Tuesday, November 6, 2018

Republicans Mislead on Pre-existing Conditions


By Edwin Amenta and Drew Halfmann

The GOP celebrates the House vote to Repeal the ACA
In 2017, Republicans almost succeeded in destroying the Affordable Care Act and its protections for people with pre-existing conditions.

But they’d rather you forget all about that. Facing tough re-election, they now are posing as protectors rather destroyers of such protections.

A good example is Orange County Congresswoman Mimi Walters. She voted for the Republican health care bill even though she had pledged many times to preserve protections for pre-existing conditions. She even took joyful selfies at President Trump’s party celebrating the bill. But in a recent Twitter video, she makes her promise again. She shows a photo of a baby covered in wires, her constituent Callan. He was born with a severe congenital heart defect and survived four open heart surgeries. Walters then stares into the camera and vows to protect his access to health care. This pledge is hardly credible. She vowed to protect people with pre-existing conditions before and then went back on her word when it counted.

So why are pre-existing condition protections so important? Because before the ACA was signed into law, insurance companies could avoid patients who might use a lot of costly medical services by refusing to sell them policies or by charging them exorbitant, often unaffordable, rates. And insurance companies defined these conditions broadly to include even common maladies like allergies, acne, or being prescribed an anti-depressant.

That meant a lot of Americans simply didn’t have access to health insurance.

The ACA ended those shady practices. It required insurers to sell insurance to everyone and prohibited them from charging discriminatory rates. The House GOP tried to roll back these protections while dishonestly claiming to preserve them.  

Sure, the Republican health legislation required insurers to sell to everyone, but waivers in the bill meant that they could charge patients according to their health status. Callan’s parents could buy him insurance, but at what cost? Non-partisan analyses found that they and hundreds of thousands like them would not have been able to afford it.

Protecting high-income people with pre-existing conditions is not the same as protecting people with pre-existing conditions.

Under the failed Republican legislation, the Congressional Budget Office estimated that some 23 million people would have lost insurance coverage, all so corporations and the wealthy could get tax cuts. Meanwhile, Republicans leaders now claim that we must cut Medicare to pay for the budget deficits created by their most recent tax cuts (also for corporations and the wealthy).

Republicans continue to tout their support for pre-existing condition protections. Recently, some even sponsored a bill on the matter. But this, too, was dishonest. The bill is merely intended to give vulnerable Republicans cover for their unpopular health care vote. The sponsors know that the GOP leadership will bury the bill and will turn to cutting health care benefits if they retain power. 

Despite their misleading claims, the Republican position on health care is clear. You can have it if you can afford it.  

Edwin Amenta is Professor of Sociology at the University of California, Irvine, where he writes and teaches about social policy. He is the author of  When Movements Matter: The Townsend Plan and the Rise of Social Security. He can be contacted at ea3@uci.edu.

Drew Halfmann is Associate Professor of Sociology at the University of California, Davis, where he writes and teaches about health policy. He is the author of Doctors and Demonstrators: How Political Institutions Shape Abortion Policy in the United States, Britain and Canada.  He can be contacted at dhalfmann@ucdavis.edu.

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