The Corner

Health Care

McSally Is Right About Pre-Existing Conditions

At the Huffington Post, Jonathan Cohn accuses Arizona Republican Senate candidate Martha McSally of “deceiving the public” and “rewriting history” about health care in a recent debate.

At issue is her vote for the House version of the Obamacare-repeal bill. McSally said, “I voted to protect people with pre-existing conditions. We cannot go back to where we were before Obamacare, where people were one diagnosis away from going bankrupt, because they could not get access to health care.”

The bill for which McSally voted included protections for people with pre-existing conditions. Those protections would be stronger than the ones in place before Obamacare. They would, however, be weaker than the ones in Obamacare; how much weaker is a matter on which reasonable people can disagree. McSally is glossing over that point, as one would expect, but that strikes me as a matter of political spin rather than deceit.

The bill would have allowed states to apply for a partial waiver from Obamacare’s rule that insurers cannot discriminate based on health status. That waiver would apply only to people who had not maintained continuous insurance coverage—and maintaining continuous coverage would be easier than it was in the pre-Obamacare world. (It would be easier because the bill largely continued Obamacare’s tax credits and prohibited insurers from discriminating against people with chronic health conditions who, for one reason or another, were switching their coverage. It would also be easier because even under the Republican bill, Medicaid would still cover a larger share of the population than it had before Obamacare, although how much larger is open to dispute.)

The Republican bill also included funding to help those who fell through the cracks of this new regulatory regime—that is, for people with pre-existing conditions, in waiver states, who had not maintained continuous coverage. The adequacy of all these protections can be debated. But what McSally said is correct.

Ramesh Ponnuru is a senior editor for National Review, a columnist for Bloomberg Opinion, a visiting fellow at the American Enterprise Institute, and a senior fellow at the National Review Institute.

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