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There Probably Needs to Be a Law

Fact Check: No, the GOP Healthcare Bill Doesn't Make Rape a Pre-Existing Condition

The public "debate" over the House-passed American Health Care Act continues to devolve into an orgy of demagogic stupidity, with legitimate questions and concerns over certain policy components being drowned out by fact-free hysteria. On Friday, we dealt with the oft-repeated and preposterously false claim that the AHCA crushes people with pre-existing conditions, returning to the 'bad old days' and rolling back safeguards.  In fact, there are four layers of protections for such individuals within the bill, starting with the preservation of a nationwide requirement that insurers must sell plans to consumers with pre-existing conditions.

One can question whether the discrete, tiny subsection of people with these afflictions who aren't continuously insured and live in states that seek and receive "community rating" waivers will have access adequately-funded high risk pools (the legislation allocates approximately $130 billion to funds and programs designed for this purpose).  But that's a very different argument than the hyperbolic and dishonest complaint that the bill callously throws Americans with pre-existing conditions to the wolves.  It does not.  Another breathtaking line of attack claims that the AHCA makes sexual assault and rape pre-existing conditions.  This is a lie so appalling that even left-leaning Politifact awarded it a "mostly false" rating.  The Washington Post's more credible fact-checker -- who also deserves credit for owning up to mistakes -- was less forgiving, dishing out 'Four Pinocchios' over this "out of control rhetoric:"

The AHCA does not specifically address or classify rape or sexual assault as a pre-existing condition. It also would not deny coverage to anyone because of a pre-existing condition. The notion that AHCA classifies rape or sexual assault as a preexisting condition, or that survivors would be denied coverage, is false...At least 45 states prohibit insurance discrimination like this. Then, it takes several leaps of imagination to assume that survivors of rape and sexual assault will face higher premiums as a result of conditions relating to their abuse. A person would need to be in the individual or small-group market (most Americans under 65 are on employer-provided plans), in a state that sought waivers, and in one of two to five states that did not prohibit insurance-company discrimination against survivors of sexual abuse...Both media coverage and hyperbole among advocates are at fault for creating a misleading representation of the House GOP health bill. We wavered between Three and Four Pinocchios, but the out-of-control rhetoric and the numerous assumptions pushed us to Four Pinocchios.

The 'rape' lie is one variant on a broader misleading argument: Namely, that because the House bill would allow states some flexibility to voluntarily pursue waivers on some Obamacare mandates -- including the ten federal categories of 'essential health benefits' -- it "guts" a whole array of protections.  In reality, if a state meets all the criteria and is granted a waiver, carriers within that state would have the ability to sell some less-comprehensive (and more affordable) coverage offerings.  Remember, every single state had regulations and mandates in place prior to Obamacare, including 45 states that prohibited counting sexual assault and/or domestic abuse as pre-existing conditions, as noted above.  The Democrats' failing law created a wide-ranging national standard under which a very wide array conditions and services had to be covered in order to qualify as eligible for sale on the government-approved exchanges.

This drove up the cost of many plans, undermining the ostensible goal of the law: Affordability.  The AHCA's waiver component could allow a state to only retain, say, seven or eight of the ten fundamental EHB requirements, with a smaller handful becoming optional.  Under that scenario, some plans would remain more comprehensive for people who want or need them, while others would be scaled back a bit -- and cheaper.  Consumers would have a wider menu, including less expensive selections from which to choose. Casting this effect as "making [fill-in-the-blank] a pre-existing condition" is a distortion that preys on people's fears.  Here's Mary Katharine Ham trying to set the record straight in a CNN segment in which the 'rape' talking point was treated credulously and seriously, as opposed to an irresponsible deception:


Ham also penned a Facebook post (later turned into a column at The Federalist) demanding that if emotionalism is going to rule the day in our healthcare debates, real stories of Obamacare harm must not be memory-holed or airbrushed out of the conversation:

You may know me as the widow with two children you know and love regardless of our respective political beliefs. What you might not know is I was a pregnant widow with two children who got a letter two weeks after my husband died informing me I'd lost the third or fourth health insurance plan since ACA passed. If you'll remember, the promise was that I could keep my plan if I liked it. I could not. I predicted what would happen to us, and to much less fortunate people subjected to the exchanges with me, who have seen doubled premiums and tripled deductibles. If you'll remember, the promise was everyone's premiums would go down. They did not. For predicting it, I was routinely called a lying hack in public. Hazard of the job, but I wasn't lying. I was right...ACA has helped people. I know some of them well! I have never denied this. I am not in the habit of asserting any piece of health legislation is either perfect or a tool of evil designed by hateful actors. They're not...It has come to my attention that, even among those who should know and who assert they know a lot about health care policy and the market, many people don't know that people like me exist. But there are many of us, many with far fewer resources than I, who now have much more expensive, less effective, junkier, nearly unusable plans than we had back when our allegedly "junk" plans were outlawed. Again, we are not the only ACA story, but we are part of the story, we were sold a bill of goods, and we're often overlooked.

I'll leave you with (a) a reminder that the AHCA will not become law in its current form due to an expected Senate overhaul, (b) a personal story from Republican Congresswoman Cathy McMorris Rodgers about her son's pre-existing condition (and why she voted for the bill), and (c) an example of the unhinged rhetoric on the Left in this discussion. Volatile left-wing Newsweek writer Kurt Eichenwald, who wished death upon GOP lawmakers' loved ones, used his own health story to illustrate how monstrous the Republican plan is.  But he was wrong on the facts, then baselessly tarred me as a liar for pointing out his factual error.  His original tweet was retweeted thousands of times. My correction only racked up a few hundred.  This is how alarmism and lies spread:

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