The GOP "Pledge to America" includes a pledge to "ensure access for patients with pre-existing conditions." Andrew Roth of the Club for Growth didn't take too kindly to this section. He wrote:

They want to FORCE health insurers to insure anyone who wants coverage, regardless of the cost...

But the GOP proposal wouldn't force insurers to insure "anyone who wants coverage." Yuval Levin sets the record straight:

But what the Pledge actually proposes is a system of high-risk pools combined with protection from preexisting-condition exclusions for people who are continuously insured (basically an extension of the protection that has existed in federal law since 1996). It does not create an added incentive for healthy people to avoid getting insurance, and so absolutely would not involve an individual mandate.

This pro-market (and far cheaper, though not cheap) approach to the preexisting-conditions issue builds on the great work of conservative health-care wonks like Mark Pauly (of the University of Pennsylvania), James Capretta (my colleague at the Ethics and Public Policy Center), and Tom Miller (of AEI).

Capretta and Miller laid out how this would all work, and also provided an excellent overview of the preexisting conditions problem (the scope of which is far smaller than the rhetoric of many liberals implies), in the summer issue of National Affairs, here.

Here's the relevant section from the GOP pledge (emphasis added):

Health care should be accessible for all, regardless of pre-existing conditions or past illnesses. We will expand state high-risk pools, reinsurance programs and reduce the cost of coverage. We will make it illegal for an insurance company to deny coverage to someone with prior coverage on the basis of a pre-existing condition, eliminate annual and lifetime spending caps, and prevent insurers from dropping your coverage just because you get sick. We will incentivize states to develop innovative programs that lower premiums and reduce the number of uninsured Americans.

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