Government & Politics

The Existing Lies About Pre-Existing Conditions

One of ObamaCare's central premises was covering pre-existing conditions, but the crisis was greatly exaggerated.

Allyne Caan · May 4, 2017

Say “pre-existing condition” lately and leftists will launch into their predetermined narrative that conservatives want to throw sick Americans to the curb. Sadly, too many Americans are predisposed to believe unfounded rhetoric, so they prejudge the issue and end up with a preponderance of baseless opinions.

In the interest of truth (not to mention as a service to the sanity of anyone who has to answer accusations of wishing uninsured purgatory on infirm people), here is the reality.

While the guarantee of coverage for those with pre-existing conditions was central to ObamaCare’s promises, Obama and his allies duped Americans by greatly exaggerating the “crisis” — an oft-used tactic of the Left. As Forbes writer Avik Roy explains, before ObamaCare (ah, remember those days?), 90% of Americans with health insurance were already enrolled in plans that required coverage regardless of pre-existing conditions. These included employer-based plans and government plans like Medicare, Medicaid and the VA. The rest — those buying insurance on the individual market — could technically be denied coverage because of pre-existing conditions.

However, only a fraction of these individual market customers actually were denied coverage because of a pre-existing condition. “We know this,” Roy writes, “because of an Obamacare program called the Pre-Existing Condition Insurance Plan, or PCIP. PCIP was designed … as a bridge until Obamacare’s insurance regulations took effect. … Americans could sign up for heavily subsidized coverage under PCIP if they had documented proof that they had been denied coverage by an insurance company and had a pre-existing condition. … Enrollment in PCIP peaked in February 2013 at 114,959.”

In short, claims that without ObamaCare over 120 million could be denied insurance because of pre-existing conditions were flat-out lies. It wasn’t even 120 thousand. But this is ObamaCare we’re talking about, so lies were par for the course.

Still, even these 115,000 wouldn’t be forgotten in the GOP House bill. Here’s why:

Assertions that the health care bill being debated in the House would allow states to get a waiver from ObamaCare’s pre-existing coverage mandate — and as a result let insurance companies send sick customers out to sea with no lifeboat — are (not surprisingly) hyperbolic. More accurately, as Ramesh Ponnuru explains, the proposed waiver would let states avoid ObamaCare’s regulations on pre-existing conditions “only for people who do not maintain insurance coverage.” In other words, those with pre-existing conditions who have coverage under ObamaCare or elsewhere would be protected from being denied coverage.

Additionally, the House bill makes maintaining coverage easier through tax credits for those purchasing insurance on the individual market. (While ObamaCare offered tax credits based on income, the House bill bases the credits on age.)

That’s not all. As the Wall Street Journal notes, “States can only receive a waiver if they avail themselves of the bill’s $100 billion fund to set up high-risk pools. These state-based programs, which were run in 35 states until they were pre-empted by ObamaCare, subsidize coverage for older and sicker patients. This helps these individuals and keeps coverage cheaper for everyone else.”

In other words, in states that get a waiver, if individuals with pre-existing conditions for some reason did not maintain continuous coverage under Obamacare or do not use tax credits to purchase insurance on the individual market, they would still have access to high-risk pools.

This is hardly tossing sick Americans to the curb.

Still, so emotionally rich and fact-depleted is the debate over pre-existing conditions that moderate Republicans threatened to reject the House bill over the issue. One of those moderates, Fred Upton of Michigan, proposed an amendment as a bargaining tool for his support — and that of other moderates. His plan would give $8 billion over five years to help individuals with pre-existing conditions pay insurance premiums. It’s window dressing that could end up increasing prices, but at least the moderates “care.”

Without a doubt, rhetoric, not realty, is driving this proposed funding boost — particularly given the protections already offered those with pre-existing conditions. Unfortunately, as we’ve seen all too often, facts are simply nuisances to those who would rather tax, spend and regulate based on lies than create the free-market environment proven throughout history to benefit more people the world over than any other government system.

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