What The Election Means To Your Medical Care.

• Author: Orient, Jane M.
• Position: [GUEST OPINION]

* People are marching with "Health Care Voter" signs, and this is generally believed to be one of the most important issues in the 2018 midterm elections. Republicans who got elected on the promise to repeal ObamaCare, and reneged, may now get unelected. Voters who supported them are dissatisfied, and Democrats demand still more government involvement in medicine.

On Twitter, #HealthCareVoter posts warned that the confirmation of Brett Kavanaugh to the U.S. Supreme Court would "rip health care away from people with pre-existing conditions." This illustrates several profound misunderstandings.

By "health care," most seem to mean health "insurance"--usually a prepaid health plan, which is not at all the same as medical care. The Supreme Court already decided that it is unconstitutional under the Commerce Clause to force people to buy a commercial product. Remember stare decisis? Would it be ok to overturn the ACA decision, just not Roe v. Wade?

The Affordable Care Act (ACA or ObamaCare) ripped away Americans' freedom to refuse to buy an unaffordable or objectionable insurance product, punishing such refusal by a "tax." Contrary to Obama's promises, it also ripped away insurance plans that Americans had relied on for years. Some people had three or more policies cancelled, one after the other, forcing them into plans with less coverage and a much higher price. Many such plans ripped away actual medical care by excluding physicians or facilities that provided the needed specialized treatment.

What happened with pre-existings before ACA? Most people were unaffected because they had employer-sponsored coverage. Only the seven percent of Americans in the individual market faced underwriting for pre-existings. If they were insured before they became ill, the insurance contract generally prohibited dropping them from coverage or stopping treatment. Prudent people bought insurance at low cost when they were healthy and maintained continuous coverage. Those who didn't often had access to a state high-risk pool--before ObamaCare did away with them. Almost all got medical care--either they paid for it, or the doctor didn't get paid.

ObamaCare removed the incentive to buy insurance before one "needed" it, since one could not be declined or charged more. The individual mandate did not prevent this system-gaming, the equivalent of buying fire insurance when your house is on fire.

Now Congress has reduced the ObamaCare tax to SO, and the Trump...