No, Pre-Existing Conditions Are Not Like Car Wrecks

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One of the most maddening aspects of the debate over Obamacare isn’t simply the fact that conservatives dislike it, but the fact that they seem unable even to understand what the point is. Via Ed Kilgore, here is Georgia state insurance commissioner Ralph Hudgens—surely a guy who should understand what insurance is and how it works—comparing pre-existing condition requirements to having a car wreck:

A pre-existing condition would be then you calling up your insurance agent and saying, “I’d like to get collision insurance coverage on my car.” And your insurance agent says, “You’ve never had that before, why would you want it now?” And you say, “Well I just had a wreck, it was my fault, and I want the insurance company to pay for the repairs to my car.” And that’s the exact same thing on pre-existing insurance.

Well, sure, it’s the exact same thing except for the fact that it has nothing in common whatsoever. In fact, this is basically a defense of the individual mandate, though Hudgens doesn’t seem to understand that either.

People with pre-existing conditions aren’t folks trying to scam the system. They’re just people who got sick. And Republicans simply have no realistic plan for allowing them access to affordable health care. This is a problem for the GOP, because unlike the $100-a-plate crowd that tittered at Hudgens’ story, most people understand that pre-existing conditions can happen to anyone. That’s why Obamacare’s requirement for community rating—i.e., for insurance companies to cover people with pre-existing conditions at the same price as anyone else—is so popular. What most people don’t quite understand is that this is what produces the rest of Obamacare too. If insurance companies have to cover people with pre-existing conditions, they’ll go out of business unless they cover everyone else too. That way the entire insurance pool covers the small number who get seriously sick in any given year. So you have to have an individual mandate. But lots of people can’t afford insurance. So if you have an individual mandate, you have to have subsidies for low-income workers. And with that, you have community rating, the individual mandate, and subsidies. And that’s about 90 percent of what Obamacare is.

It’s one thing to oppose Obamacare. But Republicans have no realistic alternative. They can blather away about tort reform and HSAs forever, but even low-information voters dimly understand that it’s just blather. Either you’re going to cover sick people or you aren’t. And if you do, you’re going to end up with something that has most of the same features of Obamacare. Smarter Republicans understand this perfectly well, which is why they dance around the issue so manically. They know that their plans don’t actually provide health coverage for much of anyone at all. Dimmer Republicans like Hudgens don’t have a clue, so they just tell dumb stories to well-heeled crowds. I’m not really sure which is worse.

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THE TRUTH...

is the first thing despots go after. An unwavering commitment to it is probably what draws you to Mother Jones' journalism. And as we're seeing in the US and the world around, authoritarians seek to poison the discourse and the way we relate to each other because they can't stand people coming together around a shared sense of the truth—it's a huge threat to them.

Which is also a pretty great way to describe Mother Jones' mission: People coming together around the truth to hold power accountable.

And right now, we need to raise about $400,000 from our online readers over the next two months to hit our annual goal and make good on that mission. Read more about the information war we find ourselves in and how people-powered, independent reporting can and must rise to the challenge—and please support our team's truth-telling journalism with a donation if you can right now.

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