Republicans Offer Health Care Bills to Protect Patients (and Themselves)

The Affordable Care Act also requires insurers to provide certain “essential health benefits,” including maternity care, prescription drugs, mental health care and drug abuse treatment.

The protections for people with pre-existing conditions are among the most popular provisions of the 2010 health law. Democrats rode the issue to victory in many House races last fall, and they give every indication that they intend to emphasize it again in 2020.

“Republicans are terrified that Democrats will use the issue of pre-existing conditions as a cudgel to beat up Republicans,” said Michael F. Cannon, the director of health policy studies at the libertarian Cato Institute. “That’s what they did in 2018, and it worked.”

Health care dominated television commercials run by Democratic candidates for Congress in the fall. They argued that Republicans, in trying to repeal the Affordable Care Act, had repeatedly voted to take away the protections for people with pre-existing conditions.

The political risks for Republican lawmakers increased in December after a federal judge in Texas invalidated the entire health law, including the protections for pre-existing conditions. The Trump administration said it would not defend the law in court, but would instead support the judge’s ruling on appeal.

Representative Kevin Brady of Texas, the senior Republican on the Ways and Means Committee, promised that “Republicans won’t let the courts take away pre-existing condition protections.” And that “if the court strikes down the Affordable Care Act,” he said, “Republicans will act to protect those with pre-existing conditions.”

Democrats distrust those assurances.

“The Republican bill does not include critical A.C.A. consumer protections, including community rating, essential health benefits requirements and annual or lifetime prohibitions,” said Representative Frank Pallone Jr., Democrat of New Jersey and the chairman of the Energy and Commerce Committee.