During Thursday’s presidential debate, President Donald Trump claimed that he would protect a provision in the Affordable Care Act that prevents health insurers from denying coverage to people with pre-existing conditions.
“Pre-existing conditions will always stay,” Trump said onstage. “What I would like to do is a much better health care, much better, will always protect people with pre-existing. So I’d like to terminate Obamacare, come up with a brand-new beautiful health care.”
This statement flies in the face of the actions Trump has actually taken during his presidency. For one, he is responsible for legislation that allows the sale of cheap, lightly regulated insurance plans that are not required to cover sick patients. Other, unsuccessful legislation he has supported would erode many of the core protections of the pre-existing provision. His administration is also gearing up to argue before the Supreme Court in November that the Affordable Care Act is unconstitutional—despite having no plan for a replacement. More than 20 million Americans currently rely on Obamacare for health insurance coverage.
Repealing the Affordable Care Act would have consequences extending far beyond that. In a court brief filed by a bipartisan group of economists and health care experts, the scholars wrote that “billions of dollars of private and public investment—impacting every corner of the American health system—have been made based on the existence of the ACA,” and that abolishing the law “would upend all of those settled expectations and throw health care markets, and one-fifth of the economy, into chaos.”
The President did recently sign an executive order pledging to protect pre-existing conditions, but an executive order is not legislation and has no power in the court of law. If the Affordable Care Act was outright eliminated—which is exactly what the Trump administration is trying to accomplish in the Supreme Court—the order would do nothing to force insurers to protect patients with pre-existing conditions.
Democratic nominee Joe Biden targeted Trump on this posturing during the debate, saying, “I guess we’re going to get the pre-existing conditions plan at the same time we’ll get the infrastructure plan,” in reference to Trump’s promises earlier in his presidency to spend $1 trillion on improving American infrastructure.
The former Vice President said that he would expand upon Obamacare, referring to his new health care policies as “Bidencare.” He plans to expand eligibility for financial assistance within the Affordable Care Act marketplace; cap premiums at 8.5% of a family’s income; and uphold the pre-existing conditions provision.
During the debate, Biden also picked up on a key point regarding the ongoing coronavirus pandemic: Those who tested positive for COVID-19, even if they made a full recovery, would qualify as having a pre-existing condition. More than 8 million people in the U.S. have tested positive for the virus, potentially resulting in drastic impacts on the American health care system should the Affordable Care Act be repealed without a replacement.
That means Trump himself now has a pre-existing condition. He may also have a policy in mind to protect those like himself should the Affordable Care Act be eliminated, but as of now, he’s done nothing to indicate that’s true.
