Opinion: The GOP and its pre-existing lie

ajc.com

Republicans all over the country, from Brian Kemp here in Georgia to Donald Trump up in Washington, claim that they want to make sure that Americans with pre-existing medical conditions can continue to get health insurance.

They don’t, and they won’t.

And how do Americans know that they don’t and won’t?

Because they haven’t.

For at least a decade, Republicans have promised to protect people with pre-existing conditions. For at least a decade, they have failed to propose, let alone enact, a plan that would accomplish that. For at least a decade, they have tried to frustrate and undo plans that did offer such protections.

Remember all those years when they were casting umpteen show votes to repeal Obamacare? The bills that they supported would have left Americans with pre-existing conditions out in the cold, without affordable insurance.

In 2017, when only John McCain’s downturned thumb stopped them from repealing all of Obamacare, the GOP’s “replacement” bill left those with pre-existing conditions unprotected. Had it become law, it would have allowed insurance companies to resume charging huge premiums to those with asthma, diabetes, cancer, heart disease and other conditions, in effect making insurance too expensive for those who need it most.

Even now, in a federal court in Texas, Republicans are mounting yet another legal challenge to Obamacare, attempting to destroy through the courts what they could not destroy through Congress. If they win, the entire Affordable Care Act, including its protections for pre-existing conditions, would be tossed out as unconstitutional, and Republicans would still have no workable plan for how to replace it.

The reasons for their failure aren’t complicated: Pre-existing conditions can be expensive to treat, which means that profit-seeking insurance companies have a huge financial incentive not to cover them. Put bluntly, they make money on healthy customers; they lose money on sick customers. So they don’t want sick customers.

Given those realities, the only feasible means of getting insurance companies to cover the sick and healthy alike is by forcing them to do so through federal regulation or law. Likewise, the only means of making that coverage affordable for many Americans is through federal subsidies. But subsidies and regulations are two things that Republicans can’t bring themselves to accept, which creates quite a dilemma for them.

In the latest Fox News poll, voters were asked their opinion of “the 2010 health care law, also known as Obamacare.” I cite the precise language of the question because not so long ago, calling it “Obamacare” would have guaranteed a negative poll result. These days, however, 54 percent of likely voters told Fox they view Obamacare favorably; just 43 percent viewed it unfavorably. Among independent voters, 61 percent view it favorably.

That’s pretty strong vindication for Nancy Pelosi. At the time of Obamacare’s passage, she famously predicted that the new law would become popular once voters saw what it actually did, instead of what Republicans were claiming it would do. Time has proved her right. And of course, provisions guaranteeing coverage of pre-existing conditions are a key reason for that popularity.

Given those numbers, Republicans have no choice but to pretend to protect those with pre-existing conditions, even as their ideology requires that they oppose every plausible mechanism to do so. Don’t take my word for it; look at their track record.