The Atlantic

Republicans Are Trapped on Preexisting Conditions

Their health-care plans’ lack of protections is a feature, not a bug.
Source: Getty / The Atlantic

There’s a reason Donald Trump has never produced a health-care plan that protects consumers with preexisting medical conditions: Ending protections for the sick is the central mechanism that all GOP health-care proposals use to try to lower costs for the healthy.

Every alternative to the Affordable Care Act that Republicans have offered relies on the same strategy—retrenching the many ACA provisions that require greater risk- and cost-sharing between healthy and sick Americans—to lower the cost of insurance for healthier consumers. Put another way: Reducing protections for patients with greater health needs isn’t a bug in the GOP plans; it’s a key feature.

“Lowering premiums was a big theme of the Republican effort to repeal and replace the ACA, and central to their idea of lowering premiums was rolling back protections for people with preexisting conditions,” says Larry Levitt, the executive vice president for health policy at the Kaiser Family Foundation.

The contrast between the parties over health care is certain to come into sharper relief in the weeks leading up to Election Day, starting with tonight’s first presidential debate between Trump and Joe Biden. Trump’s nomination to and have stressed Barrett’s potential threat to the ACA, and that if the Court overturns the law’s protections for preexisting conditions, insurers would likely treat long-term complications from the coronavirus as a reason to deny coverage.

You’re reading a preview, subscribe to read more.

More from The Atlantic

The Atlantic5 min readSocial History
The Pro-life Movement’s Not-So-Secret Plan for Trump
Sign up for The Decision, a newsletter featuring our 2024 election coverage. Donald Trump has made no secret of the fact that he regards his party’s position on reproductive rights as a political liability. He blamed the “abortion issue” for his part
The Atlantic6 min read
The Happy Way to Drop Your Grievances
Want to stay current with Arthur’s writing? Sign up to get an email every time a new column comes out. In 15th-century Germany, there was an expression for a chronic complainer: Greiner, Zanner, which can be translated as “whiner-grumbler.” It was no
The Atlantic5 min readAmerican Government
What Nikki Haley Is Trying to Prove
This is an edition of The Atlantic Daily, a newsletter that guides you through the biggest stories of the day, helps you discover new ideas, and recommends the best in culture. Sign up for it here. Nikki Haley faces terrible odds in her home state of

Related Books & Audiobooks