PRESS EDITORIAL: A battered survivor defends health care for those who need it most

Battered, bruised, bloodied and missing some limbs, the hulking figure looks like a mugging victim that failed to get competent medical treatment.

This creature is a 906-page monster of a law that as a product of congressional sausage-making (otherwise known as compromise) wasn’t too healthy when it was born in 2010 and since then has been subject to repeated assaults with intent to kill.

It’s the Affordable Care Act.

The ACA barely escaped death last year when a repeal attempt in the U.S. Senate failed by a single vote. It then survived debilitating changes made by the Trump administration that the president predicted would cause it to collapse.

This survivor is wounded and weakened, yet in one important way it is healthy: Most Americans like the ACA and want it to live on.

In a Fox News poll released last week, 54% of those polled approved of the ACA. A survey by the Kaiser Family Foundation, a non-political organization with expertise on health care issues, showed that the law’s growing popularity is based largely on its provision that prevents insurance companies from denying coverage to people with pre-existing health problems. According to the foundation, 27% of Americans have a health condition that could have resulted in them being denied coverage without the protection of ACA.

A senior scholar at the foundation explained that the pre-existing conditions feature “registers in such a profound way with the public, they want that to continue to be the law of the land.”

Well, of course they do. People with health problems need health insurance more than anyone else. Before the ACA, “pre-existing condition” was an easy out for insurance companies to charge exorbitant premiums or deny coverage altogether for those most likely to use it.

This apparently is news to the federal politicians marching in the “Repeal Obamacare” crusade, who cannot bring themselves to propose an alternative that includes the ACA’s iron-clad protection against the pre-existing-condition trap.

Twenty Republican governors are exhibiting even more advanced symptoms of tone deafness. They are suing in federal court explicitly to remove the pre-existing condition protection provision from ACA.

Wisconsin Gov. Scott Walker is one of the 20. No doubt, some of the most uncomfortable moments of his campaign for re-election occur when that subject is raised.

Meanwhile, the ACA is showing signs of improving health besides it growing favorable perception by the public. Enrollments are steady and health insurance premiums for next year in ACA exchanges have risen only about 4%, which is less than the rate of inflation for health care in general.

Health care analysts say the premiums would be even lower if President Trump had not amputated several parts of the body of the law that helped control costs for insurers, including the tax penalty for Americans who choose not to buy health insurance, a feature that encouraged people who were younger and healthier and thus less likely to have expensive claims to buy insurance.

More and more, the drive to repeal Obamacare is looking like an obsolete obsession. Insurance companies, which were given an outsized role in the ACA to pacify critics who wanted the market to influence health care solutions more than the government, have figured out how to adapt to the law’s requirements and are now generally more profitable than before it was passed.

Major private employers have also been influential in reacting to the changes to the health care environment resulting from the law by developing innovative programs that have led to healthier workers and lower insurance costs.

The ACA doesn’t deserve to die. Change it, improve it, fix it, but lock up the protection for people with pre-existing health problems so it can’t be stolen. Or else be prepared to face some very angry health care consumers.