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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Truth #1: The chaos is the point.

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SIX TRUTHS

Reclaiming power from those who abuse it often starts with telling the truth. And in "This Is How Authoritarians Get Defeated," MoJo's Monika Bauerlein unpacks six truths to remember during the homestretch of an election where democracy, truth, and decency are on the line.

Truth #1: The chaos is the point.

Truth #2: Team Reality is bigger than it seems.

Truth #3: Facebook owns this.

Truth #4: When we go to work, we're in the fight.

Truth #5: It's about minority rule.

Truth #6: The only thing that can save us is…us.

Please take a moment to see how all these truths add up, because what happens in the weeks and months ahead will reverberate for at least a generation and we better be prepared.

And if you think journalism like Mother Jones'—that calls it like it is, that will never acquiesce to power, that looks where others don't—can help guide us through this historic, high-stakes moment, and you're able to right now, please help us reach our $350,000 goal by October 31 with a donation today. It's all hands on deck for democracy.

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