Wednesday July 06, 2022

In search of healthcare

August 14, 2018

Last month the Trump administration filed a court brief, joining 20 other states, Florida among them, in a lawsuit that seeks to throw out the requirement of insurance companies to cover pre-existing conditions. The states are actually arguing that Obamacare is entirely unconstitutional. The Trump administration isn’t going that far. It doesn’t need to. It’s done plenty to plunder the Affordable Care Act as it is, eviscerating so many of its provisions – cutting off subsidies, aborting birth control coverage, curtailing enrollment helpers, and actually shutting down the Obamacare website periodically (shutting down a website?), among other gouging – that the law is already an invalid hobbling in most states. But covering pre-existing conditions had become a moral red line. Then again, moral lines are mere squares in Trump’s hopscotch, there to be hopped on the way to sadism’s plum pudding.

There are many reasons to dispute the validity of Obamacare. The requirement to cover pre-existing conditions is not among them. It is the most popular provision of the 2010 law, because it’s its most effective one. Without it, Americans would go back to the days of bankruptcy by illness, and worse. No coverage doesn’t mean no care, but it means less care, much less preventive care, and more early, unnecessary deaths. As Jimmy Kimmel famously said after his son’s emergency heart surgery last year, “if your parents didn’t have medical insurance, you might not live long enough to even get denied because of a pre-existing condition.” Covering pre-existing conditions is also a principal reason health insurance exists, at least anywhere civilized health insurance exists: Life is a pre-existing condition. The rest is endurance.

The point of health insurance is that it’s there when you get sick. That’s why you pay premiums for your whole life, most of it healthy you hope. And if you happen to have diabetes or cancer or had a C-section, that shouldn’t count against you. Instead, insurers want to return to the days when pre-existing conditions, as arbitrarily defined as drug offenses, are the equivalent of a prior criminal record, there only to aggravate your sentence: Not only will you get no coverage, but you’ll get blacklisted across the industry. Until 2010 when Obamacare kicked in, the United States was the exception in the developed world where insurance companies could cherry-pick their clients. It was a simple way for actuaries and annual report fantasists to minimize services and maximize profits.

But Obamacare has done nothing to dent profits. It’s been sending them to new highs. Trump’s own White House this year reported that “the stock prices of health insurance companies rose by 272 percent from January 2014 to 2018, resulting in improved profitability and outperforming the S&P 500 by 106 percent.”

Still, insurers want to eliminate coverage for those who need it most, going back to times when they could deny one in seven people for that reason. It’s part of the ideology of greed that’s redefined the purpose of essential services. The insurance industry is not here to help you while making a decent profit along the way. You are here to help the industry make obscene profits, pouring in your premiums while you’re healthy and kindly getting out of the way when you get sick. And government should help business get its way. That’s what Florida Attorney General Pam Bondi is pushing for by joining that lawsuit. That’s what the Trump administration is hoping for by lending it its voice.

This article has been excerpted from: ‘It Should Be Criminal to Let Health Insurers Deny Coverage Based on Pre-Existing Conditions’.