Monday, January 18, 2021

Pre-existing conditions

Glenn Kessler of the Washington Compost says that soon-to-be ex-President Trump has lied about pre-existing conditions. Link

Far more truthful is that Kessler's article is a big fat lie, as was Kamala Harris saying basically the same thing while debating before the November election last year. Both Kessler and Harris talk as if pre-existing conditions is a widespread concern, whereas in fact it is an extremely narrow concern. It pertains to so few people that Kessler and Harris make a mountain out of an ant hill.   

Like I argued here, Harris absurdly claimed that Trump/Pence would take away health insurance from people who have pre-existing conditions. Harris' vague lie said, "you have Donald Trump who is in court right now trying to get rid of – trying to get rid of the Affordable Care Act (ACA), which means that you will lose protections, if you have pre-existing conditions. ... If you have a pre-existing condition, heart disease, diabetes, breast cancer, they're coming for you."

Trump/Pence have not done or advocated any such thing. They got rid of one small part of the ACA --the mandate to buy health insurance by reducing the penalty to $0 for non-compliance. They did nothing to eliminate the ACA's health insurance exchanges, or cancel the insurance of people with pre-existing conditions. Insurers on the Obamacare health insurance exchanges cannot refuse an applicant for pre-existing conditions and are prevented by law from ending somebody's coverage because the insured has pre-existing conditions.

Insurers who sell Medicare Advantage and Medicare supplement policies cannot refuse coverage to a person when they first become eligible for Medicare. Medicare itself does not deny coverage to people with pre-existing conditions. These rules concerning Medicare, Medicare Advantage and Medicare supplement policies existed long before the Affordable Care Act. A total repeal of the Affordable Care Act would thus not alter those programs.

In summary pre-existing conditions pertain to only a very small segment of the population -- those below age 65 trying to get individual insurance outside the the Obamacare health insurance exchanges and those over age 65 who have a Medicare supplemental policy (not Medicare Advantage) and want to switch carriers. These are the only two situations an insurer can underwrite and decline to provide new coverage. 

Even when people lose health insurance due to a job loss, insurance in the form of Medicaid or CHIPs (link) may be obtained not subject to pre-existing conditions.

Kessler falsely asserts, "Trump had nothing to do with the ACA, signed into law by President Barack Obama in 2010." That is irrelevant. When the ACA was modified like Trump wanted, nothing about pre-existing conditions was modified. 

Kessler asserts, "Before passage of the ACA, even minor health problems could have led an insurance company to deny coverage." This makes a mountain out of an anthill, due to the very few times an insurer can decline to provide new coverage.

Ironically then, Kessler's article is worth four Pinocchios.

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