Email #157: “charged more because of a pre-existing condition”?

According to a Quinnipiac University poll released yesterday, 64% of respondents approve of the ACA’s protections for people with pre-existing conditions, and 75% think it’s a “bad idea” to allow states to opt out of them. That includes a majority of Republicans–59%.

But despite this overwhelming support, I keep reading contradictory claims about whether “Trumpcare” would cover pre-existing conditions.

The President tweeted in April:

“New healthcare plan is on its way. Will have much lower premiums & deductibles while at the same time taking care of pre-existing conditions!”

He added on TV:

“Pre-existing conditions are in the bill. And I mandate it. I said, ‘Has to be.'”

Your form letters to me have also emphasized the importance of maintaining the ACA’s ban on pre-existing conditions, highlighting its inclusion in an early version of the American Health Care Act. But after that version did not have enough Republican support to make it to the House floor for a vote, the MacArthur amendment allowed states to waive protections. Under the amended AHCA that you voted for, insurers can charge much higher premiums for people with pre-existing conditions—but only if they’ve gone uninsured for two months. The House GOP website states this clearly:

“The MacArthur amendment to the AHCA does allow states to seek a limited waiver to allow the insurance companies to charge higher premiums for a person with a health condition only if they do not maintain continuous coverage.”

However, the GOP website also states:

“Americans should never be denied coverage or charged more because of a pre-existing condition.”

Or at least the website used to say that. The New York Times referenced that statement on April 26, and NBC referenced it on May 4. But when I went to the website myself over the weekend, I couldn’t find it. I presume it was deleted—and for good reason: it’s not true of the AHCA.

Unfortunately for those who voted for the bill, it does remain true morally. It shouldn’t matter if someone has no insurance for two months, or for any period of time. So-called pre-existing conditions shouldn’t be used against any American. Before the ACA, pregnancy was a pre-existing condition. Under the AHCA waiver, it can be again. So if an uninsured women gets pregnant and tries to sign up for insurance, she can be automatically overcharged.

The term “pre-existing condition” was invented by insurance companies for the purpose of limiting coverage for people who most need it. “Obamacare” struck the concept entirely. Now “Trumpcare” is resurrecting it.

Voters–both Democrats and Republicans–will remember that in 2018.

Author: Chris Gavaler

Chris Gavaler is an associate professor at W&L University, comics editor of Shenandoah, and series editor of Bloomsbury Critical Guides in Comics Studies. He has published two novels: School for Tricksters (SMU 2011) and Pretend I’m Not Here (HarperCollins 2002); and six books of scholarship: On the Origin of Superheroes (Iowa 2015), Superhero Comics (Bloomsbury 2017), Superhero Thought Experiments (with Nathaniel Goldberg, Iowa 2019), Revising Fiction, Fact, and Faith (with Nathaniel Goldberg, Routledge 2020), Creating Comics (with Leigh Ann Beavers, Bloomsbury 2021), and The Comics Form (Bloomsbury forthcoming). His visual work appears in Ilanot Review, North American Review, Aquifer, and other journals.

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