As we rapidly race toward the September 30th deadline that Republicans face for repealing Obamacare with the low, 50 vote threshold that lets them tell Democrats to fuck off, there has been a lot of debate about whether or not this new health care bill they're attempting to ram through, Graham-Cassidy, protects people with preexisting conditions. Senators Graham and Cassidy as well as President Trump claim that it does, meanwhile liberal groups claim that it does not.

Now there are a lot of things in government that are subjective. Did Senator so-and-so do well on Face the Nation? Was president such-and-such's speech inspiring or terrifying? When you only have enough funding for one important program that would do a lot of good, which program do you choose to pursue? These are questions where both sides could make fair points. But when it comes to a question as fundamental as "Will this bill, which would re-work one-sixth of the American economy, fuck me over if I have a preexisting condition?" shouldn't be one of them. So how do the two sides get to such different answers?

It's actually pretty simple. Republicans are correct to say that Graham-Cassidy wouldn't allow insurance companies to prevent people with pre-existing conditions to buy insurance. The problem is, that's not the real question. The real question is, would this bill allow insurance companies to discriminate against people who have pre-existing conditions? And the answer to that one is a resounding "yes." Under Graham-Cassidy states would be allowed to remove protections for preexisting conditions as long as those people would not be barred from buying insurance. But without those protections, insurance companies could charge people with preexisting conditions far more for coverage than healthy people. And don't worry, it gets worse: Graham-Cassidy would also allow states to waive the protections that prevented insurance companies from putting lifetime caps on how much they would spend on someone. When these two things are paired together, what you end up with is an insurer charging a sick person far more money for coverage, while that coverage would be significantly worse.

I know what you're thinking. "That sounds bad." It is! But even worse than that is without the individual mandate, which this bill also does away with, healthy people aren't incentivized to get insurance. Insurance works when healthy people who don't use their coverage, which subsidizes and keeps costs down for those who, at that moment in time, need it. With fewer healthy people in the pools, premiums would have to go up, which would lead to even fewer healthy people signing up for coverage, which would make premiums go up, which would lead to even fewer healthy people... Do you see where I'm going? That's what's called a death spiral, and despite its cheery name, it turns out, that's a very bad thing.

So, does Graham-Cassidy protect people with preexisting conditions? Only if your definition of "protect" means being price-gouged by insurance companies for the crime of "having once been sick," while at the same time premiums will continue to rise as we slowly (or, not so slowly) fall into a death spiral that will not just leave millions and millions of Americans uninsured, but will also do great damage to the American economy. But if you're definition of "protecting people with preexisting conditions" means being able to afford health insurance even if you've been sick before, then no. It decidedly does not. Anyone who tells you otherwise, like say Bill Cassidy, or Lindsay Graham, or Donald Trump is lying to you.

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