Health and Science

The fight over the Senate health-care bill comes down to one word — choice

Key Points
  • "Choice" in health care is often debated on ideological lines.
  • Conservatives say government rules inhibit an individual's freedom to choose.
  • Liberals say people with pre-existing conditions will have no choice if they can't get insurance.
Penn's Zeke Emanuel: Revised health-care bill worse than previous version
Penn's Zeke Emanuel: Revised health-care bill worse than previous version

The latest Senate health-care bill is dredging up a long-debated question: What constitutes the freedom to choose in the health insurance market?

For conservatives such as Dan Holler, vice president of Heritage Action for America, such a freedom runs inversely to the level of government interference.

"What we're seeing now in this revised bill with this Cruz-type language is that there is going to be more choice and more competition and more options for individuals who are buying on the individual and small-group markets," Holler said Thursday on CNBC's "Closing Bell."

The "Cruz-type language" refers to a provision included in the health bill from Sen. Ted Cruz, R-Texas, allowing states to sell "noncompliant" plans that aren't subject to some of the rules Obamacare placed on insurers. One of those rules bars insurers from excluding coverage for pre-existing conditions.

Dr. Ezekiel Emanuel
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"It's not sufficient to fix everything that Obamacare broke, but it is a step in the right direction," Holler said of the updated bill.

Across the political aisle, Dr. Ezekiel Emanuel of the Center for American Progress took a different tack on the word "choice."

"If you want to have the pre-existing disease exclusion, you cannot give unlimited choice to people," Emanuel said on "Closing Bell," "because then the healthy people are going to choose to be out or get skimpy plans, and then the whole system collapses."

"Behind the rhetoric of choice is a total undermining of the system," he said.

Holler said Emanuel's view of health care is "not really what actual choice is," arguing that such a policy "basically says 535 members of Congress are insurance commissioners."

Emanuel reversed the question, saying that those with pre-existing conditions will have neither choice nor coverage if their premiums rise to an unpayable cost.

The doctor said his patients with cancer "will not have any choice because they will be denied insurance, or the premium will be so high they can't afford it."

"That's not choice to those people at all," Emanuel said.

— CNBC's Dan Mangan contributed to this report.