It is slowly and belatedly dawning on the Republican Congress that health care has become its greatest liability. “The Democrats’ most potent national policy issue in the 2018 midterms is health care,” warns Karl Rove. Republicans are scrambling to defend themselves. Several of the most vulnerable Republicans in Congress have erased their websites’ references to their goal of repealing Obamacare. Others are emphasizing their support for a 2017 bill purporting to protect those with preexisting conditions from being denied care. “When it comes to health insurance, Donald Trump and Republicans will protect patients with preexisting conditions,” announced Trump last night. “We’re gonna do that. We want to do that.”
They’re not gonna do that.
Republicans have been promising since 2009 that they would unveil a plan of their own that would accomplish Obamacare’s goals of making health care affordable to people with expensive health needs. They have never done so. They have a new impetus given the confluence of timing between their latest long-shot effort to repeal Obamacare through the courts and the November elections.
Numerous Republican state officials, including Senate candidates in swing states like Missouri and West Virginia, have signed on to a lawsuit seeking to challenge Obamacare as unconstitutional. As legally silly as the claim may be, it creates a massive vulnerability for Republicans, who find themselves in support of a legal gesture to allow insurance companies to bring back price discrimination against people with preexisting conditions.
Their latest gesture at covering their weakness is a bill called the “Pre-existing Conditions Protection Act,” which is gaining new Republican support in the run-up to the election. The bill would supposedly protect people with preexisting conditions from being denied coverage by preventing insurers from denying them coverage. The flaw with the bill is that it doesn’t say what kind of coverage the insurers have to sell or at what price.
McClatchy contacted numerous health-care experts to evaluate the “Pre-existing Conditions Protection Act,” and they all consider the bill worthless. “They have to cover you, they can’t exclude coverage of your preexisting condition or deny you coverage, but they can charge you a million a month, they can charge you a deterrent premium,” explains Karen Pollitz, senior fellow at Kaiser Family Foundation.
A Republican spokesman insists to McClatchy that the bill would too protect people with preexisting conditions. But that’s simply not possible, given the party’s overall health-care position. If you recall, any time Republicans explain why they hate Obamacare or what they would do better, they use terms like “one size fits all” (bad!) or “choice” (good!) to frame the contrast. What these buzzwords mean is that Republicans want to end cost-sharing within the individual market. They want to give healthy people the choice to buy insurance that doesn’t cover expensive treatments they don’t currently need.
Republicans promise that this will reduce premiums for those healthy customers. That’s correct, in many cases. What it omits is that it shifts the costs onto other people. Republicans’ favorite example — that of maternity coverage — reveals the problem pretty well. They want people who don’t need maternity coverage to save money on their premiums by being able to get policies that don’t cover it. But if the only people who get maternity coverage are the minority of young people who might have a baby soon, then they alone will finance all the cost of maternity coverage, which would become massively expensive.
Republicans have spent the entire health-care debate since 2009 making demagogic attacks on every method Obamacare takes to make health care affordable for people who are too poor or sick to pay for their own care. Republicans oppose new taxes, and they oppose regulations that shift costs from the sick to the healthy. That means that they oppose what actually makes it possible for people with preexisting conditions to afford access to modern medicine. They are still desperately trying to hand-wave away the contradiction, and a phony bill to give “access” to insurance with a million-dollar premium is merely the latest step.