A Letter to Republicans in Congress (From a Fellow Republican)

Dear Republican Members of the U.S. House and Senate:

In the matter of the Health Care Act that President Trump is attempting to amend (or should I say upend), I appeal to your sense of what is just, fair and honorable, by urging that you refuse to vote for any bill that allows pre-existing conditions to stand in the way of a person’s ability to obtain health care for the same premium as a more fortunate person who hasn’t had to deal with the suffering and anxiety that one faces with such illness.

This matter may not resonate with you, as Federal Government employees are provided (by the taxpayers) a level of health care that far exceeds what you yourselves have termed a “Cadillac plan.” You, your families and your employees never have to worry about pre-existing conditions. Your health care plan is the envy of all Americans.

But under the ACA plan now in existence, you developed the term “Cadillac plan,” which you applied to comprehensive health care plans provided by corporate America to its employees. You chose to apply a hefty 40% excise tax on those plans, the logic being that such a tax would help to fund insurance for those who were uninsured.

But you forgot to take economics into consideration by neglecting to realize that corporations would respond (and did) in a rational way, by cutting benefits to their employees and guaranteeing that their plans no longer could be deemed “Cadillac” in nature. The winners in that decision were the employers, who cut back the range of options to their employees and thus saved money; not to mention the insurance companies, whose obligations were now reduced. The only losers were the employees who had to pay higher premiums and receive fewer benefits. And the Federal Government was also a loser because, even after imposing this ill-conceived change, it failed to collect the revenue stream that was its sole justification.

Despite the decapitation of “Cadillac” plans in the corporate world, employees of most sizable companies in this country still retain the benefit of health insurance regardless of pre-existing conditions. The reasons are varied — some companies are truly good stewards of their employees and are motivated by what is the honorable way to treat their workers; other companies realize that they cannot retain top talent without such a crucial benefit, and so they add it reluctantly.

Whatever the reasoning behind providing a comprehensive corporate health care plan, the outcome is favorable because good coverage largely relieves the debilitating anxiety that reduces productivity.

Who, then, will be harmed by the current administration’s attempt to pass the all-important “pre-existing” conditions decision to the states?

Not the Federal Government employees and their families; not likely the significant part of the workforce that is employed by large corporations. No — they are safe.

It is a far larger population, including the millions of self-employed and the owners of small businesses with a few employees, collectively termed “the individual market,” that will be devastated by this change. Many of these hard-working people exist barely above the poverty level. Recall that for decades we have been describing these stalwart citizens as the engines of growth, risk takers, originators and sustainers of myriad small enterprises that add disproportionately to our national GDP.

If the Federal Government allows the states to define and determine eligibility, many of these workers could be refused medical treatment if they were once attacked by the zika virus, or if a member of their family has ever had cancer, or Lyme disease or maybe even a Caesarean birth. For sure, it will eliminate those who are HIV+ or have hepatitis C, an increasingly common and deadly silent disease that affects 3% of the 76 million baby boomers in this country, and is curable only in those instances where the sufferer can afford the huge expense of the required medication. Stated bluntly, without insurance that covers pre-existing conditions, millions of American workers are at risk of losing their lives, many through no fault of their own.

Just yesterday, Centers for Disease Control and Prevention (CDC) designated May 19 as National Hepatitis Testing Day, as it announced that more than 60% of liver cancer cases are related to Hepatitis B or Hepatitis C. That’s because the disease can be harbored within the patient long before it is diagnosed, in some cases as long as 15 years.

There is much to fix in the ACA (Obamacare) but handing over to the states the right to determine whether pre-existing conditions will be allowed to the citizens in their jurisdiction is de facto a death sentence on many thousands of people currently protected under the ACA.

On behalf of the millions of people who have as much right to a healthy life as those of us who are more advantaged, I implore you to hold intact the current pre-existing condition benefit in the ACA. To do otherwise would be a moral outrage, a wanton disregard of the value of human life. Thank you for taking this issue to heart.