The PROTECT Act, the health insurance reform bill unveiled this week by 18 Senate Republicans, is aptly named, albeit not for the reason its sponsors suggest.

The bill pretends to be about safeguarding Americans with preexisting health conditions. But it’s really about protecting Senate Republicans from the stink caused by the Trump administration’s efforts to repeal the Affordable Care Act, also known as Obamacare.

According to the Kaiser Family Foundation, a huge number of people — more than a quarter of non-elderly Americans — have preexisting conditions of the sort that would have led insurers to deny them coverage had the ACA not gone into effect. The ACA gave people who purchase their own health insurance expansive protection against such discrimination, making comprehensive coverage available and affordable to millions of Americans who’d been either priced out or shut out by insurers.

That’s one of the main reasons the public opposed GOP efforts in the last Congress to dump the ACA. Democrats pummeled Republicans over the preexisting conditions issue in 2018, providing some of the energy behind the blue wave that swept the GOP out of the House majority that year.

In a bizarre ruling in December, however, a federal judge in Texas declared the ACA unconstitutional in its entirety. After a group of Democratic state officials appealed, the Trump administration urged the appeals court to uphold the ruling and throw out every piece of the ACA.

Trump’s move revived the debate over preexisting condition protections, reportedly to the surprise and chagrin of many congressional Republicans who did not want to have to defend themselves on this issue again. There’s little disagreement among lawmakers about the need to provide such protections; the public’s demand for them is clear. The disagreement is over how to do it.

That’s where the PROTECT Act comes in. Designed to look like a life preserver for people with preexisting conditions if the courts ruled against the ACA, it would bar insurers from denying coverage to an applicant or raising a customer’s premiums based on that person’s medical history.

But the bill’s protections are chimeric, as lead sponsor Sen. Bill Cassidy, R-La., a gastroenterologist who is intimately familiar with the U.S. health insurance system, has to know.

If the ACA is repealed, insurers would no longer be required to offer comprehensive policies to all comers. All the PROTECT Act would do is encourage insurers to do something they did before the ACA: offer cheaper policies with thin coverage aimed at healthy customers, and considerably more expensive policies with comprehensive coverage for people who might actually need costly care.

In other words, it would allow insurers to go back to the bad old days of segmenting low-risk and high-risk customers, then designing their policies to attract the youngest, healthiest consumers.

Los Angeles Times