Pre-existing cruelty
Republicans want to deny many millions health coverage
Polls suggest the public considers health care the most important issue in the midterm elections. But do voters realize that if Republicans hold Congress, they will strip away protections for 52 million Americans — more than a quarter of nonelderly adults — who have pre-existing conditions that, before passage of the Affordable Care Act, could have led insurers to deny them coverage?
The Trump administration is already trying to take away those protections via the courts. It probably won’t succeed. Even so, its support fora flimsy legal challenge — one so indefensible that three career Justice Department lawyers withdrew from the case — is a clear signal of Republican priorities: GOP to Americans with health problems: Drop dead.
Some people seem surprised by the administration’s moves because Donald Trump has promised many times to protect people with pre-existing conditions. But remember: The anti-Obamacare campaign has been based on lies all along.
First there were lies about what was in the act. Remember “death panels”? Then there were lies about the law’s effects. Koch brothers-financed Americans for Prosperity ran ads featuring supposedly real stories of Americans facing terrible hardships because of the ACA But none — none — stood up to fact-checking.
But the most enduring lie from ACA opponents is their claim that they want to protect Americans with pre-existing conditions. They don’t and never did.
They claim otherwise because a huge majority of voters, including 59 percent of Republicans, want to maintain rules that prohibit insurance companies from denying coverage based on someone’s medical history. This is a powerful incentive to pretend that you’ll do so.
But the falseness of the pretense was obvious on sheer logical grounds even before Republicans began proposing supposed replacements for Obamacare. If you’re going to guarantee coverage regardless of medical history, you have to induce people to sign up for insurance while they’re still healthy, so that insurers have a manageable risk pool. That means some combination of subsidies to make insurance affordable and penalties for going uninsured — in other words, a system muchlike the ACA.
So demands that the ACA be scrapped always meant taking away coverage from the people who need it most; Obamacare opponents just hoped people wouldn’t notice. And they mostly got away with it until last year, when Republicans had to offer specific health care legislation. The game was up. It immediately became clear that every Republican alternative to Obamacare would, infact, hang Americans with pre-existing conditions out to dry. And the public backlash against that revelation is why the GOP repeal effort failed. But it failed narrowly. And if Republicans still hold Congress next year, anyone who has a history of medical problems and doesn’t get health insurance from his or her employer will lose coverage.
In fact, even getting a job with insurance coverage might not be enough: If the Trump-supported lawsuit succeeds, employers could refuse to cover new employees’ pre-existing conditions.
The cruelty is puzzling. OK, Mr. Trump obviously is utterly without empathy. But don’t other Republicans feel a bit bad about the prospect of taking health care away from millions of Americans who have done nothing wrong except having been sick?
No. Consider Rick Scott, governor of Florida, whose attorney general has joined the lawsuit to eliminate protection for pre-existing conditions. While refusing to say whether he supports the suit, Mr. Scott declared, “We’ve got to reward people for caring for themselves.” Right, because if you get cancer, or arthritis, or multiple sclerosis — all among the pre-existing conditions for which people used to be denied coverage — it must be yourown fault.
Oh, and if you think you’re safe because you’re covered by Medicare ... If Republicans win in November, they’ll come after Medicare next. They’ve said so.