The Observer's news vertical is, for the most part, a local concern. We do our best to stay focused on DFW, while occasionally allowing our eyes to wander further afield to the rest of Texas. So we are, for the purposes of this article at least, going to disregard about 99.8% of the 6,000 words or so President Donald Trump meandered through during Tuesday's State of the Union.
Here's the 0.2% we're going to focus on — one sentence, uttered about halfway through the 90-minute speech:
"I’ve also made an ironclad pledge to American families: We will always protect patients with preexisting conditions."
Unless the president has a Nixonesque secret plan to fix America's healthcare system, the above quote is a bald-faced, dangerous lie.
There is no piece of Republicans' failed 2017 healthcare plan or the ongoing Texas-led lawsuit against the Affordable Care Act that would do anything to keep Texans with preexisting healthcare conditions out of harm's way. In fact, the lawsuit, spearheaded by Texas Attorney General Ken Paxton, would erase the protections those with preexisting conditions already have.
"There's no evidence (that Trump is going to protect those with preexisting conditions) beyond his broad oral assurance," says Stacey Pogue, the senior policy analyst for the Center for Public Policy Priorities Health and Wellness team. "His Department of Justice said out of the gate that it wasn't going to defend the Affordable Care Act and that, because they thought the individual mandate was unconstitutional, that the preexisting conditions protections would have to fall with it."
The president is reacting to the overwhelming support the American public has shown for protecting those with preexisting conditions with words, but there is no evidence that he has any plans to back them up.
"It has to be more than assurance (from the president), because everything that we've seen before points in the exact opposite direction," Pogue says.
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If Texas wins its lawsuit — a lower court judge has already sided with the state against the ACA, but his ruling is on hold as the appeals process churns — Texans will be at the mercy of the state. Texas' current insurance laws allow insurers to deny coverage to those who already have health problems when they apply.
"The ACA has given an assurance to people that they totally lacked before. Even people with good, job-based insurance, they couldn't be turned down with preexisting conditions," Pogue says, "but they could be placed in a waiting period and be contributing to premiums and be working and be in a position where the health plan wouldn't pay for your preexisting conditions."
Without the ACA, Texas insurers could write policies that didn't cover the left legs of those who've had left-knee surgery, or the hearts of those who've had heart attacks. Paxton's office has defended the lawsuit by saying it will allow patients greater choice in their healthcare.
"Texas' lawsuit takes issue with Washington's unconstitutional control of the American healthcare system," Marc Rylander, Paxton's spokesman, told the Observer in response to questions about preexisting conditions after Paxton's office filed the lawsuit. "Texans should be free again to make their own healthcare choices, including which doctor they want to see."