Republicans must be smart, for once. Don’t hand the Democrats a phony issue with which to beat us over the head.
In crafting a Republican replacement for Obamacare, in the wake of the real possibility that Obamacare will be, finally, thrown out by the courts, the GOP plans must explicitly require that pre-existing conditions be covered in all government-subsidized policies. If not, the Democrats will use the issue to win elections for years to come.
As the Democrats seek to pivot away from their failed accusations about Russian collusion, they are focusing on health care, using Trump’s proposals to change Obamacare to stoke panic about the coverage of pre-existing conditions. They are trying to mobilize their base by painting a picture of millions of Americans denied adequate coverage because of pre-existing conditions.
But don’t fall for it. Here are the facts:
Both parties embrace coverage for pre-existing conditions. The difference is that Republicans want to allow insurance companies to offer plans that do not cover pre-existing conditions as long as everyone who wants to do so can buy a policy that does cover them. Democrats do not want to offer people the choice of cheaper plans with no protection against pre-existing conditions. They want there to be only plans that cover them.
Democrats say that allowing companies to offer both kinds of policies — as opposed to requiring pre-existing conditions to be covered — would lead many cost-conscious consumers to choose to do without the coverage for pre-existing conditions, leaving them bereft later on. They also accuse the Republicans of skimming off the healthier people with plans that do not cover pre-existing conditions, driving the cost of those that do even higher.
So both parties want to require that all companies offer policies that cover pre-existing conditions but the GOP wants to allow them to offer a choice of some plans without this protection
While there is a case for the Republican point of view that people should have a choice, it is a political mistake to insist on it. Democrats will be able to portray Republicans as blocking coverage for pre-existing conditions. They will make this their political rallying cry. Better to deny Democrats this foothold and require that all policies cover pre-existing conditions.
The Democratic embrace of the issue of pre-existing conditions comes after their previous obsession — covering the uninsured — no longer works. The number of uninsured has dropped from 44 million before Obamacare to less than 27 million today. And ten million of those still without insurance are here illegally. Why should a health insurance card be the only valid form of legal documentation they have?
With only 17 million uninsured citizens or legal immigrants — less than five percent of the country (and many of those uninsured by choice) — the Democrats needed to find a new excuse to scare people — and they found it in the issue of coverage of pre-existing conditions.
Meanwhile, the Democrats are seeking to make an issue of Trump’s efforts to invalidate the Obamacare law by arguing that it was only originally affirmed by the Supreme Court under Congress’ power to tax. The administration argues that without the fine for not having insurance, included in the original law but since stripped out, there is no tax in Obamacare and hence nothing on which to hang its constitutionality
But the emotional clout of the Democratic position all revolves around the issue of coverage of pre-existing conditions. We all peer into our past — more as we get older — and find pre-existing conditions that stoke our fear of losing coverage. Closely allied to this terror is the worry that insurance companies will drop us when we get sick without protections about pre-existing condition coverage.
Republicans should not allow Democrats to play this card. By covering pre-existing conditions — and permitting no other type of plan — they defang the issue and take from the Democrats their leading selling point.
The Democrats also deride Trump’s efforts to permit insurance plans to be offered that do not cover the full range of conditions. They call it “junk coverage.” But there is no way they can convince Americans that it is OK to charge higher premiums so that every medical procedure (including addiction recovery and maternity benefits for men) has to be covered even if it drives up premiums or necessitates every larger federal subsidies.
Republicans, in designing their alternative to Obamacare, need to bend on the issue of pre-existing coverage but need not waiver on the right to buy policies with less than complete coverage for all illnesses.
If the GOP drafters of the Republicans’ health care plan follow these guidelines, they can navigate these waters without running aground and truly make the Republicans the party of health care.
Several revisions were made to this Op-Ed after publication at the request of the author. — Ed. note
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