At the Atlantic, Ron Brownstein writes a simple truth about the Trump and Republican health care plans:
There’s a reason Donald Trump has never produced a health-care plan that protects consumers with preexisting medical conditions: Ending protections for the sick is the central mechanism that all GOP health-care proposals use to try to lower costs for the healthy.
Protection against pre-existing conditions and more geekily speaking, protection against re-classification risk, is popular. Very few people have the financial capability to absorb both the short term costs of a massive complex diagnosis like pediatric leukemia nor the ability to self-insure against life long incremental costs after a diagnosis like that. The AHCA and BCRA during Repeal and Replace Spring and Summer 2017 through single digit billions at this problem as massive waivers against risk pooling would be allowed. The Farm Bureau “shhh this is only an insurance like product in the same manner that Velveeta is cheese-like” plans and short term limited duration plan proliferation are also attempts to split risk pools.
The fundamental philosophical underpinning of these concepts is that people are on their own and responsible for their good health and their bad luck with no expectation that society has a responsibility.
That is an ethos.
It is also one that flipped the House in 2018.
This is why the ACA is back in the Supreme Court. If it can be knifed there, perhaps the splatters won’t be politically trace-able.