Do they think we’ll forget?

When a member of Congress held a town hall after voting to repeal the Affordable Care Act (ACA), the outrage of a constituent whose wife had survived cancer went viral: “You came after my wife! You came after my kids! There was a horrible bill, from a horrible group of people. They said if we get sick, it’s our fault. It’s completely immoral. I will not forgive. I will not forget.”

Desperately hoping for forgetfulness, Donald Trump and his congressional allies are backpedaling as fast as they can, even sanitizing their websites of previous promises to “repeal and replace” the ACA. With Election Day fast approaching, they piously pledge never to harm a hair on the head of anyone with preexisting conditions. Will voters have amnesia about these politicians’ past efforts to repeal consumer protections—not to mention their current lawsuit asking a federal judge to strike down the very safeguards these same elected officials now profess to support?

{mosads}On Monday, the Trump administration broke new ground in telegraphing its shockingly low opinion of voters’ intelligence. Literally days after President Trump tweeted his “total support” for people with preexisting conditions, Trump’s staff announced a policy that the non-partisan Congressional Budget Office (CBO), headed by a Republican-appointed economist, already found would devastate precisely such people.

Remember when Republican members of Congress partied on the White House lawn, celebrating the House’s passage of a bill to “repeal and replace” the Affordable Care Act? Both that bill and this week’s Trumpcare policy would authorize “state waivers” that let insurance companies sell junk insurance in direct competition with health plans that continue to guarantee consumer protections. Going far beyond previous administration decisions that authorized sham plans, this new policy joins last year’s failed repeal bill in giving unscrupulous insurers full access to taxpayer dollars intended to help moderate-income people afford coverage. By recruiting consumers who qualify for federal financial assistance, insurers offering cut-rate, substandard insurance could lure even more healthy customers out of the competing marketplace that serves people with preexisting conditions.

As the World Series begins, we all understand that competing teams cannot each operate by different rules. But precisely that brand of crazy lurks at the heart of last year’s Republican bill and this week’s administration policy. Unlike plans that continue to provide consumer protections, Trumpcare insurers could cut their rates for young and healthy people by eliminating benefits like maternity care and mental health care and preventing enrollment by consumers with health problems. Insurance companies could easily accomplish the latter goal by jacking up premiums for a mom who survived breast cancer or a child who takes medicine for ADHD or anxiety. Bargain-basement plans offering almost illusory coverage would leave behind a shrinking individual market increasingly limited to people with serious health problems. According to CBO, “those with preexisting or newly acquired medical conditions” would “ultimately be unable to purchase comprehensive …health insurance at premiums comparable to those under current law, if they could purchase it at all.”

We’ve binge-watched this series before. HIPAA is generally known as a medical privacy law, but it also gave states several options to protect people with preexisting conditions. Foreshadowing Monday’s Trumpcare policy and last year’s House Republican bill, 20 states decided under HIPAA to let consumers choose between plans that protected people with preexisting conditions and plans that did not. Healthy people flocked to cheaper, less protected insurance, so premiums for the “sick-people plans” tripled, quadrupled, or even quintupled. Actuaries reported that, to avoid serving people with health problems, insurers were “intentionally offering coverage at unaffordable rates.” The Government Accountability Office found that insurers and their agents deliberately steered healthier consumers into unprotected plans. GAO later surveyed three major national insurers, each of which admitted to covering a measly 200 customers through comprehensive plans that served people with preexisting conditions.

Why would any elected official want to make health insurance terrible again? Some sincerely believe we should each be on our own, even if that means an unexpected diagnosis can ruin people’s lives. Others may have a soft spot in their hearts or a prominent place on their roster of campaign contributors for unscrupulous insurers, which could amass vast sums under Trumpcare.  

Regardless of politicians’ motivations, a fundamental question about our democracy’s health now looms large: Can a political party maintain power by brazenly deceiving voters about that party’s stance on an issue of vital personal importance to roughly half of the country’s adult population? On Nov. 6, we’ll have our answer.

Stan Dorn is Senior Fellow of Families USA.