The truth about Repub­li­cans and pre­ex­ist­ing con­di­tions

The Charlotte Observer (Sunday) - - Opinion - BY THE OBSERVER ED­I­TO­RIAL BOARD

On a gray and breezy Thurs­day last May, Repub­li­cans gath­ered in the White House Rose Gar­den to cel­e­brate what they hoped would be the end of Oba­macare. Mo­ments be­fore, the US House had passed the Amer­i­can Health Care Act, and so com­menced an im­promptu sales job head­lined by Pres­i­dent Trump and House Speaker Paul Ryan.

Trump hailed the bill as “a great plan.” He said it “will get even bet­ter” once the Se­nate im­proved it, a sen­ti­ment echoed by Ryan. They did not, how­ever, dwell on how the bill treated peo­ple with pre­ex­ist­ing con­di­tions. The rea­son: While the bill would not al­low in­sur­ers to can­cel cov­er­age for peo­ple who had pre­vi­ously been sick, it would al­low for them to charge those peo­ple sig­nif­i­cantly higher pre­mi­ums.

Fast for­ward to this fall. Repub­li­cans, now try­ing to save their ma­jor­ity in the House, still aren’t ex­cited to talk about pre­ex­ist­ing con­di­tions. But when they do, they are promis­ing to pro­tect those Amer­i­cans in any fu­ture leg­is­la­tion. “Al­ways,” says the pres­i­dent at his ral­lies. “We will al­ways pro­tect Amer­i­cans with pre­ex­ist­ing con­di­tions.”

It is, for many, the pre­dom­i­nant is­sue of this elec­tion. (If you think you’re prob­a­bly not one of those peo­ple, you should check this list.) Democrats, at least, would like it to be, be­cause they know Amer­i­cans are un­cer­tain ex­actly what Repub­li­cans will do with health care leg­is­la­tion if they re­tain con­trol of Congress. Will they pro­tect Amer­i­cans who have pre­vi­ously been sick, as Trump and oth­ers prom­ise? Or will the coun­try go back to pre-Oba­macare days of in­sur­ers out­right de­clin­ing cov­er­age for some of those peo­ple?

The an­swer is nei­ther. The an­swer also is that Amer­i­cans should be skep­ti­cal of the prom­ises Trump and his party are mak­ing.

It’s true that Repub­li­cans have made progress in ac­knowl­edg­ing how im­por­tant the is­sue is to an over­whelm­ing ma­jor­ity of Amer­i­cans. But GOP law­mak­ers and the pres­i­dent have shown no signs out­side their words that they will of­fer the same level of pro­tec­tions for pre­ex­ist­ing con­di­tions that Oba­macare is pro­vid­ing.

Here’s what they have shown: Trump ad­min­is­tra­tion lawyers told a Texas court in June that they will no longer de­fend pro­tec­tions for pre­ex­ist­ing con­di­tions; that judge is ex­pected to rule soon on whether the Af­for- dable Care Act and its pro­tec­tions are con­sti­tu­tional. Thus far, all the sub­sti­tute GOP health care plans and pro­pos­als have fallen short of what Oba­macare of­fers to peo­ple who’ve had health is­sues.

That in­cludes the Amer­i­can Health Care Act, which would have al­lowed for peo­ple with pre­ex­ist­ing con­di­tions to be charged thou­sands or tens of thou­sands of more dol­lars per year.

That also in­cludes a bill spon­sored by NC Sen. Thom Til­lis that Repub­li­cans have touted this fall, called En­sur­ing Cov­er­age for Pa­tients with Pre­ex­ist­ing Con­di­tions, which experts say has loop­holes that could al­low in­sur­ers to deny some cov­er­age, as well as charge higher pre­mi­ums to peo­ple in less healthy com­mu­ni­ties and oc­cu­pa­tions.

Repub­li­cans, as they did last May, be­lieve that’s still enough to claim they are pro­tect­ing Amer­i­cans with pre­ex­ist­ing con­di­tions. It’s not. Vot­ers should remember that Tues­day.

As­so­ci­ated Press

Don­ald Trump and House Speaker Paul Ryan last May at a Rose Gar­den cel­e­bra­tion of the Amer­i­can Health Care Act.

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