able to be developed thanks to the Affordable Care Act...which Gardner has repeatedly voted to repeal.

This week, with the election quickly approaching and his prospects for re-election growing dimmer by the minute, Gardner  is at it again, showing jaw-dropping hypocrisy with the introduction of a disingenuous, one-sentence bill into the Senate which he claims would "protect coverage of pre-existing conditions", of all things.

Well, I guess Gardner's GOP colleague in North Carolina, Sen. Thom Tillis, has decided to challenge Gardner for the chutzpah award:

Tillis’ office provided a follow-up response to the senator’s stance on Medicaid expansion:

"Senator Tillis believes it is critical we protect the health and safety of North Carolinians throughout this pandemic, which is why he has supported the [Trump] administration’s effort to require all Americans, regardless of their insurance status, to be able to receive treatment if they get COVID-19," the statement says. "Senator Tillis has also been pushing to guarantee that all Americans with pre-existing conditions can get affordable health care.

"When he was Speaker of the House [in North Carolina]," the statement continues, "Senator Tillis inherited a Medicaid program that was mismanaged and plagued with overspending and inefficiency. Expanding Medicaid at the time would have been a promise that the state wouldn’t have been able to keep, requiring cuts to the program that would have harmed patients that states like New York and California have already been forced to make. Instead, Senator Tillis worked to strengthen the state’s Medicaid program to deliver quality health care to patients, and the reason the North Carolina is in a position to discuss expansion is because of Senator Tillis’ leadership."

I'll get to what this bullshit statement was a response to in a moment, but let's be clear: Like Cory Gardner, Senator Thom Tillis has repeatedly voted to strike down the Affordable Care Act...including the very expansion of Medicaid which he's now claiming that he's somehow responsible for putting North Carolina in a position to initiate.

As for the claim in the first paragraph--that he's supposedly been pushing to require coverage of pre-existing conditions--this is, of course, also utter bullshit, as the ACA already does exactly that. As far as I know, the bill Tillis is referring to here is basically a fancier version of Gardner's vaporware bill:

Unlike the ACA, the new Republican pre-existing condition bill would not disallow lifetime or annual limits, cap patient out-of-pocket costs, require coverage of essential benefits, prohibit gender rating, or provide subsidies to make premiums more affordable.

— Larry Levitt (@larry_levitt) April 11, 2019

In other words...not much has changed. Also, this cute trick:

The ACA specifies circumstances when premiums CAN vary (location, age, tobacco) so other rating (e.g. based on gender) is inherently prohibited
The new GOP bill takes the opposite approach: It specifies circumstances when premiums CAN'T vary, giving insurers much more flexibility.

— Cynthia Cox (@cynthiaccox) April 11, 2019

In other words, as Jeffrey Young noted last summer:

But prices could dramatically vary based on age, gender, occupation and other factors, including hobbies, in ways that are functionally the same as basing them on medical histories. Insurance companies have a lot of experience figuring out that stuff.

Hard Pass. Next?

(sigh) ONE MORE TIME, FOLKS:

• 1. Healthcare can be very expensive.
• 2. Some pre-existing conditions can be insanely expensive.
• 3. Many people simply can't afford to pay for treatment of those conditions.
• 4. Therefore, you have two choices: Either others pay for a large chunk of the expense (i.e., subsidies paid for via taxes) or you tell people with expensive conditions to suffer and die.

Of course, the third option is "reduce the cost of healthcare in the first place", but that gets extremely messy and complicated and can take years, and in the meantime some types of cancer/etc. can kill you in months, so while we're working on that whole "bring the cost of healthcare down" thing, a lot of people need those subsidies. That's what Medicare does (mostly). That's what Medicaid does. That's what the ACA's subsidies do (up to a point).

Both Tillis and Gardner's proposals would mandate coverage of pre-existing conditions but would do so without any financial assistance or controls on price gouging, which means that insurance companies would technically be required to offer you a policy but could charge you 10x as much for it as you could possibly afford, making it nearly as useless as not offering it in the first place.

The ACA solved this problem for millions of people via Medicaid expansion, premium subsidies & cost sharing subsidies, but didn't go far enough; that's one of the main problems solved by both the recently-House-passed H.R. 1425 ("ACA 2.0) as well as Joe Biden's healthcare plan.

Oh yeah...here's what Tillis was responding to:

Cancer survivor pleading for help with health insurance 'angry and hurt' over Tillis staffer's response

A three-time cancer survivor who reached out to U.S. Sen. Thom Tillis for help with her health insurance dilemma said that she got an insensitive response from a staffer instead.

...During Veals' calls, she came across a Washington, D.C., staffer for Tillis. Frustrated by the person's lack of empathy, she started recording her calls.

"You’re saying that, if you can’t afford it, you don’t get to have it, and that includes health care?" she asked.

"Yeah, just like if I want to go to the store and buy a new dress shirt. If I can’t afford that dress shirt, I don’t get to get it," the staffer replied.

"But health care is something that people need, especially if they have cancer," Veals said.

"Well, you got to find a way to get it," the staffer responded.

When she asked the staffer what she's supposed to do, the person responded, "Sounds like something you’re going to have to figure it out."

"To compare it to a dress shirt made me incredibly angry and hurt," Veals told WRAL Investigates.