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COVID-19 could have marked a person “uninsurabl­e” if not for the ACA. Ban on using preexistin­g conditions to deny coverage is a key part of Obamaera law that the Trump administra­tion still seeks to overturn.

Ban on preexistin­g conditions to deny coverage is critical

- By Ricardo Alonso-Zaldivar

WASHINGTON — COVID-19 could have stamped a person “uninsurabl­e” if not for the Affordable Care Act. The ban on insurers using preexistin­g conditions to deny coverage is a key part of the Obama-era law the Trump administra­tion still seeks to overturn.

Without the law, people who recovered from COVID-19 and tried to purchase an individual health insurance policy could be turned down, charged higher premiums or have follow-up care excluded from coverage. Those considered vulnerable because of conditions such as respirator­y problems or earlystage diabetes would have run into a wall of insurer suspicion.

Yet as defenders of the ACA submit written arguments to the Supreme Court next week countering the latest challenge to its existence, the Trump administra­tion remains adamant that former President Barack Obama’s health law, known as Obamacare, must go.

“A global pandemic does not change what Americans know: Obamacare has been an unlawful failure and further illustrate­s the need to focus on patient care,” White House spokesman Judd Deere said in a statement.

Deere asserted the law limits patient choice, has premiums that are too expensive and restricts patients with high-risk conditions from going to the doctors and hospitals they need. President Donald Trump has said he would protect people with preexistin­g conditions, as have other Republican­s, but he hasn’t spelled out a plan.

Some GOP lawmakers in contested races this fall are unnerved by the prospect of Trump administra­tion lawyers asking the Supreme Court during the outbreak to toss out a law that provides coverage to at least 20 million Americans.

“The ACA remains the law of the land, and it is the Department of Justice’s duty to defend it,” Sen. Susan Collins, R-Maine, said. “That is especially true during the current public health crisis our country is facing due to COVID-19.”

She is among those urging the administra­tion to make broader use of the

law to cover uninsured people during the pandemic. Collins is considered among the most endangered incumbents as Republican­s try to keep their Senate majority.

It’s unclear whether the justices will hear oral arguments before November’s election. A group of GOPled states contends that because Congress repealed an ACA tax penalty, the law’s requiremen­t for individual­s to carry health insurance is unconstitu­tional. If the insurance mandate is unconstitu­tional, their argument goes, then the rest of the law must collapse.

The administra­tion agrees, but has also suggested that federal judges could decide to keep some parts of the law. The

Supreme Court took the case after a federal appeals court in New Orleans ruled in December that the ACA’s insurance mandate is unconstitu­tional, but did not rule on the rest of the law.

From nearly 12 million people to 35 million could lose their workplace coverage due to layoffs in the coronaviru­s shutdown, according to an estimate by the consulting firm Health Management Associates. They have more options because of the Obama-era law.

They are entitled to a special sign-up opportunit­y for coverage through HealthCare.gov or their state insurance market, and may qualify for financial assistance with premiums and other costs. They cannot

be asked about health problems. In states that expanded Medicaid, some may qualify for that program, usually at little or no cost.

Before the law, people who lost their jobs and wanted to keep their employer health insurance could do so under a law known as COBRA. It’s still on the books, but requires them to pay the full premium, plus an administra­tive fee. That’s often costprohib­itive.

Karen Pollitz of the nonpartisa­n Kaiser Family Foundation said people seeking an individual health insurance policy “would have been very much at risk in today’s pandemic” were it not for the health law.

“The conditions associated

with a more complicate­d case of COVID-19 would have been especially radioactiv­e,” she said.

For Republican­s, the Supreme Court case “has to be the ultimate in ‘be careful you don’t get what you wish for,’ ” said health industry consultant Robert Laszewski.

Part of the reason Trump failed to repeal and replace the law in 2017 was that Republican­s didn’t have a plan they could agree on, he said.

“Before COVID, if they won the suit, then what?” asked Laszewski. “And now with COVID in the face of a major medical crisis, and depression-level unemployme­nt, and people losing their health insurance? Yikes!”

 ?? JOHN MINCHILLO/AP ?? Resident physician Leslie Bottrell stands outside a room at a Yonkers, New York hospital as a nurse suctions the lungs of a patient with COVID-19.
JOHN MINCHILLO/AP Resident physician Leslie Bottrell stands outside a room at a Yonkers, New York hospital as a nurse suctions the lungs of a patient with COVID-19.

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