In this year’s midterm elections, there is a life-and-death issue on the ballot. No, it’s not the “caravan,” despite what Republicans and some in the media might have you believe. The life-and-death issue that we’re voting on this Tuesday (or before, if you have early voting) is healthcare.
In particular, the Affordable Care Act and its preexisting conditions coverage is on the line. There’s a lot of confusion about the ACA and preexisting conditions, but the reality is pretty simple: the 2010 ACA, based on the conservative Heritage Foundation plan and implemented first by Republican Governor Willard Mitt Romney in Massachusetts, is essentially a grand trade-off: Americans got a number of healthcare protections, including coverage of preexisting conditions at non-discriminatory prices, coverage of a comprehensive list of “essential health benefits” (meaning no more junk plans that were cheap but didn’t cover anything), removal of lifetime coverage caps, free annual preventive exams and the ability of young people to remain on their parents’ plans until age 26. In return, since all these protections cost the insurance companies a lot more, the companies got a guarantee of millions more customers, many of them younger people with few or no healthcare claims, via mandatory enrollment. It’s a delicate balance, and those protections can’t be provided under the current system without those extra paying customers.