Americans overwhelmingly support consumer protections that ban health insurers from denying or canceling coverage because of people’s health problems — even if such rules increase premiums. But if a pending court decision finds the Affordable Care Act (ACA) and its guarantee of coverage for preexisting conditions to be unconstitutional — or if the law’s opponents successfully repeal it — the coverage of 54 million Americans with health problems would be at risk. 

This issue is at the forefront of voters’ minds, and figured prominently in the 2018 midterm elections, writes Commonwealth Fund President David Blumenthal, M.D., in a new op-ed for The Hill . Looking ahead to the 2020 elections, Blumenthal says that conservatives are stuck between a rock and a hard place: while they typically favor private-sector solutions to health care problems, the “pre-ex” issue is hard to solve without government regulation.
 
If the ACA is struck down, voters should “demand that candidates address the pre-ex issue forthrightly,” writes Blumenthal, “and should carefully examine promises — whether from the right or the left — that claim to solve the problem.”