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Editorial: Pre-existing expectations

Before the Affordable Care Act became law — pre-Obamacare —  a congressional investigation into four major insurers over the period of 2007-2009 found the companies had denied coverage to 651,000 people because of pre-existing conditions.

Now insurers cannot turn away the sick or charge them more for coverage.

Whether the Affordable Care Act is amended or repealed, the fact remains that the American people now expect virtually everyone to be able to get health insurance, even if they have heart disease, cancer, pregnancy or any of the more than 400 conditions that insurers once used to justify denial.

Congress may wipe Obamacare off the books, but the controversial law will leave a legacy nevertheless. The Affordable Care Act raised the bar on the public’s expectations when it comes to access, and Congress will have a hard time lowering it again The majority of people believe the pre-existing conditions rule should stay in place. In that way and others, the Affordable Care Act  has changed the lay of the land for health care providers, insurers and consumers.

Some consider the pre-existing conditions rule a minor point. Everyone who got insurance through their employer had such protections before the Affordable Care Act. Medicaid and Medicare don’t turn people away because they are sick. So only people buying insurance on their own were affected. A Congressional Budget Office study conducted before Obamacare found that, among the uninsured, only 3.5 percent were uninsured because their health was too poor to qualify.

That 3.5 percent may seem small, but the people who comprise it are significant to the American people and their sense of fairness. The 3.5 percent included people who lost health insurance through job loss or divorce, adding hardship to heartache. It included people who realized the cost of foregoing health insurance might some day crush them so they’d better get coverage — only to find they could not.

Keeping the pre-existing conditions rule is not as simple as it sounds. Lawmakers will present multiple proposals that claim to do just that but also allow unaffordable premiums or complicated hoops for people to jump through.

Obamacare is ripe for reform. If the law is replaced with something better, more power to the people. Congress faces a new reality because of the law, however. Being able to get health insurance is now seen as a right. There is no going back on that — only a different way forward.

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