Throughout the debate over repealing and replacing Obamacare, many Republicans have objected to provisions that would roll back protections for patients with preexisting conditions. Allowing insurance companies to charge those patients more for coverage — which the replacement bill would do — has emerged as a major sticking point for moderate Republicans and an impediment to getting the votes to pass the American Health Care Act.
Few Republicans have publicly defended the practice of charging patients with preexisting conditions more money — and perhaps none as prominently as Rep. Mo Brooks of Alabama, who on Monday gave an interview defending charging more for preexisting conditions, arguing that this allows insurers to reward “people who lead good lives.”
The Republican health care bill, which Brooks supports, would once again allow insurance companies to charge sick customers higher premiums than healthy customers. This insurance practice, known as “underwriting,” is banned under the Affordable Care Act.
Brooks argued in an interview with CNN’s Jake Tapper that this should change. Here’s what he said about once again allowing insurers to charge people more when they have a preexisting condition:
It will allow insurance companies to require people who have higher health care costs to contribute more to the insurance pool that helps offset all these costs, thereby reducing the cost to those people who lead good lives. They’re healthy; they’ve done the things to keep their bodies healthy. And right now, those are the people who have done things the right way that are seeing their costs skyrocketing.
Of course, this framing of preexisting conditions is absurd. There are some expensive health care conditions that can be traced back to lifestyle. We know that smoking, for example, is the top risk factor for lung cancer.
But there are plenty more expensive health care conditions that aren’t the result of any choice at all. Before the Affordable Care Act, as the Kaiser Family Foundation has documented, insurers would charge higher premiums — or deny coverage — to people with diseases like multiple sclerosis, epilepsy, and arthritis.
A healthy person is at risk of becoming a sick person at any moment, and not just because they didn’t lead a “good life,” as Brooks suggests. This risk of sickness is the whole point of buying health insurance: to protect against high health care costs that could hit anyone at any time.
Jimmy Kimmel talked on his show yesterday about his newborn son, who within hours of birth needed heart surgery. That baby will have a preexisting condition for his entire life. Under the Republican plan, he could face higher insurance premiums for something that happened when he was three hours old.
Preexisting conditions are not, in most cases, the result of bad choices, like Brooks describes. They are not the result of living a bad life. They are the result of bad luck, plain and simple.