Before the Affordable Care Act individual health insurance coverage was like the Wild West. Insurance companies had the power to deny coverage, drop coverage, or charge people more when people got sick.

Not only did insurance companies have this power, they used it a lot. A 2010 congressional report found that the top four health insurance companies denied coverage to one in seven consumers on the individual market over a three year period. This was horrific.

ADVERTISEMENT

You would hear stories about how one health scare would put families on the brink of financial ruin — or much worse. Walking into urgent care for a nagging cough, only to ultimately go home with a cancer diagnosis . Giving birth to a new child, only to have your infant hit her lifetime maximum limit for coverage within a matter of weeks . Getting dropped by your insurance company because you forgot tell them you had acne

By overwhelming proportions, Americans want these days to stay behind us. Poll after poll has shown health care to be a top issue for voters, with fully seven in 10 voters in key battleground districts saying it’s their top issue.

For solid majorities of battleground, independent and Democratic voters — and half of Republican voters — a candidate’s position on pre-existing conditions protections is “the single most important” or “a very important factor” in their vote this election.

What’s driving the enthusiasm on health care and protections for people with pre-existing conditions? The fact that Republicans have have taken a sledgehammer to the pre-existing conditions protections Democrats cemented in federal law.

Republicans have taken a few steps to destroy the pre-existing conditions protections that millions rely upon. Almost all Republicans in Congress have voted to repeal the Affordable Care Act, including its protections for people with pre-existing conditions.

In its place, they tried to pass “the American Health Care Act,” which would have gutted protections for pre-existing conditions and forced people to spend thousands more for the care they need: an estimated $4,270 extra for asthma,$17,060 extra for pregnancy, $26,180 extra for rheumatoid arthritis and $140,510 for metastatic cancer.

Twenty Republican state officials and the Trump administration have teamed up to ask a federal court to overturn protections for people with pre-existing conditions. Republicans have also revived the very type of junk insurance plans that discriminate against people with pre-existing conditions from the life support the Affordable Care Act rightly put them on.

The list goes on.

Confronted with consistent, passionate opposition from the public, Republicans aren’t relenting their attacks on people with pre-existing conditions. Instead, they’re just trying to cover their tracks.

In a move that would make George Orwell proud, congressional Republicans, whose votes to repeal the ACA actually would gut protections for pre-existing conditions and whose leaders continue to call for repeal, are now running ads that falsely claim it was a vote to uphold those protections.

At least 20 Republican incumbents have scrubbed their websites to soften their pro-repeal rhetoric. In Missouri, Senate candidate and current state Attorney General Josh Hawley has claimed that he wants to protect pre-existing conditions,while simultaneously asking a federal court to eviscerate them overnight. Others have introduced sham legislation as publicity stunts that, upon closer inspection, would actually undermine the pre-existing conditions protections in current law.

The trouble for Republicans this November is this: The American people are not stupid. We’ve all watched as Republicans have worked in plain sight to rip health care away from so many of us, including the millions of people living with pre-existing conditions. As Republicans desperately try to conceal this record from voters, we are all left to wonder: Have they no shame?

Undermining pre-existing conditions protections has been central to their health care agenda for eight years now. It’s time that they own up to it.

Brad Woodhouse is the executive director of Protect Our Care, the coalition leading the fight against health-care repeal. Jim Duffett is the executive director of Doctors for America, a national movement of doctors and medical students working to ensure that everyone has access to affordable, high quality care.