Republicans say they want to protect people with pre-existing conditions. But this is like saying you want to reduce gun violence -- while also advocating legal concealed carry and the elimination of all background checks for gun ownership 1/ huffingtonpost.com/entry/republic…
To make affordable insurance available for people with preexisting conditions, you need guaranteed issue -- insurers can't turn you down -- and community rating -- they can't charge you high premiums because of your medical history 2/
But even these steps aren't enough by themselves, because they can lead to a situation in which healthy people don't sign up, so you have a sick risk pool and prohibitively high premiums. So you need more: incentives for the healthy to buy insurance 3/
A mandate requiring you to have insurance helps, but can't work unless you also provide financial aid to people with lower incomes to make sure they can afford the premiums. Obamacare did both of these things -- because that's what the logic required 4/
Republicans have killed the mandate, which has damaged the program -- but not as much as one might fear, because the subsidies limit premiums as a percentage of income for the majority of those signing up. So the ACA is still standing, if somewhat eroded 5/
Republicans will not come up with an alternative that still protects people with pre-existing conditions. I don't say this based on knowledge of what they'll propose, but because any plan that really protects PECs *has to look a lot like Obamacare* 6/
So what's coming if Rs hold Congress will be a massive exercise in fraudulence: a bill that pretends to protect pre-existing conditions, but actually doesn't, and would cause millions of vulnerable people to lose coverage. That's not speculation, it's deduction 7/
It will also be a test for the news media -- in fact, the test has already started. Will they accept R lies about health care -- because that's what they will be -- at face value, or at most say "some Democrats" say their plans won't do what they claim? 8/
