Over a quarter of all non-elderly adults, 27%, have pre-existing conditions. Americans consider keeping all of these people with medical needs insured to be a major priority. According to Kaiser Family Foundation, it’s the single-most important health care issue for Americans of all parties.
Ahead of the midterm elections, President Donald Trump and GOP lawmakers have repeatedly stressed in tweets and speeches that he and Republicans care deeply about protecting the health care for these vulnerable populations. Under current Obamacare law, insurers are not allowed to raise prices on health plans for people with pre-existing conditions or deny someone seeking a plan.
The most common pre-existing conditions? Acne, anxiety, diabetes, asthma, sleep apnea, depression, COPD, obesity, atherosclerosis, and cancer are the most common ones, according to a CNN analysis. In some cases, pregnancy has even been considered a pre-existing condition.
Should protections for pre-existing conditions be thrown out, 100 million people could be affected, according to analysis from consulting firm Avalere.
But the actions of Trump and the Republican-controlled Congress have not been consistent with trying to protect pre-existing conditions. Despite loud pre-election support of protecting pre-existing conditions, the Republican party has failed to support them. In other words, Trump is fibbing.
The 2017 ACA repeal effort
The repeal efforts centered around the American Health Care Act, which were pushed back by Sen. John McCain’s nay vote in 2017, would have put pre-existing conditions in doubt for a significant number of Americans.
First off, House Republicans amended the bill to allow certain states to get waivers to eliminate “community rating” for people who had a gap in coverage. This is a key provision of the ACA that prevents older people with more health expenses from being charged more than three times what younger people get charged. So while consumers couldn’t be denied insurance, it could be prohibitively expensive for some.
The waivers would have also covered the elimination of “essential health benefits,” which would mean that while a person with a disease or pre-existing condition could obtain coverage, they might not have their medications covered.
Furthermore, the GOP’s singular efforts to erase the individual mandate would have a similar effect on people with pre-existing conditions. With younger, healthier people able to opt out of insurance with no penalty, people with pre-existing conditions unable to opt out would be left in insurance pools on their own, something that would result in higher premiums or the famous “death spiral” situation for a pool. In this situation, insurers would drop out of certain markets as they became less lucrative, leaving people with pre-existing conditions with pricier, less competitive plans with fewer options.
The Trump administration has also opened up another type of insurance called “short-term plans” that provide a skinny option for coverage that is noncompliant with the ACA’s provisions. Under these plans, insurers don’t have to cover pre-existing conditions.
“By covering primarily people who are healthy at the time they apply, short-term plans have much lower claims costs than ACA-compliant plans and can charge substantially lower premiums,” the Kaiser Family Foundation, a non-partisan health care policy group, wrote about these plans.
This, like the removal of the individual mandate, has the effect of destabilizing the markets that still accept people with pre-existing conditions. By letting healthy consumers go without insurance and raising the concentration of people with pre-existing conditions, insurance premiums will rise.
Obamacare lawsuits supported by the Trump administration
The most damning proof showing the fake commitment to the protection of those with pre-existing conditions, as many other reports have noted, is the fact that the Trump administration is literally supporting the fight against the protection of pre-existing conditions and the mandate in court through a brief and by not defending the law of the land.
Twenty GOP attorneys general are fighting these measures in Obamacare, despite what the politicians are saying. As Vox’s Sarah Kliff noted, Missouri Senate candidate Josh Hawley is part of this lawsuit, but has released ads that say, “I’m Josh Hawley. I support forcing insurance companies to cover all pre-existing conditions.”
The evidence is clear and incontrovertible: These politicians’ actions do not support keeping protections for people with pre-existing conditions.