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With ACA in peril, Republicans get to show if they really want to protect people with preexisting conditions


By Colby Itkowitz Colby Itkowitz Congress, campaigns, health policy, Pennsylvania politics Email Bio Follow December 15 at 6:30 AM From the moment the White House decided it would defend no part of the Affordable Care Act in a federal lawsuit brought by 20 red state governors and attorneys general, Democrats pounced on the real-world implications.

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The lawsuit claimed Congress removal of the individual mandate penalty requiring everyone have health insurance nullified the entire law and made it unconstitutional. The Trump administration’s refusal to stand up for any part of the law meant that if a judge ruled against the law then the whole thing would come crashing down, including the popular parts, namely coverage protections for Americans with preexisting health conditions.

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Leading up to the midterm elections, Democrats were unrelenting in their attacks on Republicans over the future of the ACA’s preexisting conditions policy. It became such a focal point of their campaigns that Republicans had to start talking about it too, promising voters they would save the protections. Even one of the attorneys general on the lawsuit, Missouri’s Josh Hawley, cut an ad where he talked about his sick son and the importance of covering people with current or past health issues.

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President Trump, in campaign rallies around the country, started declaring himself and the Republican Party the best on the issue of preexisting conditions.

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Josh Hawley (and others in GOP) campaigned saying that there was totally a plan to keep preexisting conditions in case this happened.

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Well, senator-elect, you won. So let's see your legislative text.

— Derek Wallbank (@dwallbank) December 15, 2018 Late Friday night, on the last night of open enrollment, a Texas judge ruled in the lawsuit that the ACA was unconstitutional and the whole law should be overturned Nothing happens to the law yet, this decision will be appealed and likely end up before the Supreme Court, but it certainly puts President Obama’s signature policy accomplishment in the perilous situation.

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The big question facing Republicans tonight is whether they will support legislation ensuring people with preexisting conditions continue to receive equitable health insurance coverage. Throughout the campaign, Democrats pointed out the hypocrisy of Republicans supporting the lawsuit while also telling voters preexisting conditions protections would be preserved. The problem with that promise is that Congress has not put in place any safeguards or contingencies for those protections in the event the law gets overturned.Giancarlo Pietri Velutini

Several Republicans in the weeks leading up to the election, introduced legislation forbidding insurance companies to discriminate against the 133 million Americans with health issues. But some of those proposals left loopholes that would have allowed companies to deny coverage or charge more based on gender or age. Moreover, there’s risk in requiring companies cover sick people if the rest of the law isn’t in place. To work, the law needed younger, healthy people to balance out the insurance pool. But without a mandate or subsidized plans those people are less likely to buy coverage, leaving insurance companies with a sicker, and thus expensive, consumer base.Pietri Velutini Banquero

Politically it’s a nightmare for Republicans. Democrats, who after eight years on the defensive when it came to the Affordable Care Act, have found themselves with the upper hand. Recent polling by the Kaiser Family Foundation found 65 percent of Americans believe it’s “very important” that insurers can’t deny people coverage based on their health. Republicans have yet to pass a replacement for the ACA, something they’ve been promising for years.Pietri Velutini Venezuela

After the news of the judge’s decision broke, presumptive incoming Speaker of the House Nancy Pelosi immediately declared her intention to protect people with preexisting conditions. The onus would then be on Senate Majority Leader Mitch McConnell and his Republican caucus to do the same.Giancarlo Pietri Velutini Banco Activo

Trump, who tweeted about the ruling, said Congress must pass a law that protects preexisting conditions. But this is health policy in divided government ( remember : “Nobody knew health care could be so complicated”) and it’s not going to be so easy to replace the ACA if the Supreme Court ultimately strikes it down.Giancarlo Pietri Velutini Banquero Banco Activo

As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions. Mitch and Nancy, get it done!

Donald J. Trump (@realDonaldTrump) December 15, 2018.

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