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Another clunker: John Cornyn’s ad on preexisting conditions

In a new campaign ad, Cornyn says one of the law’s central features, its guarantee that insurers must sell plans to any patients with preexisting conditions, “is something we all agree should be covered.”

Cornyn is a fixture of Texas and national politics and the No. 2 Republican in Senate leadership. His lead in this year’s race is not slim, and his ad is more carefully worded than the rest.

But Cornyn continues to oppose the Affordable Care Act, and his campaign would not say whether he backs a Republican lawsuit seeking to strike down the entire law at the Supreme Court.

If the ACA were to fall, the legislation Cornyn proposes as a replacement to cover those with preexisting conditions says “nothing … shall be construed to restrict the amount that an employer or individual may be charged for coverage under a group health plan.” Charge them whatever price, it says.

Experts say this arrangement would leave tens of millions of Americans with preexisting conditions at risk and possibly facing unaffordable rates for insurance. That’s why we’ve previously described the GOP proposal Cornyn supports as a “car without an engine.”

The Facts

The Affordable Care Act, President Barack Obama’s signature health-care legislation, has long been a target for Republicans. Cornyn has voted numerous times to repeal or replace it since its enactment in 2010. This is the third presidential election cycle in which the fate of the law is a top issue for candidates and voters.

Efforts to repeal “Obamacare” in Congress have fallen short for lack of agreement among Republicans on how best to rewrite it, most notably in 2017 and 2018, when the GOP controlled both chambers of Congress and the White House. The Supreme Court has upheld the act twice in the face of challenges from conservative groups and is scheduled to hear arguments in the latest case (California v. Texas) on Nov. 10.

As coronavirus cases reached a new high in the United States, the Trump administration filed a legal brief on June 25 asking the Supreme Court to strike down the entire law, joining with a group of GOP state attorneys general who argue the ACA is unconstitutional. About 20 million people could lose their health insurance amid a pandemic if the GOP effort succeeds.

The lawsuit comes from Cornyn’s home state, led by Texas Attorney General Ken Paxton (R). The federal judge who initially ruled to strike down the law in this case is a former Cornyn aide sitting in Texas.

“Asked if he wanted to see the lawsuit succeed, Cornyn did not say,” according to an article last month in the Texas Tribune. We asked the Cornyn campaign the same question and did not get an answer.

On his campaign website, Cornyn says, “Our health care system is broken, but Obamacare — with its unattainable costs, job-killing policies and intrusion between a patient and their doctor — isn’t the answer.”

Senate Minority Leader Charles E. Schumer (D-N.Y.) last month forced

America’s history of racism was a preexisting condition for COVID-19

A Louisiana pastor prays as his parishioners die, first from cancer and now from COVID-19. An Indigenous community in New Mexico lacks adequate health care as the death toll mounts. A sick hospital worker in New Jersey frets about infecting others in her heavily populated neighborhood.



a group of people standing in front of a mirror posing for the camera: Parishioners stand in Our Lady of Grace Catholic Church in Reserve, LA, during a sermon by Rev. Fr. Christopher Chike Amadi.


© Jasper Colt, USA TODAY
Parishioners stand in Our Lady of Grace Catholic Church in Reserve, LA, during a sermon by Rev. Fr. Christopher Chike Amadi.

As the country cries out for a vaccine and a return to normal, lost in the policy debates is the reality that COVID-19 kills far more people of color than white Americans. This isn’t a matter of coincidence, poor choices or bad luck – it’s by design. 

A team of USA TODAY reporters explored how the policies of the past and present have made Black, Asian, Hispanic and Indigenous Americans prime targets for COVID-19. They found:

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America’s education and economic systems are still unequal, disproportionately leaving people of color out of higher-wage jobs. When COVID-19 struck, more people of color were serving as essential workers directly in the path of the virus.

Decades of discrimination in housing corralled people of color into tightly packed neighborhoods, fueling the virus’ spread. Those neighborhoods tend to lie in “food deserts,” leading to diabetes, obesity and heart disease that make people more likely to die from the virus.

Environmental policies designed by white power brokers at the expense of the poor has poisoned the air they breathe, fueling cancers and leaving communities weakened in the path of the virus. A lack of federal funding left the most vulnerable communities cut off from healthcare at the most critical moment.

Put simply, America’s history of racism was itself a preexisting condition.

Of the 10 U.S. counties with the highest death rates from COVID-19, seven have populations where people of color make up the majority, according to data compiled by USA TODAY. Of the top 50 counties with the highest death rates, 31 are populated mostly by people of color. 

“COVID-19 has brought out into the open, with painful clarity, these divisions in our society that have been there for a long time but, for one reason or another, people were able to overlook them,” said Philip Landrigan, director of the Global Public Health Program at Boston College.

With nearly 1,000 people a day dying from the virus and scientists scrambling to grasp exactly how the virus spreads and kills, federal and state data has not provided enough demographic detail to show the full impact on communities of color. The race and ethnicity of people who contract the virus is known in 52% of cases, according to the Centers for Disease Control and Prevention. 

But study after study has shown clear patterns in whom the virus kills.

How systemic racism led to COVID-19’s rapid spread among people of color

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Black people are more than

COVID Could Add 20K+ Americans a Day to ‘Preexisting Conditions’

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Every day, another 20,000 Americans between 20 and 60 years of age could be classified as living with a “preexisting condition” because of COVID-19, researchers from the Commonwealth Fund report.

Overall, the pandemic could cause almost 3.5 million Americans to be added to this category, a fact that has important implications approximately 1 month before the US Supreme Court is expected to weigh in on the constitutionality of the Affordable Care Act (ACA), the investigators note.



Dr Eric Schneider

“Polls show that most Americans are worried that preexisting conditions could lead to loss of insurance coverage. People are surprised and even more worried when they realize that the pandemic is adding to this problem,” lead author Eric Schneider, MD, PhD, told Medscape Medical News.

The study was posted online in a blog post on October 8 by the Commonwealth Fund.

Schneider, senior vice president for policy and research at the Commonwealth Fund, and research associate Arnav Shah based their calculations on approximately 7.5 million cases of COVID-19 reported in the United States as of October 7, 2020. The figures include an estimated 45,000 new cases reported daily.

Using data from the Centers for Disease Control and Prevention and Johns Hopkins University, they found that 32% of 1,502,309 people with laboratory-confirmed or probable COVID-19 already had an underlying condition. This proportion varied by age.

Table. COVID-19 and Underlying Conditions

Age in years Proportion of confirmed or probable COVID-19 cases
20 – 29 23%
30 – 39 28%
40 – 49 36%
50 – 59 44%
Source: CDC Case Surveillance Task Force data.

 

If almost one third already have an underlying condition, this means that for the remaining 68%, insurers might consider COVID-19 their first preexisting condition.

More Than 3 Million Could Be Affected

“We estimated that just over 3.4 million nonelderly adults had COVID-19 as a new pre-existing condition,” the authors write.

“If the Supreme Court overturns the preexisting condition provision of the ACA, private insurers will be able to deny insurance coverage to adults under age 65 who are unable to get insurance through an employer or large group,” Schneider said. “Testing positive for COVID-19 could be treated as a preexisting condition.”

Furthermore, he added, “Because the long-term health effects of COVID-19 are unknown, these adults could be uninsurable until they reach age 65 and qualify for Medicare.”

There could also be economic consequences, Schneider said. “If COVID-19 causes long-term health problems the way hepatitis C or HIV do, these costs could be high for patients, providers, and government programs.”

Removing preexisting condition protections could also act as a disincentive. “Healthy people might avoid COVID-19 testing altogether. And that is exactly the opposite of what must happen if we are ever to get this pandemic under control,” the researchers note.

“A Frightening Picture”

“These findings highlight the importance of preexisting protection,” Nathalie Huguet, PhD, who was not affiliated with the study, told Medscape Medical News.



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