One thing I've noticed while watching the new wave of Obamacare change discussions is that some Republican members of Congress say they want to ban preexisting condition exclusions.
One problem with Obamacare repeal, repair and replacement discussions is that the participants rarely give a clear statement about what they think the word "Obamacare" means.
They sometimes seem to be well-informed people who are using the term to refer to every last character in the Affordable Care Act statutory package: the Patient Protection and Affordable Care Act of 2010 and the health-related provisions of the Health Care and Education Reconciliation Act of 2010.
In other cases, the discussion participants seem to be referring only to the parts of PPACA and HCERA that related to Medicaid or commercial health insurance.
In still other cases, the participants seem to use the word Obamacare to refer only to the Affordable Care Act public exchange program, the mandate that requires many individuals to own coverage or else pay a penalty, and the mandate that requires many employers to offer health coverage or else pay a penalty.
My suspicion is that one reason members of Congress bluster so much about the ACA is that they know too little about it to talk about how it really works, or fails to work. They can't pound on the facts, so they pound on the table.
The talk about a ban on pre-existing exclusions seems to be another example of fuzzy language leading to fuzzy thinking.
Some would-be Obamacare replacers say they want to ban pre-existing condition exclusions, even after the ACA goes away.
But a pre-existing exclusion is simply a health coverage provision that lets a health insurer put off covering a specific health problem for some period of time, or for all time.
Allowing or banning pre-existing exclusions may indirectly affect the cost and availability of coverage, but it has nothing directly to do with whether people with health problems can get health coverage, or whether those people will pay the same rates that everyone else pays.
That raises the question: Are lawmakers talking about banning pre-existing condition exclusions, at least for people who are diligent about paying to keep their health coverage in place, because they personally think banning pre-existing condition exclusions means the same thing as banning medical underwriting?
