The Pre-Existing Condition Trick


Despite What The President Tweets, If Republicans Gain Some Seats In The Senate And Keep Control Of The House–Which Is Well Within The Realm Of Statistical Probability–You Can Kiss Blanket Coverage For Pre-Existing Conditions Goodbye!


Forget what Trump and Republicans keep pledging. They’ve got a trick up or two up their sleeves that will shut many people out, while still being able to claim they weren’t out-and-out liars.

How can we say that so definitively?

A lot of media has been correctly reporting that the Trump Administration itself is part of a lawsuit challenging all mandatory aspects of Obamacare, including coverage of pre-existing conditions. That’s true. And that’s not a good thing.

But we think there’s even stronger evidence if you look elsewhere

And that’s at the 3 failed Obamacare replacement bills Republicans attempted to pass last year. Each time Republicans and Trump claimed each of the bills protected people against loss of coverage for pre-existing conditions. Technically they weren’t lying. In each case Federal Law would’ve continued to require coverage of pre-existing conditions. But that was a complete illusion and a sneaky trick, because in reality all the plans would’ve taken dramatic steps to take away or reduce that coverage. How?

  • By allowing states to waive pretty much any part of the federal law they wanted. Including the coverage of pre-existing conditions.
  • By allowing insurance companies to sell plans that didn’t cover pre-existing conditions as long as they sold at least one that did. (That was Ted Cruz’ idea). Problem with that? In order for Obamacare to work, health plans need to have a mix of relatively healthy people in order to compensate for the cost of insuring sicker ones. Since plans that shut out people with pre-existing conditions would almost certainly have much lower premiums, they’d be a lot more attractive to relatively healthy people. As a result, premiums for sicker people would almost certainly go up, because they’d be stuck in the one fully compliant plan with many other sick people. Lawmakers worked on compromises on how to deal with this outcome, mainly by proposing putting those sicker individuals into “high risk pools” that the government would support. But it was never clear how much support they’d get or how long it would last.

But maybe what Trump means by “far better” is that the Republican legislation also would’ve taken money from the mostly blue states that did a good job of getting people covered under Obamacare and  given it to the mostly red states that didn’t (or rejected Medicaid expansion funds altogether, basically because they were coming from Obama). According to reports by health research firms at the time, California would’ve lost $78-billion in funding, New York $45-billion, while Texas would’ve gained $35-billion and Mississippi $6-billion.

We’re not done yet

Because on top of that was an even bigger catch. Yes, you might indeed be covered for pre-existing conditions, unless you miss a payment. Then, if you try to sign up again in the future, guess what? No pre-existing condition coverage. That’s a big change from the way it works now. (If/when you hear Republicans talking about “continuous coverage”, that’s what they’re talking about.) Of course, Republicans don’t really have a plan ready to go right now, so there’s no way of knowing for sure if their plan will be the same this time around. But there’s no reason to believe it won’t. Especially if the Senate and House are populated with fresh, new members who are much more about getting Trump’s agenda done than their predecessors. (Remember, Republicans can lose a bunch of seats in the House of Representatives and still retain control).

So why is this such a big deal? You’re still covered as long as you keep up with your payments, right? As we mentioned last year, if someone’s a little short on cash one month, but feeling relatively healthy, their health insurance payment is probably one of the first they’re going to skip. Especially if they’re putting it up against feeding their family or staying in their home.

It also probably hits the people the hardest whom Trump says he’s trying to protect the most: families that aren’t so poor the government covers their entire healthcare premium, but aren’t wealthy enough to have wads of money always lying around, especially if some other emergency comes up. And under all the Republican plans, fewer people would’ve qualified for full subsidies in the first place.

And that’s just the beginning: Republicans say they’ll “reform” Medicare, Medicaid and Social Security too if they have the votes (Trump promised not to touch any of that so we’ll see how he navigates that), saying those social programs are to blame for the ballooning budget deficit, not their $1.5-trillion in tax handouts to corporations and the rich.