Mitt Romney made some news when he appeared on Meet the Press yesterday and said he intended to reform the health-care system to allow people with preexisting conditions to obtain health insurance:
I'm not getting rid of all of healthcare reform. Of course there are a number of things that I like in healthcare reform that I'm going to put in place. One is to make sure that those with pre-existing conditions can get coverage.
This would be big news, if true. Finding a way for people with preexisting conditions to get coverage requires some pretty major reforms. Obama’s approach (which was also, of course, Mitt Romney’s approach in Massachusetts) was to ban insurance companies from discriminating against people with preexisting conditions, which in turn required an individual mandate to make sure people didn’t only start buying insurance when they were sick, which in turn required subsidies to people who couldn’t afford insurance. You could find another way to do it, like create special insurance pools for sick people, but that would require spending a lot of money (because sick people are expensive to insure), and Romney and Ryan’s budgets are premised on massive cuts to domestic spending.
In other words, it’s not true. Romney doesn’t have a plan, or even a vague outline of a plan, to cover people with preexisting conditions. To preempt a conservative freak-out, Romney’s campaign clarified to National Review that its actual position remains, “Governor Romney will ensure that discrimination against individuals with pre-existing conditions who maintain continuous coverage is prohibited.”
The key clause here is “who maintain continuous coverage.” Romney is saying that if you have health insurance, you won’t get kicked off health insurance if you develop a serious condition, even if you switch insurers. That’s not the same as finding a way to give coverage to people who are locked out of the insurance market for medical reasons. It’s not even a new proposal. That right has existed in federal law since 1996. It’s possible Romney is saying he wants to strengthen it but, as Jonathan Cohn has explained, that’s really hard to do, and even if he could, it would be a very limited change that would affect very few people.
In any case, trying to analyze Romney’s comments about preexisting conditions as though they’re a genuine policy goal misses the point. It’s a campaign ploy. Romney is committed to fully repealing Obamacare. But since Obamacare contains a lot of popular provisions — indeed, most of them are popular — that puts Romney in the position of wanting to let insurers exclude people who are sick and do all sorts of other nasty things he’d rather not have to defend. His solution is to come up with a line that sounds like a promise to protect people with preexisting conditions, but isn’t. Indeed, it sounds so much like a promise to protect people with preexisting conditions that Romney himself forgot to add the requisite wording that rendered the pledge meaningless.