Andy Barr says he'll 'always protect people with preexisting conditions.' He hasn't.

Sep. 21--Running for a fifth term, Republican U.S. Rep. Andy Barr of Lexington says in a television ad that "I will always protect people with preexisting conditions."

That's a lie, counters his Democratic challenger, Lexington lawyer Josh Hicks, in a response ad that began airing Friday.

Hicks says Barr repeatedly voted to repeal the Patient Protection and Affordable Care Act, the 2010 law that -- among other things -- guarantees equal access to health insurance at approximately the same cost for people with preexisting conditions, such as asthma, diabetes, heart disease and cancer.

Before the law was enacted, many Americans with such conditions were denied coverage or charged exorbitant premiums.

This year, GOP incumbents who once vowed to "repeal Obamacare," as the Affordable Care Act also is known, are looking at opinion polls where 83 percent of adults say it's important for Congress to preserve the law's protections for preexisting conditions. Many have dropped their "repeal" rhetoric and are now running ads like Barr's.

Hicks contends Barr is trying to rewrite history.

"I can't let a lie like that stand," Hicks says in his ad. "The truth is, he voted over and over to end protections for people with preexisting conditions, people like my mom and my sister."

Rolling down the screen as Hicks speaks is a list of 13 of Barr's House votes from the last seven years.

In a written response to the Herald-Leader, Barr's re-election campaign identified three votes he cast in the past two years, after Democrats won control of the House in 2018, that were intended to allow Congress to consider unspecified future efforts to help people with preexisting conditions.

One of those votes, for example, was on an April 2019 resolution that would "require Congress and the (Trump) administration to work together to protect Americans with preexisting conditions, lower premiums, reduce drug prices, and strengthen Medicare and employer-provided coverage." It included no further details.

Andy Barr's voting record on preexisting conditions

Barr, first elected to Congress in 2012, voted with the Republican caucus multiple times to repeal the Affordable Care Act and its protections for people with preexisting conditions. That group includes an estimated 1.8 million Kentuckians.

Sometimes, as in May 2013, Barr voted to eliminate the Affordable Care Act and not replace it with anything, but simply restore federal health care laws to their previous status quo. That particular measure passed a Republican-controlled House but died in a Democratic-controlled Senate.

Four years later, in May 2017, Barr and his GOP colleagues passed another measure, the American Health Care Act, that would have repealed portions of the Affordable Care Act and replaced them with new language. This bill, too, failed to pass the Senate, then controlled by Republicans. In place of the House plan, the Senate GOP promoted a "skinny repeal" bill that died when U.S. Sen. John McCain, R-Ariz., famously gave it a late-night thumbs down.

When Barr voted for it, he said the American Health Care Act's House passage marked "a great day for freedom in America." He lists the bill on the health care section of his campaign website, at the top of the "Andy Barr is getting results" list.

That Republican House proposal would have weakened protections for Americans with preexisting conditions, according to an analysis by the nonpartisan Congressional Budget Office.

A key amendment to the American Health Care Act would have required insurance companies to provide access to coverage for people with preexisting conditions. But it would not have prevented insurers from charging that group far higher premiums, just as they did before the Affordable Care Act.

The amendment also would have let states request waivers to avoid important preexisting condition protections in the individual insurance markets. About 16 percent of the U.S. population lives in states that could be expected to apply for such waivers, the Congressional Budget Office said in its report.

"Over time, less healthy individuals (including those with preexisting or newly acquired medical conditions) would be unable to purchase comprehensive coverage with premiums close to those under current law and might not be able to purchase coverage at all," the Congressional Budget Office said.

Overall, the American Health Care Act that Barr supported would have resulted in an estimated 19 million more Americans without insurance by this year had it become law, according to the Congressional Budget Office. It was opposed by AARP, the American Medical Association, the American Hospital Association, the American Cancer Society and other groups representing health care professionals and consumers.

"In short, this plan is terrible," said the National Disability Rights Network. "It permits discrimination against people with disabilities in the insurance market for their preexisting conditions."

Similar claim labeled 'mostly false'

A preexisting conditions claim nearly identical to Barr's, made by former U.S. Rep. Robert Pittenger, R-N.C., was rated as "mostly false" in 2017 by the nonpartisan fact-checking website PolitiFact.

Like Barr, Pittenger voted to replace the Affordable Care Act with the American Health Care Act and later told voters that he never acted to weaken protections for people with preexisting conditions. But that's untrue, PolitiFact concluded after a point-by-point analysis.

"While insurers technically would still be required to offer coverage to people with preexisting conditions, the AHCA would weaken protections for those people," PolitiFact wrote.

"Insurers would be able to charge people significantly more if they had a preexisting condition like heart disease, cancer, diabetes or arthritis -- possibly requiring people to pay thousands of dollars extra every year to remain insured," PolitiFact wrote.

Over the last two election cycles, Barr has collected at least $436,680 in political donations from the insurance industry, according to an analysis by the nonprofit Center for Responsive Politics.

Barr defends American Health Care Act

The Barr campaign defended the American Health Care Act in its statement to the Herald-Leader. Had the bill become law, insurance companies could not have hiked premiums on Americans with preexisting conditions unless there was, for some reason, an interruption in their insurance coverage, it said. Only a "relatively small number of people" conceivably could have been affected, it said.

For states that sought waivers to preexisting condition protections, the Barr campaign added, the bill would have set aside $123 billion over 10 years to subsidize mandatory high-risk pools to cover people who were uninsured and viewed as too risky by insurance companies.

"Those funds would've helped to offset the cost of insurance premiums for individuals," the Barr campaign wrote.

However, critics, including the American Medical Association, warned in response to the House GOP plan that high-risk pools operated in 35 states before the Affordable Care Act took effect, and they seldom worked well for sick people. The pools traditionally came with higher costs, capped enrollment and limits on covered services.

"The history of high-risk pools demonstrates that Americans with preexisting conditions will be stuck in second-class health care coverage -- if they are able to obtain coverage at all," the AMA said in 2017.

And others, such as health care consulting firm Avalere Health, said the money for high-risk pools included in the House GOP plan likely would have fallen short, even after lawmakers added an extra sum at the last minute.

"Given the amount of funding in the bill, the program can only afford a few small states to opt into medical underwriting," Caroline Pearson, Avalere senior vice president, said in a 2017 statement. "If any large states receive a waiver, many chronically ill individuals could be left without access to insurance."

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