ASKOM: What’s Up with the Pre-Existing Conditions in Trumpcare?

Got questions? Hashtag them #ASKOM and we'll answer them!

Got questions? Hashtag them #ASKOM and we’ll answer them!

Q: I saw a ton of social media posts about these pre-existing conditions for Trumpcare. I saw some included c-sections, rape, even seasonal affective disorder? Is this real? -Maya Diaz, Rochester, NY 

A: Oh it’s definitely real, Maya, and to be perfectly honest a little scary when you consider how many Americans display these “pre-existing conditions.” In fact from CNN to AARP, there are an estimated 52 million Americans under 65 who suffer from these conditions, but let’s back up and talk about Trumpcare for a second, the Republicans’ response to Obamacare or the Affordable Care Act (ACA).

President Trump has been working since the campaign trail to repeal and replace the ACA, which aimed to make healthcare more accessible to all Americans. One of the major differences between the two is that originally the ACA made it so health insurance companies couldn’t refuse to cover you or charge you more just because you have a “pre-existing condition”- a health problem you had before your new health coverage would begin. However, under Trumpcare, health insurances have a right to refuse you coverage or charge you more and now the list of pre-existing conditions has been lengthened as well. They include:

  • Acne
  • Acromegaly
  • AIDS or ARC
  • Alzheimer’s Disease
  • Amyotrophic Lateral Sclerosis
  • Anemia (Aplastic, Cooley’s, Hemolytic, Mediterranean or Sickle Cell)
  • Anxiety
  • Aortic or Mitral Valve Stenosis
  • Arteriosclerosis
  • Asthma
  • Bipolar disease
  • Cancer
  • Cardiomyopathy
  • Cerebral Palsy (infantile)
  • Chronic Obstructive Pulmonary Disease
  • Cirrhosis of the Liver
  • Coagulation Defects
  • Congestive Heart Failure
  • Cystic Fibrosis
  • Demyelinating Disease
  • Depression
  • Dermatomyositis
  • Diabetes
  • Dialysis
  • Hepatitis (Type B, C or Chronic)
  • Menstrual irregularities
  • Multiple Sclerosis
  • Muscular Dystrophy
  • Obesity
  • Organ transplants
  • Paraplegia
  • Parkinson’s Disease
  • Polycythemia Vera
  • Pregnancy
  • Psoriatic Arthritis
  • Pulmonary Fibrosis
  • Renal Failure
  • Sarcoidosis
  • Scleroderma
  • Sex reassignment
  • Sexual assault
  • Sjogren’s Syndrome
  • Sleep apnea
  • Transsexualism
  • Tuberculosis

And if that’s not bad enough, there are still more health issues that could incur high premiums.  These include:

  • Acid Reflux
  • Acne
  • Asthma
  • C-Section
  • Celiac Disease
  • Heart burn
  • High cholesterol
  • Hysterectomy
  • Kidney Stones
  • Knee surgery
  • Lyme Disease
  • Migraines
  • Narcolepsy
  • Pacemaker
  • Postpartum depression
  • Seasonal Affective Disorder
  • Seizures
  • “Sexual deviation or disorder”
  • Ulcers

Some of these are legitimate physical illnesses that can cost a ton to cover (so imagine paying yourself) but many LGBT and women advocates are saying it’s also a thinly veiled attempt to delegitimize the health issues of others, from women who have c-sections, have “menstrual irregularities” or have been sexually assaulted to the mentally ill who have depression or even just seasonal affective disorder. And even “sexual deviation” is on the list of premiums, with transsexualism being an outright pre-existing condition. Many think it’s an attack on lifestyle, or even viewed innocently, a result of a lack of knowledge about the health of millions of Americans and today’s health issues.

Now this latest attempt is still just a bill and has only passed one chamber of Congress so it’s certainly got a bit of a journey before, or even if, it becomes law. Although Trump has been celebrating with House Republicans as if it has passed, the bill must still work its way through the Senate, a chamber set up to be more deliberative about passing bills. The political cultures between the two chambers are radically different and they were created to be so. Why? The idea is that the House better represents the desires and whims of the people. Elected every two years, these representatives tend to be more aligned to what their voters want and the result is legislation that mirrors the desire of the people. However, the Senate is voted in differently. Every six years, a third of the Senate goes up for re-election. These long wait times allow Senators to take their time on bills and deliberate fully with other Senators. They don’t have to prove to voters every two years their activity. So the Senate was designed to, yes, represent the people, but to also think in a more legislative sense about what’s best for the people.


However, what happens when lawmakers aren’t even reading the bills? This brings me to another quick point since you asked about memes and social media posts. Over the weekend, a number of media outlets wrote stories about Congress not even reading the bill. From The Hill to CNN, these stories showed Republican lawmakers who didn’t even read the bill before voting on it. However, very few of them mention that this is actually a common practice. Now this obviously doesn’t make it right but it’s less about Republicans being “bad” lawmakers who don’t care about the people and more of an issue with American politics generally actually.

Bills have gotten much, much longer over the past two to three decades. Some bills, like the AHCA, are well over 1,000 pages long and with that much packed in them, there’s sure to be parts lawmakers will want to debate over, change or amend. However, that process takes time and can change the law so much the original creators of the bill are no longer happy with it. Already criticized for being slow, a bill that doesn’t even reflect what party leaders want isn’t exactly ideal. So the solution? Don’t give them enough time to read the bill.

“…basically we’re writing our own bill.” – Sen. Alexander

Since the 90s, long and complex legislation has only gotten longer and more complex. They’re often omnibus legislation also and deal with a number of issues and segments of society not even related. And even when they do read the bill, its crafted to have complex and almost unreadable language. In 2010,  Senator Max Baucus admitted he hadn’t even read the ACA, which he actually helped craft. Of course, he went onto say he still knew what was in it and through aides, briefs and conversation, many other senators knew but many voters want officials who will read the bills, since many of us won’t. Another bill not fully read? The  2015 National Defense Authorization Act which Rep. Jim Moran (D-VA) laughed about when asked if he’d read it.

So where does that leave us right this second? With a looming bill that could radically change how Americans get coverage but with a Congressional chamber that has the power to radically change what the text of this bill reads. In fact, with the ACA, the Senate used an old housing tax bill (since all revenue-related bills must start in the House) dumped all of the contents and then made it a carrier for their version. Many experts think the Senate could just start from scratch, infuriating Republican voters who want the ACA out and a new law of the land.

“I’m going to read the House bill, find out what it costs and where I find good ideas there, why we’ll borrow them. But basically we’re writing our own bill,” Sen. Lamar Alexander, R-Tenn., chairman of the Senate health committee, said in an interview with Newsmax. 

However, Senate Majority Leader Mitch McConnell stated they could pass the bill without blue help, though this would still take a few months as Alexander’s committee works on the bill before it’s put on the floor. For those of you worried about your current healthcare, insurers are required to honor all 2017 plans.

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