The truth about Republicans and preexisting conditions

President Donald Trump and then House Speaker Paul Ryan share a smile last May at a Rose Garden celebration of the American Health Care Act.
President Donald Trump and then House Speaker Paul Ryan share a smile last May at a Rose Garden celebration of the American Health Care Act. Associated Press

On a gray and breezy Thursday last May, Republicans gathered in the White House Rose Garden to celebrate what they hoped would be the end of Obamacare. Moments before, the US House had passed the American Health Care Act, and so commenced an impromptu sales job headlined by President Trump and House Speaker Paul Ryan.

Trump hailed the bill as “a great plan.” He said it “will get even better” once the Senate improved it, a sentiment echoed by Ryan. They did not, however, dwell on how the bill treated people with preexisting conditions. The reason: While the bill would not allow insurers to cancel coverage for people who had previously been sick, it would allow for them to charge those people significantly higher premiums.

Fast forward to this fall. Republicans, now trying to save their majority in the House, still aren’t excited to talk about preexisting conditions. But when they do, they are promising to protect those Americans in any future legislation. “Always,” says the president at his rallies. “We will always protect Americans with preexisting conditions.”

It is, for many, the predominant issue of this election. (If you think you’re probably not one of those people, you should check this list.) Democrats, at least, would like it to be, because they know Americans are uncertain exactly what Republicans will do with health care legislation if they retain control of Congress. Will they protect Americans who have previously been sick, as Trump and others promise? Or will the country go back to pre-Obamacare days of insurers outright declining coverage for some of those people?

The answer is neither. The answer also is that Americans should be skeptical of the promises Trump and his party are making.

It’s true that Republicans have made progress in acknowledging how important the issue is to an overwhelming majority of Americans. But GOP lawmakers and the president have shown no signs outside their words that they will offer the same level of protections for preexisting conditions that Obamacare is providing.

Here’s what they have shown: Trump administration lawyers told a Texas court in June that they will no longer defend protections for preexisting conditions; that judge is expected to rule soon on whether the Affordable Care Act and its protections are constitutional. Thus far, all the substitute GOP health care plans and proposals have fallen short of what Obamacare offers to people who’ve had health issues.

That includes the American Health Care Act, which would have allowed for people with preexisting conditions to be charged thousands or tens of thousands of more dollars per year.

That also includes a bill sponsored by NC Sen. Thom Tillis that Republicans have touted this fall, called Ensuring Coverage for Patients with Preexisting Conditions, which experts say has loopholes that could allow insurers to deny some coverage, as well as charge higher premiums to people in less healthy communities and occupations.

Republicans, as they did last May, believe that’s still enough to claim they are protecting Americans with preexisting conditions. It’s not. Voters should remember that Tuesday.

Follow more of our reporting on Health Care Workers

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