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Editorial: Meaningless Republican rhetoric around pre-existing conditions

 
Republican nominee for governor Ron DeSantis is flanked by Gov. Rick Scot at a rally at the Ace Cafe in downtown Orlando, Thursday, Sept. 6, 2018. (Joe Burbank/Orlando Sentinel/TNS)
Republican nominee for governor Ron DeSantis is flanked by Gov. Rick Scot at a rally at the Ace Cafe in downtown Orlando, Thursday, Sept. 6, 2018. (Joe Burbank/Orlando Sentinel/TNS)
Published Nov. 5, 2018

Days before the mid-term elections, Republican candidates finally recognize health care is a big issue and promise people with pre-existing conditions will continue to have access to insurance. Count among the converts Gov. Rick Scott and former U.S. Rep. Ron DeSantis, who built their political careers fighting the Affordable Care Act that provides that protection. These campaign conversions are hollow promises, because guaranteeing access to insurance for everyone with pre-existing conditions only works in the context of the broader reforms these Republicans continue oppose.

Health care consistently ranks among voters' top concerns, and polls show Democrats are trusted more to expand access to affordable care. That perception is not lost on Republicans, including President Donald Trump, who recently tweeted "Republicans will totally protect people with Pre-Existing Conditions, Democrats will not! Vote Republican."

History suggests otherwise. Republicans in Congress — including gubernatorial candidate DeSantis — voted repeatedly to repeal the Affordable Care Act. The law prevents insurers from denying coverage or charging higher premiums for people with pre-existing conditions such as high blood pressure, diabetes or pregnancy. That is what distinguishes the law from many Republican-offered "repeal and replace" alternatives. Last year, when the Senate came within a single vote of repealing the Affordable Care Act, the Republicans argued their alternative still required insurers to cover people with pre-existing conditions — but it also allowed states to opt out of that requirement and could have made coverage unaffordable. Now the Trump administration is expanding the availability of short-term health plans that don't have to cover preexisting conditions, under the false guise of consumer choice for people struggling to pay rising insurance premiums.

The Republicans' supposed solutions are disingenuous. Re-introducing junk plans that don't cover preexisting medical problems does nothing for those who most need coverage. And the Republicans' opposition to requiring everyone to have coverage is at odds with the entire premise that affordable health insurance requires creating large pools of patients to help spread the risks. Creating smaller pools of sicker patients only drives up costs.

Meanwhile, a coalition of Republican-led states is forging ahead with a federal lawsuit seeking to have the Affordable Care Act declared unconstitutional. Thanks to Attorney General Pam Bondi, Florida is part of that crusade, and Scott suggests Bondi signed on without talking to him. That's implausible, given that Bondi spent the last eight years essentially acting as Scott's general counsel rather than as an independent thinker. Now Scott is airing a warm and fuzzy ad in his U.S. Senate campaign that says he favors forcing insurance companies to cover pre-existing conditions. But the governor hasn't said Florida should withdraw from the lawsuit seeking to kill that requirement.

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It's one thing to support a politically popular idea in concept. It's another to work for it rather than fighting federal law that makes that concept a reality. DeSantis says on his campaign website that he "believes" no one should be denied care because of a pre-existing medical condition. Scott calls the issue "personal" to him. The record shows they have relentlessly fought to try to dismantle the law that protects those patients, and they cannot be counted on to follow through on these last-minute campaign promises.