All the ways Republicans are trying to destroy pre-existing conditions coverage

Do you have a pre-existing condition, like arthritis, diabetes, asthma, or about a million other problems? About one in four Americans (or over 50 million people) do. Even if you aren't personally in that group, it's highly likely one of your friends or family are — and what's more, such a condition can develop at any time.

That's why it's important for each and every American to know that, contrary to what President Trump claims, the Republican Party has made great efforts to snatch health insurance from people with pre-existing conditions. They have tried multiple times to do it through legislation and are trying to do it right now through legal and regulatory efforts.

Let's take them in turn. Back in 2017, the Republican Party tried multiple times to repeal ObamaCare with the American Health Care Act. Now, this would have preserved "guaranteed issue" regulations, meaning insurers would have to sell you a policy if you had a pre-existing condition — but it would have heavily eroded "community rating" regulations which prevented insurers from charging you through the nose for that policy. For states that set up high-risk pools, those restrictions could be removed. What's more, the AHCA subsidies for these pools were so stingy — about 6 percent of a reasonable amount — that the premiums were sure to be outrageous. An AARP report estimated that premiums in such a pool would cost about $25,000 per year, and the policies would be garbage. (A later conservative amendment had the same waiver problem.)

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This is a natural outgrowth of conservative ideology when it comes to health insurance. As House Speaker Paul Ryan has explained in detail, conservatives can't abide the idea of shifting money from one person to another (well, unless the recipient is a bank, oil company, or other wealthy businessman, but never mind). But people with pre-existing conditions often require more treatment than they can afford — sometimes many multiples of their entire income. What happens if you deliver health care through pure market institutions is that people who have expensive conditions go without treatment, unless they are rich.

That is why in a Republican utopia the pre-existing condition population would need maybe half the median household income to spare on premiums alone to be insured. And it's why the Republican Party has kept up their war on the sick even after the AHCA efforts failed.

After the AHCA went down, Republicans moved to good old judicial activism. If repealing ObamaCare through legislative action didn't work, then maybe they could make up some tendentious gobbledygook saying it violates the Constitution and get their partisan hack judges installed by Trump to approve.

Thus the lawsuit filed by the Texas attorney general, and joined by 20 other states, to overturn ObamaCare (sure enough, the "reasoning" is like something out of the Argument Sketch). In federal court, the Trump administration has filed a brief siding with the conservative attorneys general, arguing that ObamaCare's individual mandate, the guaranteed issue, and community rating regulations should all be abolished — meaning back to pre-ObamaCare rules where insurers could just straight-up deny you coverage over a pre-existing condition. Attorney General Jeff Sessions has also declined to defend ObamaCare, a decision confirmed by a Department of Justice spokesman to the The Daily Beast on Thursday.

Finally, the administration has recently taken regulatory steps to allow red states to escape from ObamaCare regulations, by widening rules to allow more cheap conservative-style plans that don't cover much. It's "a move that could boost cheaper health plans with fewer protections for pre-existing conditions," Politico reports. Oh, and last week, Senate Majority Leader Mitch McConnell said they would try again at repealing ObamaCare should the GOP win the midterm elections.

In sum, the Republican Party has consistently used every lever of power at its disposal to weaken, roll back, or outright abolish protections for pre-existing conditions, and they promise to do more if they can.

Now, all of the above is incredibly unpopular. Fully 75 percent of Americans think preserving guaranteed issue is "very important," while a further 15 percent say it is "somewhat important." The figures for community rating are 72 and 19 percent, respectively. The internal dialectic of the Republican Party requires them to attack the sick, because any GOP politician who is seen to stand behind the dread ObamaCare is certain to draw a firestorm of criticism from Fox News and probably a primary challenge.

To wriggle out of this bind, the Republicans have chosen baldfaced up-is-down, black-is-white lying. Trump as usual takes it the furthest, lying not only that his party will protect pre-existing conditions regulations, but also that the Democrats — who, let's recall, passed the regulations he is talking about in the first place — are the ones would would repeal them.

Health care is consistently ranked among the most important political issues — but it's getting little media attention. In a recent poll, twice as many respondents reported they had heard "a lot" about Elizabeth Warren's DNA test, or the nasty name Trump called a porn star, as had McConnell's latest plot to repeal ObamaCare.

Luckily, the issue is easy to understand. If you want to protect the sick, vote against Republicans.