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How to Fully Protect People with Pre-Existing Conditions: It's Called Medicare for All

While Democratic candidates have rightfully exposed the outlandish lies by Trump and numerous Republicans suddenly acting as defenders of the sick, the inconvenient truth is that even with the ACA, insurance companies have found numerous ways to skirt the law, part of their business goals which prioritize profits over patients

House Minority Leader Nancy Pelosi, (D-CA) gestures during a news conference held by House Democrats condemning the Trump Administration's targeting of the Affordable Care Act's pre-existing condition, in the US Capitol on June 13, 2018 in Washington, DC. (Photo: Toya Sarno Jordan/Getty Images)

Republicans will totally protect people with Pre-Existing Conditions, Democrats will not! Vote Republican – Donald Trump

In George Orwell’s Animal Farm, the top dog, or pig in this case, Napoleon can’t get the land to produce food, so he makes it up. For example Napoleon orders nearly barren storage bins be loaded up almost to the brim with sand, deceiving a human onlooker to report there was no food shortage on the farm. After he finally leaves the White House, Trump could play Napoleon in a remake of Animal Farm.

Or maybe Trump was best explained by Mark Twain more than a century ago – “one of the striking differences between a cat and a lie is that the cat only has nine lives.”

Facts apparently have little meaning to this President and his administration, but they are twisted, distorted and repeated over and over for the benefit of its most loyal defenders.

Why is Trump making this easily refutable claim?

As the Houston Chronicle reported October 24, more than 100 million people in the U.S. have “pre-existing” health conditions – which can range from cancer treatment to chronic conditions like high blood pressure, asthma, diabetes, or even pregnancy. 

"Increasingly, Americans across the board, regardless of political affiliation, age, ethnicity, or whether they live in a city or rural area, or red or blue, now support Medicare for All as the real, lasting solution to assure them and their families real health security."

An October Kaiser Family Foundation (KFF) poll found that health care is the number one issue for voters in the mid-terms, and protection of pre-existing conditions is a key concern, along with, of course, the escalating out-of-pocket costs for care.

In the key battleground states of Florida and Nevada where healthcare is the “most important” issue for voters in making their electoral choice, KFF reported, two thirds of the voters say they are more likely to vote for a candidate who supports maintaining pre-existing conditions protections.

Yet the past does not work well for Trump or the Republicans he is trying to promote in November, most of whom have their own records to disown.

The Napoleon act is pretty easy to expose:

  1. After the Affordable Care Act, with its requirement that insurance companies stop the disgraceful practice of denying coverage to people with pre-existing conditions, was passed, Republicans in Congress voted dozens of times to repeal it -- a point conveniently ignored by numerous Republican incumbents (at least 32 of them according to Think Progress) who voted for the repeal. That includes, for one, former Rep. Ron DeSantis, now running for Florida governor as a protector of people with pre-existing conditions  against Democrat Andrew Gillum, a strong advocate of health care rights.

  2. In 2013, Congressional Republicans carried out a 16-day partial shutdown of Congress in a failed effort to force repeal of the law. The shutdown was inspired and led by Sen. Ted Cruz who, parroting Trump’s prevarications, said in a debate with his Senate election opponent Rep. Beto O’Rourke last week, “we can protect pre-existing conditions, and you need to understand, everyone agrees we’re going to protect pre-existing conditions.”  Really Ted?

  3. With Trump in office, Republicans in Congress finally thought they’d get a Presidential signature to repeal the ACA, trying again but falling just one vote short due to one of John McCain’s last acts in the Senate. Senate Majority Leader Mitch McConnell recently said that post-election he hopes to take another shot at repealing the ACA.

  4. A major lawsuit by Texas Attorney General Ken Paxton, backed by 19 other Republican state attorney generals, including some running for office now, seeks to overturn the ACA including the provision on pre-existing conditions. Trump’s Department of Justice is refusing to defend the ACA, defacto endorsing the lawsuit.  A  federal judge heard the case in early September. The DOJ asked the judge to hold off a ruling during the open enrollment period, a move many believe is intended to protect GOP candidates who are desperately claiming they want to protect people with pre-existing conditions.

  5. Executive orders signed by President Trump would permit and encourage states to sell junk insurance plans that evade many of the requirements of the ACA, including coverage for people with pre-existing conditions, or forcing them to pay much higher costs for the plans. Kaiser Family Foundation estimates that as many as 41 percent of adults in some areas could be rejected for coverage as a result of this policy and other pre-ACA guidelines.

How to Really Protect People with Pre-Existing Conditions – Medicare for All

While Democratic candidates have rightfully exposed the outlandish lies by Trump and numerous Republicans suddenly acting as defenders of the sick, the inconvenient truth is that even with the ACA, insurance companies have found numerous ways to skirt the law, part of their business goals which prioritize profits over patients.

In the Lancet last year, MDs Adam Gaffney and Danny McCormick described some of the ways insurers game the system, for example structuring the narrow networks their plans include to exclude access to specialty care providers, such as prominent cancer centers, and “tailor(ing) benefit packages to discourage high-cost patients from choosing or remaining in their plan.” Those tactics are clearly intended to screen out patients with higher cost pre-existing conditions. 

While stopping this attack, there’s a surer method to protect patients.

As KFF’s Larry Levitt points out, “the ACA isn’t the only way to protect pre-existing conditions. Medicare for all does it.”

An improved Medicare for All guarantees everyone can get health care, not just “insurance,” when and where you need it without the restrictive insurance networks, limited drug formularies, caps on coverage, and punitive care denials.

Increasingly, Americans across the board, regardless of political affiliation, age, ethnicity, or whether they live in a city or rural area, or red or blue, now support Medicare for All as the real, lasting solution to assure them and their families real health security.

And that’s the reason why more than half the Democratic candidates running for the House in the mid-terms support Medicare for all and why the Trump administration and its acolytes are so vehemently attacking it.

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Chuck Idelson

Chuck Idelson is the Communications Director for the California Nurses Association/National Nurses Organizing Committee, the nation's largest organization of direct care registered nurses with 80,000 members from California to Maine.

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