- Healthcare is the leading issue going into Tuesday’s midterm elections, according to polling.
- One of the top healthcare-related campaign debates has come over protections for people with preexisting conditions.
- President Donald Trump and Republican candidates have argued that the party supports protections for people with preexisting conditions.
- Trump and the GOP’s record flies in the face of that assertion.
- Here are 4 ways that Trump and the Republicans have sought to make people with preexisting conditions worse.
Democrats have gone all out attacking Republicans for their attempts to strip preexisting condition protections away from Americans, and the GOP has been on the defensive.
President Donald Trump has continually claimed that his administration and the entire Republican Party’s healthcare platform would provide as good, if not better, protections for people with preexisting conditions.
“Republicans will protect people with pre-existing conditions far better than the Dems!” Trump tweeted Wednesday, the latest in a slew of earlier tweets on the subject.
It’s no wonder that Trump is focused on the issue: Voters rank healthcare among the most important issues for the upcoming midterm elections. Protecting preexisting conditions is a large – and popular – part of that concern.
The protections created in the Affordable Care Act, or Obamacare, made it so that insurance companies could:
- Not deny people coverage because of a preexisting condition, known as guaranteed issue.
- Not charge more because of a preexisting condition or any other health status, an idea called community rating.
But while Trump may toss out the suggestion that the GOP will provide similar preexisting condition protections for Americans, the actions of the administration and the party it represents are very much in conflict with that promise.
Outside of the GOP’s eight-year crusade to repeal Obamacare, which created the protections, the Trump administration has recently attempted to undermine preexisting condition protections in various ways.
Here’s a rundown of four different actions taken by Trump or the GOP that would harm the protections:
- Short-term, limited-duration plans: These plans used to be only available to three months at a time and could not be renewed, but the Trump administration unveiled a rule that will now allow enrollees to stay on the plans for 12 months – re-enroll for up to three years. But these plans do not have to abide by Obamacare’s preexisting condition rules, meaning people on these plans could face higher costs if they get sick. Additionally, these short-term plans could pull healthy people out of the Obamacare marketplace, leaving the pool sicker and more costly for insurers to cover. Insiders would then have to raise premiums to cover the Obamacare pool filled with people that need more robust care, including those with preexisting conditions. (Read more on short-term plans »)
- New guidance on Obamacare state waivers: On October 22, the administration released guidance on the use of the ACA’s state innovation waivers, which were designed to give states the freedom to adjust their markets to bring down premiums. The guidance could allow states to expand the use of non-ACA compliant plans. Additionally – as with short-term, limited-duration plans – the guidance could pull healthier people out of the Obamacare marketplace, making the overall ACA pool sicker and more expensive to cover. (Read more on the wavier changes»)
- The Obamacare lawsuit: Possibly the biggest outright threat to the ACA’s preexisting conditions protection is a lawsuit filed by Texas Attorney General Ken Paxton and supported by 19 other state attorneys general (including GOP Senate candidates in Missouri and West Virginia) that would effectively repeal Obamacare entirely. Republicans argue that the repeal of the individual mandate in the GOP tax law passed in 2017 invalidates the rest of the ACA, including provisions that protect preexisting conditions. The Trump administration declined to defend the ACA, leaving Democratic state attorneys general to head up the defense. The case is still pending.
- The GOP healthcare bill: The most high-profile example of the GOP possibly undermining preexisting condition protections were their attempts to repeal and replace Obamacare. While Republicans argue their bill, the American Health Care Act, would have protected preexisting conditions, most experts disagree. The law would have allowed states to receive waivers to create high risk pools in which sicker people could be placed, undermining community rating. The GOP argued they would give states funds to help combat higher costs, but experts generally agreed that the amount of money allocated was far short of what was needed.