Survivors of COVID now have a preexisting condition.
Two years ago, Democrats successfully rode the healthcare issue to victory in the elections for control of the U.S. House of Representatives. Specifically, the Democrats ran on protecting and strengthening the Affordable Care Act (ACA) against Republican efforts to repeal it. This year, at the confirmation hearing on Judge Amy Coney Barrett‘s nomination to the U.S. Supreme Court, the Democrats are pointing out once again that the Republicans seek to repeal the ACA and take away our healthcare, and that a 6-3 Republican majority Supreme Court, with the addition of Barrett, could easily do so.
Republicans such as Donald Trump and U.S. Senate Majority Leader Mitch McConnell keep telling us in response that, no matter what, they would still “protect preexisting conditions,” the coverage of which is a major element of the ACA. But one look at the Republicans’ nightmare healthcare scenario makes it clear that the GOP will offer no such protection.
First of all, recall that the ACA was, at its core, a grand bargain: On the one hand, insurance companies must provide numerous protections, including a ban on denying or terminating coverage, the requirement to cover folks with preexisting conditions at non-discriminatory prices, coverage of a comprehensive list of “essential health benefits” (meaning no more “junk plans” that were cheaper but didn’t cover anything), removal of lifetime coverage caps, free annual preventive exams, the ability of young people to remain on their parents’ plans until age 26, financial subsidies for those with lower incomes, and even a 20 percent limit on administrative, overhead and marketing costs. In return for all of these protections, which obviously cost the insurance companies a lot, they got tens of millions more customers via the “individual mandate” requiring all Americans to have health insurance (with monetary penalties for those who refuse). There’s really no way to sustain one side of this equation without the other, absent a radically different healthcare system such as government-funded “single payer” that is paid for by substantial tax increases, and which, at this time, is a political non-starter.
However, under Donald Trump, Congressional Republicans got rid of the individual mandate. No surprise that, as a result, the number of new ACA enrollees has fallen dramatically since its high in 2016. Likewise, in 2018, Trump brought back “junk plans” that do not cover preexisting conditions or much of anything. And most importantly, just over three months ago, the Trump administration (joined by numerous Republican U.S. Senators) filed a new brief with the U.S. Supreme Court supporting the case brought by a number of Republican state Attorneys General to repeal the entire ACA, including, of course, its preexisting conditions coverage requirements. This is the very Supreme Court case on which Judge Barrett, if confirmed now, could rule. That’s why, when Republicans say that they would continue to “protect preexisting conditions,” it’s a big lie.
Even if we took Republicans at their word, let’s imagine the best case scenario of what they say: (1) the ACA gets struck down, in addition to the previous repeal of the ACA personal mandate to have insurance; (2) insurance companies are left with a one-sided mandate to cover preexisting conditions (again, impossible in the real world); but (3) they have no mandate to cover them at the same price, which is what ACA requires. The obvious result is that millions of Americans with preexisting conditions could have their insurance rates tripled, causing insurance to be unaffordable for them. And this includes the more than eight million Americans who have had COVID, who now have a preexisting condition too. These folks will be forced to cancel their unaffordable insurance, or buy GOP junk plans, allowed by Trump, that cover nothing. The Republicans then will say, “See? The insurance companies didn’t cancel anybody; this is just consumer choice.”
Therefore, while the Democrats smartly are raising the red flag on Republican efforts to repeal the ACA, it’s very important for Democrats to talk about the Republicans’ “protect preexisting conditions” lie, and to lay out the nightmare scenario of what happens when the ACA is repealed.
Photo by Ninian Reid, used under Creative Commons license. https://is.gd/A2a0lR
