Sen. Baldwin calls GOP's bluff on pre-existing conditions

2018 MIDTERM ELECTION

Time: D H M S

U.S. Senator Tammy Baldwin (D-WI) recently introduced a new bill which, while it has zero chance of actually passing (or even being voted on) neatly tackles not one but two different types of Republican sabotage of the Affordable Care Act: The expansion of short-term plans being pushed hard by Donald Trump and the elimination of pre-existing condition protections being pushed hard by 20 GOP Attorneys General in the idiotic #TexasFoldEm case. Per Dylan Scott in Vox last week:

Senate Democrats are preparing a long-shot procedural maneuver to reverse new Trump administration regulations that they say would sabotage the Affordable Care Act by expanding “junk” insurance that isn’t obligated to cover preexisting conditions.

Sen. Tammy Baldwin (D-WI) is leading the effort, introducing a resolution to unwind the Trump administration’s expansion of short-term insurance plans. Those plans are not subject to Obamacare’s rules for preexisting conditions or essential health benefits and Democrats dismiss them as “junk.”

“It is sabotage, in my mind, against the guarantees for preexisting conditions,” Baldwin told me and other reporters on Tuesday. “These policies aren’t worth the paper they’re written on.”

Baldwin is doing so under the purview of the Congressional Review Act, which gives Congress the ability to reverse federal regulations within a certain time window. The odds of Baldwin’s resolution bearing fruit are long: The House would have to pass the same resolution, and President Donald Trump would have to sign a measure unwinding his own administration’s agenda or there would need to be a veto-proof majority.

Um...yeah. That's not gonna happen.

But the Senate Democratic offensive also gives the minority an opening to keep health care and preexisting conditions — Democrats’ core themes in the 2018 midterms — as live issues ahead of November.

Baldwin, who has had a preexisting condition since she was 9 and is facing a serious reelection fight of her own against Republican Leah Vukmir, says she has the 30 senators needed to force a vote under the Senate’s discharge petition rules. She is eyeing “some time in October,” she said, though there is no firm schedule.

OK, so it's a symbolic move only, of course, but in addition to highlighting how crappy short-term plans are, this is also a great way of forcing Republicans to put their money where their mouths are when it comes to the issue of pre-existing condition protections. As Jonathan Cohn and Kevin Robillard noted the other day:

In reality, Hawley and other Republicans have no concrete or well-developed plan for replacing the law with something that would provide the same kind of access. If either the lawsuit he supports or repeal legislation were successful, people with cancer, diabetes and a variety of other chronic conditions would have a much tougher time getting comprehensive coverage. The GOP, including Hawley, is now talking up a Senate bill experts have said wouldn’t solve the problem.

Hawley is hardly the only Republican Senate candidate making statements so inconsistent with his record.

Mike Braun in Indiana, Martha McSally in Arizona, Patrick Morrisey in West Virginia, Rick Scott in Florida ― the list goes on. All across the country, Republicans running for Congress are promising voters they will look out for people with pre-existing conditions while supporting some combination of legislation, litigation and regulation that would undermine those very protections.

Baldwin's bill is a perfect way of putting the GOP in a bind over their hypocrisy on the pre-existing condition issue (well, it would be if they had the slightest bit of shame or self-awareness, anyway). If they really believe no one should be denied coverage for having a pre-existing condition, they'd be all for reining in or outright eliminating so-called "short-term, limited duration" plans...as well as any other type of healthcare policy which can discriminate against people based on their medical condition, for that matter, including "Health Sharing Ministries" and even pre-ACA "Grandfathered" and "Transitional" policies.

Of course, they don't actually believe that, or else they'd either a) NOT vote over and over again to repeal the ACA or b) would have come up with their own alternative which does truly protect people with pre-existing conditions...which, of course, they haven't.

This is hardly surprising. Covering people with pre-existing conditions costs a buttload of money no matter how you slice it. The best way to mitigate that cost is to spread it as widely and evenly as possible, via the largest and most stable risk pool you can. The ultimate example of that, of course, would be a single risk pool with all 320 million Americans in it...and the most obvious variety of that would be...wait for it...Medicare for All or similar.

So, the GOP has once again painted themselves into a corner: They keep trying to square the circle on healthcare coverage and costs, but there's no getting around it: If you want to cover everyone with pre-existing conditions, it's gonna raise the cost of healthcare quite a bit. That means someone has to pay for it all. If you further pledge not to dump those costs onto the individual enrollees, that means the government has to pay for the bulk of it...and that means raising revenue, generally in the form of higher or new taxes. The GOP refuses to do that (and in fact just slashed taxes by a whopping $1.5 trillion over the next decade for not particularly good reason), so they're left with...not covering pre-existing conditions.

Wash, rinse, repeat.