Under Trumpcare, Being a Human Is a Preexisting Condition

We're all going to get sick or hurt and we shouldn't be punished for it.
June 28, 2017, 9:29pm

There are a few truths to being a human:

  • You're going to die someday. Sorry!
  • Along the way you'll get sick and injured and sick again.
  • Access to good healthcare will prevent #2 from turning into #1 before it should, and before you get the chance to enjoy the many, many happy, productive human days you've got to live.

It feels insane to have to write this, but here we are. I wrote in March about just how craven is House Speaker Paul Ryan's attempted dismantling of the healthcare system. In short, Ryan and his fellow GOP congresspeople are trying to pretend that getting sick is a matter of personal responsibility, that some people don't deserve health insurance because being sick is a personal failing, or a personal choice. It's tortured logic that's merely a cover for one of the greatest thefts in American history: The wellbeing of millions is being traded for tax cuts for the super-wealthy.

But gutting healthcare spending and providing smaller tax credits to buy insurance isn't the only way the GOP is taking a hatchet to America's medical system. One of the more slippery, insidious provisions currently designed is in the Senate's healthcare bill. Unlike Ryan's bill, the Senate bill does not include language allowing states to waive protections for people with pre-existing conditions. But the Senate bill does something even worse: By expanding allowable exemptions for "essential health benefits" (EHBs, or basic required services laid out by Obamacare), it will allow insurance providers to sell people health insurance that doesn't actually cover their health problems.

As Tonic's Susan Rinkunas wrote in a good comparison of the bills:

House bill: It let states opt out of the requirement that they cover the same ten "essential health benefits" or EHBs, set by Obamacare, which include maternity care, prescription drugs, and mental health and addiction treatment. States could opt out with waivers, known as 1332 waivers.
Senate bill: Dramatically expands the state waiver program, and crucially and shockingly, removes the requirement that states applying for waivers have to guarantee to cover as many people with coverage that's as affordable and as comprehensive. Governors can also seek these waivers without consulting their state legislatures, aka the elected representatives of the people the waivers would affect.
What it means: True, a person with cancer couldn't be denied insurance or charged more for a plan, but it's possible that their state would only offer plans that don't cover cancer treatment. Same goes for people with mental health conditions who need inpatient or outpatient care. And this provision would once again permit price discrimination against women simply because they can get pregnant and give birth and men can't.

Pretending to cover patients with preexisting conditions while actually removing protections for a huge swath of entirely normal human conditions—including pregnancy, my god—is dastardly and cowardly in equal measure. That's a hard level of shittiness to reach! But it's even worse because this assault on preexisting conditions is just one part of the GOP's larger demonization of the sick or pregnant as a drag on everyone's wallets, which entirely ignores that getting sick (or pregnant) is an inevitable part of being human. To attack healthcare from a snide position of virtuous invincibility is one hell of a disgusting way to rob Americans in service of the rich.

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It's terrifying to know that the soulless automatons controlling Congress want me to live the rest of my life with the nagging fear that I'll never get affordable health insurance again. I was diagnosed with testicular cancer four months ago, and I've already racked up close to $200,000 in medical bills since. This is despite everything going as smoothly as one could hope for: this the most common form of cancer for young men (I'm 29), I caught it early, and have a medical team with enough experience and data to make treatment a straightforward affair.

I still had absolutely zero way of preparing for having $200k of bills dropped in my lap. Except, of course, I'm lucky enough to have a good job with good insurance.

I do have to spend the next few years—and the rest of my life, really—with the thought in the back of my mind that the cancer could still be there lurking somewhere in my body, or it might come back, or some other rogue cells will also discover my body is a cancer wonderland, or whatever. I'm doing my best not to worry about it; plenty of people have it far worse.

Even with a good job from a caring employer, letting states set their own essential benefits (which effectively kills pre-existing conditions protections) means very simply that you and I could both end up with useless health insurance that has annual and lifetime limits. That's because many insurance providers are going to take any cost-saving loophole they can. Or maybe I'll spend the rest of my life in high-risk pools with unconscionable premiums just because one of my balls randomly turned against me when I was 29.

This is a story that will be repeated millions of times across America if the Senate's bill takes hold. People everywhere will get priced out of having insurance or go bankrupt simply for having dealt with human conditions, such as a surprise bit of cancer or having a kid. This collapse in people able to pay for healthcare will then hit doctors and hospitals, and the whole system, and our collective health, will get worse.

Paul Ryan has said that not buying health insurance is a choice, which is not only shockingly amoral toward patients, but displays an incredible level of dickishness to medical professionals as well. Ask any doctor, paramedic, or EMT and they will tell you of stories of patients who couldn't afford a checkup and let their treatable condition get worse and worse until they ended up in the emergency room for something way more expensive than the original problem. And hospitals will treat those patients, knowing that they are losing money doing so, because doctors are generally good people who care about healing people.

Taking useful insurance and turning it into meaningless nonsense is the main result of the Senate's proposed healthcare bill. The AARP has called out the bill's "age tax" because of how much premiums would be allowed to rise for the elderly. The lack of preexisting conditions protections, then, is a tax on being human, because the Senate is proposing shifting life-ruining costs of simply being alive onto most Americans for the sake of saving money for a few.


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