29 May 2017 - The Republican health care plan recently passed by the House would hollow out one of the most popular provisions of the Affordable Care Act: a prohibition on charging higher prices to people with pre-existing medical conditions. States, under the plan, could waive that rule, provided they offer publicly funded alternatives for coverage.

The Republican plan raises questions, including about cost: Many experts believe the more than $100 billion earmarked for alternative programs, such as “high-risk pools,” would be inadequate. According to the Congressional Budget Office, many patients with pre-existing conditions would be priced out of the market.

But the Republican proposal also raises a more basic issue: Who will decide what constitutes a pre-existing condition?

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