The Corner

Politics & Policy

The Phrase ‘Pre-Existing Conditions’ Leads to the Suspension of All Thought

The moderates are abandoning the health-care bill largely because it makes it possible for states to get a waiver from the pre-existing condition regulation in Obamacare. This is being distorted as an abolition of that regulation, with the moderates either contributing to the misunderstanding or being carried along by it. Ramesh ably explained the other day why this isn’t true. But apparently all you have to do to win the debate over Obamacare repeal is say “pre-existing condition,” regardless of whether you have any idea what you are talking about. I don’t think anyone wants to go back to the pre-Obamacare status quo on this issue, but Avik Roy had a good piece at Forbes on how this problem was exaggerated during the original Obamacare debate:

First: prior to Obamacare, the vast majority of Americans with health insurance were already in plans that were required to offer them coverage regardless of pre-existing conditions. Employer-based plans were required to offer coverage to everyone regardless of pre-existing conditions. So were Medicare, Medicaid, and other government programs like the VA. Employer- and government-based plans, prior to Obamacare, represented 90 percent of Americans with health insurance.

The other 10 percent were people buying coverage on their own, on the individual market. In most — but not all — states prior to Obamacare, people buying coverage on their own could, in theory, be denied coverage for a pre-existing condition.

That gets us to point number two: that in practice, a tiny percentage of Americans were being denied coverage due to a pre-existing condition prior to Obamacare. We know this in general because surveys consistently indicated that this was the case, and in detail because of an Obamacare program called the Pre-Existing Condition Insurance Plan, or PCIP.

PCIP was designed to work from the years 2010 to 2014, as a bridge until Obamacare’s insurance regulations took effect. During those years, 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.

But good luck getting anyone to take note of any of this.

Rich Lowry — Rich Lowry is the editor of National Review. He can be reached via email: comments.lowry@nationalreview.com. 

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